The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals [10]; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.

In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.
A 2012 study also showed that people on a low-carb diet burned 300 more calories a day – while resting! According to one of the Harvard professors behind the study this advantage “would equal the number of calories typically burned in an hour of moderate-intensity physical activity”. Imagine that: an entire bonus hour of exercise every day, without actually exercising. A later, even larger and more carefully conducted study confirmed the effect, with different groups of people on low-carb diets burning an average of between 200 and almost 500 extra calories per day.
There isn't "a" Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many of the same principles. Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that offers guidelines on how to fill your plate – and maybe wineglass – the Mediterranean way.

Why was the DASH diet been ranked as the best diet, the healthiest diet, and the best diet for diabetes, 8 years in a row? The expert panel of physicians assembled by US New & World Reports chose DASH because it is proven to improve health, has a balance of healthy food groups, and it actually works. And now the Mediterranean diet has jumped out in front. So delicious and heart healthy. DASH has been proven to lower blood pressure and cholesterol, and is associated with lower risk of several types of cancer, heart disease, stroke, heart failure, kidney stones, reduced risk of developing diabetes, can slow the progression of kidney disease, and now is associated with reduced risk of depression.
Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes.[9][10]  Learn more here about how carb cycling works.
You can eat what you love. It’s evident that with such a variety of whole, fresh foods available to you as options, it’s easy to build meals based on the diet. And, you don’t have to eliminate your favorites, either. They may just require some tweaks. For instance, rather than a sausage and pepperoni pizza, you’d choose one piled high with veggies and topped with some cheese. You can also fit in a lot of food into one meal. Filling up on fresh foods like fruits and vegetables will allow you to build volume into meals for fewer calories.
Obviously, it’s still possible to lose weight on any diet – just eat fewer calories than you burn, right? The problem with this simplistic advice is that it ignores the elephant in the room: Hunger. Most people don’t like to “just eat less”, i.e. being hungry forever. That’s dieting for masochists. Sooner or later, a normal person will give up and eat, hence the prevalence of “yo-yo dieting”.
This is a helpful article. But there are some inaccurate things too. I have type two diabetes and use a keto genie diet to lose weight (45# so far). I was able to get my cholesterol down, Triggs down, and my A1C to 6! I went off and followed a Mediterranean diet for a year. I gained back 15# and my diabetes got worse. So I am back on keto. I am using a closer to Mediterranean keto both then and now.
Need more tips to follow the DASH diet? You'll find a free guide that is full of meal plans, DASH diet food lists and recipes at the National Institutes of Health website. You'll also find a 7-day DASH Diet Eating Plan that guides you through a full week's worth of meals. If you want more help, there are other DASH diet guides online and DASH diet books that are available for purchase. 
DASH stands for Dietary Approaches to Stop Hypertension. It’s a lifelong approach to eating that’s designed to prevent and treat high blood pressure, also called hypertension. It also falls in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.  DASH encourages a variety of nutrient-rich foods while reducing the amount of sodium eaten. This eating plan includes plenty of fruits, vegetables, whole grains, low-fat dairy products, fish, poultry, legumes, nuts, and seeds.  Red meat and sweets are eaten in small amounts.
Participants completed take-home food records (4 consecutive days, including a weekend) collected at baseline and at weeks 2, 8, and 16 during the study. Participants were given handouts with examples of how to complete the records. A registered dietician analyzed the food records using a nutrition software program (Food Processor SQL, ESHA Research, Inc., Salem, OR).
I picked up this book because I had heard in several places that the DASH diet was currently the diet most recommended by doctors. So far the books have been disappointing. This book basically lays out a low carb diet, low fat diet that I'm not sure is mainstream DASH or just the program used by this particular author. I can see where the diet would result in weight loss for someone eating the Standard American Diet (SAD) but I can't think that sugar-free jello and flavored yogurt and low-fat pr ...more
Really, it shouldn’t be so difficult to figure out which eating regimen will set fire to fat while maintaining muscle. Fortunately, the International Society of Sports Nutrition just released its position paper, which combs through all existing scientific studies to report how every diet will affect your body composition. Here, we’ve pulled five of the most six-pack-friendly diets and streamlined how they’re great, as well as why they might be right (or wrong) for you—according to the hard science.
The keto diet is intriguing because it appears to run counter to the prevailing wisdom about the importance of lowering fat intake to prevent diabetes and heart disease, says a co-author of the new study, Gerald Grandl, PhD, a postdoctoral researcher at the Institute for Diabetes and Obesity at the Helmholtz Center in Munich. ETH Zurich conducted the study with University Children's Hospital Zurich.

The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.

Many equate healthy eating, particularly lower-sodium eating such as DASH, with the idea that all meals have to be cooked from scratch. This is overwhelming for many (myself included), but there are plenty of tricks and tips to help you. First, understand that “whole foods” doesn’t exclusively mean fresh produce. Take advantage of time-saving, minimally processed foods like unseasoned frozen vegetables and no-salt-added canned veggies.
Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)
I, too, am finding the keto diet to be beneficial. My weight is moving down. My recent A1c was 5.7. I am consistently below 90 each morning when I check my blood. I am learning to adapt my cooking to the needs of maintaining this way of eating. I have incorporated walking because now I FEEL like it. I don’t feel deprived. I feel empowered. No medications for diabetes!
If you want to lose weight you should start by avoiding sugar and starch (like bread, pasta and potatoes). This is an old idea: For 150 years or more there have been a huge number of weight-loss diets based on eating fewer carbs. What’s new is that dozens of modern scientific studies have proven that, yes, low carb is the most effective way to lose weight.
He has been on keto diet for at least 3 years now. I think that he is some proof that yes, it does work. And it may be that some people do need keto. However, I don’t believe that everyone needs keto diet to get reversal. I have had reversal with regular ADA diet in my clinic. Not just a few! Many have reversed. However, I just want for keto dieters to find a clinical trial. We do need more information. We must understand what happens in the long term on keto diet. I personally did Atkins years ago, which was 20 grams. I had a very hard time to stay on it. I lost 20 pounds, and then I did gain it back. I just could not live without some more carbohydrates than this allowed. I don’t know about being on 60 to 70 carbs, and staying in ketosis. It seemed I was out of it at 22 carbs. Anyway, this was not for me. Maybe it is for you. No one is saying that one should never go on a keto diet, but we are wary of it. We need more science behind it. Therefore, I am just going to put this out here now. I will paste it down the page so that others may see it. They are taking participants. If you fit the criteria, please help us to get more than people’s opinion about this diet. Then we can be more positive about it, and recommend it if the science is there. Here is the link to the clinical trial. Thanks for your comments:
In her book, Susan highlights one of the major problems with dinner time today: quality time. Does everyone else remember when dinner time was family time? When we would all sit down together, share our day, talk, laugh, and leave when the meal was done? Susan and I shared our childhood dinning experiences when we discussed her call for embracing the the Mediterranean lifestyle — incorporating exercise, relaxation, and family meals back into our daily routines. This book is looking for someone who is looking to make a lifestyle choice. The way that you eat, sitting down with your families at the dinner table. No more meals on the go, no more meals with the TV. I wanted to bring back the importance of food in our households,” noted Susan.
I would love to join a study! Could you recommend where to go to find one? I have done 30 or less total carbs a day for almost 2 years and feel great. I have NEVER EVEN ONCE gone over 40 total so I do follow it and I do not cheat on high carb foods, although I do occasionally over-eat on low carb foods resulting in a bit over 30 maybe 1 -2 times a month. I do feel that time will provide more support and think that the medical community should educate on this as another alternative. It isn’t for everyone because it is a bit more problematic if a person does fall of the straight and narrow too often but it can be done!
That’s because the DASH Diet has been proven to work, says Reshmi Srinath, M.D., an assistant professor at the Icahn School of Medicine at Mount Sinai. One study found that people who followed the DASH Diet had lower blood pressure and LDL (bad) cholesterol levels than those who consumed a typical American diet or an American diet infused with extra fruits and veggies.
DASH stands for "dietary approach to stop hypertension" and was created by the National Institutes of Health (NIH) as a way to help reverse national trends of obesity and heart disease. Scientists combed through decades of research to come up with an expert-backed list of diet tips, along with a prescription for exercise. And it worked: The DASH diet has topped nearly every diet list for nearly a decade. Doctors particularly recommend it for people looking to lower high blood pressure, reverse diabetes, and lower their risk of heart disease. (Here's the basic list of DASH diet-approved foods.)
There is research that supports the ketogenic diet for diabetes management, while other research seems to recommend opposing dietary treatments like a plant-based diet. Research from 2017 confirms that people with diabetes who followed a plant-based diet experienced significant improvements in blood sugars and A1c, cardiovascular disease risk factors, gut bacteria that is responsible for insulin sensitivity, and inflammatory markers like c-reactive protein.
On keto, I’ve adjusted my basal rates and I barely need to bolus at all. My blood glucose numbers have definitely improved and what I find really extraordinary is that I’m needing about 60% less total daily insulin, than I did before starting keto. What’s even more fascinating to me is seeing a steady straight line across my pump for 6, 12, and even 24 hours – no crazy spikes or dips in my blood sugar.
Pros: The most consistently beneficial of all diets here, study after study shows that upping your protein intake can help significantly reduce body fat and build lean muscle. For example: Guys who ran sprint intervals, did resistance training, and ate a diet of 2.4g of protein per kg of bodyweight per day (roughly 1g per lb of bodyweight) gained 1.2kg of lean muscle and lost almost 5kg of fat in just four weeks, according to a study in the American Journal of Clinical Nutrition. If you cut calories but eat high protein, the macro can help prevent your metabolism from plummeting and help keep hunger at bay, since protein is so satiating. The study analysis also confirmed that eating a ton of protein stuff doesn’t cause you to gain weight or harm any internal systems, despite myths.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.
I do have a couple of questions. I’m not vegan, but is there room for tempeh (as an alternative)? I love yogurt but I also love cottage cheese – would that be allowed and what about green tea or organic matcha? Oh, one more question, after doing weight watchers, I became obsessed with weighing my food and watching my portion sizes. When I was an unhealthy eater that was my downfall. I’ve mainly been trying to eat clean for the last year, but I still weigh/measure my food. What is the rule for portion sizes in the mediterranean lifestyle? Sorry for all the questions, but thank you for your time!! I look forward to trying all your recipes.
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.

Anna Taylor, RD, CDE, a licensed dietitian at the Cleveland Clinic in Ohio, says very-low-carb diets can hurt people with type 2 diabetes if done incorrectly. She and Keratsky say it’s important that anyone with diabetes who wants to try a low-carb or ultra-low-carb diet meet with a dietitian or physician to create a plan and make sure their eating style won’t react negatively with their current medicines.
“I think the caution with a low-carbohydrate diet is the idea that it’s very restrictive,” Zeratsky says. “When you start getting into the very low carbohydrates, when you’re talking about 20 grams, which for some people would be a cup of [starchy] vegetables. … If there is someone who is interested in it, it’s very important they understand what a low carbohydrate diet means in a practical sense.”

"We recommend against 'dieting', which is invariably a short-term solution," Dr. Gonzalez-Campoy, tells EndocrineWeb, "and since weight loss may be accomplished by a reduction in calories by any means, a ketogenic diet that restricts carbs is simply shifting the calories away from foods that typically demand insulin as in both of these studies.1,2  


There is a lack of scientific research when it comes to the long-term effects of the keto diet. When it comes to healthy eating and weight loss, creating sustainable, lifelong changes will result in the best outcomes. Most importantly, think about how this restrictive eating plan will fit into your lifestyle, and if you are willing to give up what may be some of your favorite foods. It’s important to make time for yourself to prepare meals at home and get regular exercise. Strive for progress, not perfection.
Yes, peanut butter is high in calories, but if you stick the real stuff—a tasty combo of peanuts and maybe a touch of salt—the legumes can work their weight loss magic. In addition to providing you with belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein, peanuts also contain genistein, a compound that helps turn down the genes for obesity and reduces your body’s ability to store fat.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
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