Ben Tzeel is a Registered Dietitian and Certified Strength and Conditioning Specialist (CSCS), holding a Masters in Nutrition from the University of North Carolina at Chapel Hill. Ben has lived with Type 1 Diabetes since 1999 and has never allowed it to hold him back from achieving his goals. He is a published fitness model and author who writes about exercise, nutrition, and diabetes.
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!
Another study, published in the New England Journal of Medicine in 2008, assigned 322 moderately obese adults to one of three diets: calorie-restricted low-fat; calorie-restricted Mediterranean; and non-calorie-restricted low-carb. After two years, the Mediterranean group had lost an average of 9 7/10 pounds; the low-fat group, 6 4/10 pounds; and the low-carb group, 10 3/10 pounds. Although weight loss didn't differ greatly between the low-carb and Mediterranean groups, both lost appreciably more than the low-fat group did.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
The subjects had a mean BMI of 42.2, mean age of 56 years, and were of either African-American or Caucasian descent. In their intervention, subjects consumed a LCKD diet with the goal of eating less than 20 grams of carbohydrates per day while reducing dosages of diabetes medication. Subjects also received nutritional counseling and medication adjustment every two weeks.
Researchers at Florida State University studied watermelon for its ability to regulate blood pressure due to it being “one of the richest natural sources of L-citrulline”, an amino acid that the body converts into L-arginine, which improves circulation. They discovered that watermelon, due to its high L-citrulline, may prevent pre-hypertension from becoming full blown hypertension.
From intermittent fasting to the keto diet to teatoxes, there's a plethora of diet advice out there. Maybe the keto diet worked wonders for your co-worker, but it’s just not conducive to your nutritional needs. Or not eating after 7 p.m. helped your sister lose 20 pounds, but you like doing evening workouts. The truth is losing weight is hard—and it takes patience—so if it's too good to be true, then it probably is. “Adopting healthy habits is not easy, but most things in life that are worthwhile take work,” explains Bonnie Taub-Dix, RDN and author of Read it Before You Eat It - Taking You from Label to Table. But losing weight doesn't need to be complicated. Following these simple nutritionist-backed tips will help point you in the right direction and reach your goals.
The DASH Diet, which stands for dietary approaches to stop hypertension, is promoted by the National Heart, Lung, and Blood Institute to do exactly that: stop (or prevent) hypertension, aka high blood pressure. It emphasizes the foods you've always been told to eat (fruits, veggies, whole grains, lean protein and low-fat dairy), which are high in blood pressure-deflating nutrients like potassium, calcium, protein and fiber. DASH also discourages foods that are high in saturated fat, such as fatty meats, full-fat dairy foods and tropical oils, as well as sugar-sweetened beverages and sweets. Following DASH also means capping sodium at 2,300 milligrams a day, which followers will eventually lower to about 1,500 milligrams. DASH Diet is balanced and can be followed long term, which is a key reason nutrition experts rank it as U.S. News’ Best Overall Diet, tied with the Mediterranean Diet.
Recent studies have also shown that garlic supports blood-sugar metabolism, and helps control lipid levels in the blood. What’s more? Eating garlic can help boost your immune system, help ward off heart disease, fight inflammation, increase memory retention, and lower blood pressure, so consider adding some to your next meal. At the very least, it is preferable over salt, which can lead to water weight gain and bloating.
It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
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.

You say keto is a highly controversial topic. For those of us following a keto diet, there is no controversy whatsoever because the diet proves itself efficacious very quickly. I think the real controversy comes in because the ADA has been recommending dangerous levels of carbs for decades now, and they would lose face if they had to change their recommendation and admit they’ve been wrong for so long. You say there are not many studies on the keto diet, and I disagree with you. You’ll find the evidence if you look for it. Eric Westman, Steve Phinney, Jeff Volek and many other researchers have written volumes about this.


Fish and seafood come next, eaten about twice a week. Poultry, eggs and dairy in the form of cheese and yogurt are eaten in moderate portions on a daily or weekly basis. For example, one review of research on Mediterranean eating suggests about four eggs a week. At the very top of the pyramid -- meaning you eat them only sparingly -- are red meat and sweets. Preferred beverages include water, as well as red wine, in moderation.
Rich in low-starch vegetables, fruit, healthy fats (mostly from olives and olive oil), nuts, seeds, whole grains, legumes, and fish, the Mediterranean diet eschews simple sugars and refined starches and is low in red meat. Interested in embarking on the diet for yourself? Read through to see a Mediterranean diet shopping list, what it's like to be on the diet, and why it's so easy to follow.
Fairly recently, the diet was introduced as a weight-loss diet by an Italian professor of surgery, Dr. Gianfranco Cappello of Sapienza University in Rome. In his 2012 study, about 19,000 dieters received a high-fat liquid diet via a feeding tube inserted down the nose. The study showed an average weight loss of more than 20 pounds in participants, most of whom kept it off for at least a year. The researchers reported a few minor side effects, like fatigue.
Calcium and vitamin C team up well to boost metabolism, and broccoli is just one of several healthy foods that contain both nutrients. What sets broccoli apart from the others, however, is that the green veggie also contains kind of fiber that’s been shown to increase the digestion, absorption and storage of food, also known as the thermic effect of food or TEF. A revved up metabolism combined with an increased TEF is a match made in weight loss heaven!

Elena Paravantes, RDN is a Registered Dietitian Nutritionist, Writer and consultant specializing in the Greek Mediterranean Diet and Cuisine. She has been active as a clinician, consultant and lecturer for 20 years, both in the U.S. and Greece. An expert on the Greek Mediterranean Diet, her interviews and articles have been published in many publications including CNN, U.S. News and World Report, Prevention, NPR, and Shape. Elena has collaborated with a number of organizations including Loyola University, Yale University, University of Missouri, Louisiana State University, and the American College of Greece.
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.)
“There are many diet plans on the market today that promote good health,” says Emily Kyle, RDN, who is in private practice in Rochester, New York. “The key is finding one that does not cause you stress or agony.” Ask yourself questions such as: Would the diet guidelines make you happy? Anxious? Stressed? Are you able to follow them long term? “Factors such as enjoyment, flexibility, and longevity should be strongly considered,” adds Kyle.

Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.
While 1,200 may be the right number for some, it can be super restrictive for others, says Jaclyn London, MS, RD, CDN, Nutrition Director at the Good Housekeeping Institute. Try basing your meals and snacks off this plan and double up on veggies at any opportunity — more fruit at snack time works too! You can also add an extra ounce or two of protein at all meals if you find yourself feeling hungry. The combo of fiber from produce and lean protein makes this an adaptable strategy that’ll help you lose weight safely — one meal (and snack) at a time!

Using the Bulletproof Diet, including Brain Octane Oil every day for long periods of time, and eating carbohydrates some of the time but not always, avoiding inflammatory foods, and using Bulletproof Intermittent Fasting, I was able to recently test with perfect insulin sensitivity — I scored a one on a scale of 1 to 120 (see my numbers below). I also had above average glucose tolerance. That’s metabolic flexibility by the numbers!

As for individuals with type 2 diabetes, Dr. Galati says, "a very low carbohydrate diet could be tolerated, albeit with extreme caution. Transitioning to a ketogenic diet will require several lifestyle changes as well as careful monitoring of both your food intake and glucose levels and adjustments to your medications. Also, you should increase your water consumption." 
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
I started on a strict keto diet one year ago, and it has been the easiest diet I have ever been on. I was prediabetic before the diet, and now am not. My triglycerides are lower ( in normal range) and my good cholesterol is high. I am at lower than normal risk for heart disease because of my cholesterol ratios. I was not overweight to start with, am not now….and have not changed my weight at all. So the good effects are due solely to the diet change and not weight loss, which the author implies throughout the article that it is the weight loss that causes the good effects….not so. I am a veterinarian and believe in good medicine. This diet makes sense biochemically for those with diabetes or prediabetes.
I would just like to share with you that my patients are HORRIFIED if their physicians ask them to cut out “everything white” in their diet. This is what some doctors ask for…essentially asking for the Ketogenic diet and most of my patients are in shock! Not only would I never want to skip a year of my birthday cake, but I wouldn’t ask my patients to either! One slice of cake is certainly not going to harm anyone with diabetes and hopefully you know enough about carbohydrates and their short term effect on BG levels to know this too! I am not a Registered Dietitian, so I couldn’t speak to this diet in regard to children with epilepsy. Are you a Neuro RN? TheDiabetesCouncil did just post another article where 25 Registered Dieticians weighed in regarding the Ketogenic Diet, so I would encourage you all to check that out!
But again, when it comes to salt, there's a blood pressure-weight link that can't go ignored. A diet rich in sodium may lead to the development of obesity, according to one study, and salty foods are more likely to promote overeating, which obviously also leads to weight gain, per another study. And by now, it's more than evident that excess fat and sugar intake can contribute to caloric surpluses, blood sugar and insulin spikes, inflammation, and, yes, more weight gain, she says.
I don't think this is the same as the DASH diet that was developed by the National Heart Lung and Blood Institute. That diet is more common sense than this Atkins rip off. The DASH diet was developed to prevent high blood pressure. It consists of eating more fruits, veggies, and whole grains and avoiding excess salt. This book is not that diet. I hate diets that eliminate foods even if only for two weeks.
Lele says that it’s important to remember that, while keto is a “high fat” diet, the goal is to use your body fat as an energy source, not the fat that’s on your plate. “You don’t need to necessarily add more fats to your diet to adhere to keto. For instance, if your dinner consists of avocado, bacon, and eggs, you really don’t need to add butter to that to make it ‘more keto’,” she says.

We are all supposed to be eating 5 servings of fresh fruit and vegetables per day. That provides you with all the essential vitamins and nutrients needed to run a healthy body along with the protein you choose to consume alone with them. I guess if you can fit those into a Ketogenic diet and make that work for you for a lifetime, I would have to say that is absolutely wonderful! I just know, I have a lot of willpower and I only made it 1 year back when I tried. It was just too restrictive. I see too many stories like that. The blogger I wrote about, all the studies, most participants had dropped out at 6 months. No study I have seen has shown anyone who has stayed on it for 10 years, 15, 20, 30, 40 years. If you know one, please let me know!
HCG, or Human Chorionic Gonadotropin, is a hormone produced during pregnancy by the placenta after implantation, and doctors sometimes prescribe it for fertility issues. But this hormone has also gained popularity as a weight-loss supplement — and using it as such can be dangerous. In fact, the U.S. Food and Drug Administration (FDA) warns against purchasing over-the-counter hCG, as these supplement products are illegal. (34)
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.
However, the meta-analysis was riddled with confounding variables — one of which being their lackadaisical definition of a low-carb diet. The researchers identified a low-carb diet as a diet where less than 45% of its calories come from carbs. With such a lax criterion for low-carb, it is difficult to tell if a true low-carb diet (i.e., fewer than 26% of calories coming from carbs) is genuinely the best dietary option for type 2 diabetics.
More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
A ketogenic diet is high in fat and low in carbohydrates. It’s called “ketogenic” because people on this diet shift from using glucose (a type of sugar) as their main fuel source to ketone bodies, which are derived from fat. In other words, people on the ketogenic diet can use their bodies’ fat stores as fuel—and this is why many studies show that this diet is superior for sustainable weight loss.
Fish and seafood come next, eaten about twice a week. Poultry, eggs and dairy in the form of cheese and yogurt are eaten in moderate portions on a daily or weekly basis. For example, one review of research on Mediterranean eating suggests about four eggs a week. At the very top of the pyramid -- meaning you eat them only sparingly -- are red meat and sweets. Preferred beverages include water, as well as red wine, in moderation.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.

It is completely wrong to discuss “average lifespan”. The average lifespans of pre-industrial peoples is heavily reduced by infant and early childhood mortality, which has nothing to do with lack of fresh fruit. Once you remove this bias in the numbers, pre-industrials can have lifespans almost as long as ours. And usually without many of the degenerative diseases that bother our middle and old ages.
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.
We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low-carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again.

I hate reading, but this book is laid out so you can use it in whatever way you want. It has recipes in one section, or example meal plans in another. I skipped a lot of the actual reading, and used it for all the resources it contained, This helped save me time, so I could get down to business. After the first week I was down 8 lbs. I look forward to continuing my journey. Btw the index is your friend.
Sodium reduction is part of the DASH equation, but it’s not the only focus. Eating by DASH  recommendations also increases your intake of potassium, calcium, magnesium and fiber—all nutrients that play a role in cardiovascular health, as well as the prevention of other chronic diseases. It’s thought to be the combination of increasing your intake of these nutrients and decreasing your intake of added sugar, salt, sodium and unhealthy fats that leads to lower blood pressure and a laundry list of other long-term health benefits.
At the end of this 12 week study, scientists observed similar loss in body fat and overall body weight in all three diets. However, they noted that the VLCARB ketogenic diet was “more effective in improving tracylglycerols, HDL cholesterol, fasting and post-meal glucose and insulin concentrations. More specifically, triacylglycerols decreased by 39.9% in VLCARB subjects, 4.0% in VLF subjects, and 9.6% in HUF subjects. [11]
I’m sorry…no we don’t. Sure, more studies will happen, and more information is always good. But, we KNOW that keto works. You can argue that all you want…but in truth, facts don’t care about your feelings. There are plenty of studies, both in groups and in individuals, that prove beyond any reasonable doubt that going on a proper keto diet WILL improve your life as a diabetic, and will often allow the person to reverse diabetes completely (type 2, obviously). Not to mention the weight loss and the myriad of other health benefits it provides.
And what benefit you will have with “moderate” diets that let you eat bread and others carbohydrates but high insulin ? remember that it is critical to not only look after glucose levels on blood, it is very very important to reduce your intake of insulin to avoid a lot of diseases including metabolic syndrome for high insulin and insulin resistance.
The keto diet changes the way your body converts food into energy. Eating a lot of fat and very few carbs puts you in ketosis, a metabolic state where your body burns fat instead of carbs for fuel. When your body is unable to get glucose from carbs, your liver converts fatty acids from your diet into ketones, an alternative source of energy. Burning ketones in place of glucose reduces inflammation and spurs weight loss.[1]
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