Earlier this month during a taping of HeartTalk presented by Capital Cardiology Associates, Dr. James O’Brien mentioned the Mediterranean diet. He said it was a diet that he strongly recommend for patients with heart disease. Now, being a health and fitness enthusiast and a 40-year old man with a family history of diabetes and heart disease, I am always open to ways to improve my heart health.
I am sorry you had this experience. I feel that this educator was not giving you good advice. All my women who want to lose weight are recommended to consume 30 grams of good carbohydrates at each meal, and 15 at each snack. If you were not trying to lose weight, I would have recommended 45. I find this is all it usually takes to begin to lose some weight as you start to get active. Patients set their own goals with motivational help from their Certified Diabetes Educator. Our intent is never to insult, and you should not have gone through that. It sounds that you have now found the right path. There are many CDEs who could help you, so see what tools and motivation others may offer. I wouldn’t let one bad apple spoil the whole bunch. Many CDEs are also diabetic.
“This is a great way of eating that I highly recommend to many clients, and I even model in my own life,” says Elizabeth Shaw, RDN, who is in private practice in San Diego and is the co-author of Fertility Foods Cookbook. “Since the premise of the diet is designed to help people who have high blood pressure, low-sodium foods are recommended. But considering that most Americans exceed their daily sodium levels anyway, it’s not surprising that dietitians recommend this style of eating for treating many different conditions, such as heart disease and obesity.”
Think of it as intermittent fasting 2.0 – only a bit more complicated. Ready? Here goes. There are three windows: one to get you started, one to help you reach your goal weight and a maintenance plan. You eat within a 12-hour, 14-hour or 16-hour window depending on which phase you’re in. But what you eat counts, too. The ‘green light’ lists of foods changes with every phase. Still there?
Recently, there been some controversy surrounding the Mediterranean diet and its potential benefits. In 2013, a landmark study found that people put on a Mediterranean diet had a 30 percent lower chance of heart attack, stroke or death from cardiovascular disease than people on a low-fat diet. However, in June 2018 it was reported that the initial study was flawed. Though researchers re-evaluated the data and determined the results to be the same, this is something to consider when determining with your doctor whether the Mediterranean diet is best for you.
Upon starting the diet, some patients report symptoms like fatigue, headaches, and muscle aches. However, these short-lived symptoms are, in fact, a sign that the diet is working, and the body is switching over from burning glucose as fuel to burning fat. This transition involves upregulating certain enzymes and down-regulating others; it is a profound shift for the human body that can have uncomfortable symptoms. However, these side effect usually last only 3-4 weeks. They can be ameliorated in most cases, by drinking several cups of bouillion broth during the day until the transition is completed.15
In a bowl, combine 7 1/2 ounces (half a 15-ounce can) canned chickpeas (rinse in a colander for two minutes to remove excess sodium and drain well; save other half for Tuesday's snack), 2 teaspoons olive oil, 1/4 cup chopped white onion, 1/4 cup chopped green pepper (save the rest of the onion and pepper for dinner), 1 tablespoon sliced black olives, 1/4 teaspoon ground black pepper, and 1 1/2 tablespoons white vinegar. Mix thoroughly. Serve mixture over 2 cups romaine lettuce leaves.
What the diet advocate says: ‘We are committed to always being the best weight management program on the planet, but now we’re putting our decades of knowledge and expertise in behavioral science to work for an even greater mission,’ says Mindy Grossman, President and Chief Executive Officer, WW. ‘We are becoming the world’s partner in wellness. No matter what your goal is – to lose weight, eat healthier, move more, develop a positive mind-set, or all of the above – we will deliver science-based solutions that fit into people’s lives.’
The more recent study was conducted online to ascertain if this online approach proved effective in eliciting weight loss.1 Dr. Saslow's team randomly assigned the 12 participants to the Keto diet and lifestyle improvement group and another 13 individuals to the traditional low-fat diet known as the Plate Method,1 supported by the American Diabetes Association. 
At the conclusion of the intervention, both groups had improved in all metrics but “these changes were more significant in subjects who were on the LCKD as compared with those on the LCD.” [10]. As a result, the researchers supported the study outlined above and concluded that their “…study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects.” [10]

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.
This research found the weight loss was slightly greater in the group fasting for two days compared to the other group. It’s worth noting that the participants in these studies were given a huge amount of support, which wouldn’t happen if you were just picking up a book on the 5:2 diet. Overall, there isn’t actually much evidence and we need more data on the long-term success of these diets.’

Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].
“This is a good example of a study where you should not directly apply the information to what you are eating as an individual,” Stefanski says. “The research is interesting, but the study period examined was only three days. While this study showed insulin resistance, it did not in fact show that the mice had diabetes. Making the leap from the results of this study to a headline that concludes a ketogenic diet will cause type 2 diabetes is not supported.”
You may have noticed a bit of an explosion of gluten-free offerings on your grocery store shelves. Some may call it a trend, but over the last 70 years there’s been a steady increase in the number of people who don’t tolerate gluten or other grain proteins.[19] People with a sensitivity, intolerance or full-on Celiac disease experience any combination of brain fog, inflammation, fatigue, joint pain, and gut issues – and they tend to resolve simply by avoiding grains.[20]
It’s only dangerous to not get enough carbs at each meal if one is taking too much meds or insulin for the amount of carbs they are eating! Restricting carbohydrates doesn’t lead to hypoglycemia unawareness, but having lots of lows and lots of highs will (and decreasing insulin and carbs leads to way fewer highs and fewer lows, or at least it can). On the other hand, being in ketosis does make low blood sugars less negative as an experience. I still feel my lows just fine, but they are less of an emergency because my brain still works (feeding on ketones) and by body doesn’t freak out and release tons of adrenaline that then makes me want to eat a house. Mind you, I still wake up and know immediately if I’m low, I know from experience and how it feels in my head and body but without the crazy shakes. This is not unawareness but it is less reactive.

In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.


Obviously, if you could keep the weight off, it may help in preventing diabetes. There are many risk factors for diabetes, but the Diabetes Prevention Program in 2002 followed 1,079 people with prediabetes. This groundbreaking study showed that 58% were able to prevent the progression of developing diabetes through diet and exercise. Want to know what the great news is? They didn’t have to eat 20 carbohydrates per day to achieve this!
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
The ketogenic diet seems straightforward. Unlike a typical low-calorie diet, however, a high-fat diet requires careful monitoring. In fact, you may start the diet in a hospital. Your doctor needs to monitor both blood glucose and ketone levels to make sure that the diet isn’t causing any adverse effects. Once your body adjusts to the diet, you may still need to see your doctor once or twice a month for testing and medication adjustments.
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]

Ketogenic diet (“keto” diet for short) is a catch-all term for any diet that pushes your body into the natural metabolic state of ketosis, which means burning fat for fuel instead of carbohydrates. Though there’s no set formula for keto, generally, the diet works by cutting back on carbohydrates, to about 20 g of net carbs to start, and replacing those with mostly fat and a moderate amount of protein, according to the popular website Keto Connect. Net carbs are the total number of carbs minus the fiber and sugar alcohols, according to the Atkins website. (More on this diet later.)
There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
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