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.
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.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones. The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone. About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone. The stones are treatable and do not justify discontinuation of the diet. Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones. However, this empiric usage has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and 30s, it was largely abandoned in favour of new anticonvulsant drugs. Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs. For this group, and for children in particular, the diet has once again found a role in epilepsy management.
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!
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
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.
But the best part about the Mediterranean diet isn't that it's a concrete plan or dedicated to helping you drop pounds; rather, it's a way of eating that incorporates healthy fats, lots of fresh produce, and whole grains. Translation: You can do it for your entire life and never feel like you're actually dieting. (In fact, studies show you can lose weight on the Mediterranean diet without cutting any calories.)
The struggle as a prescriber is that you have to follow the “standard of care,” lest you open yourself up to a lawsuit. So I talk to my patents about what “the” recommendations are, and then I talk to them bout what the evidence says and what my experience says. Plain and simple, patient’s trust the government’s recommendations and can’t wrap their head around the idea of not eating carbs because they have learned their entire lives that the body “needs” carbs to survive.
“So many of us sacrifice this for work, family, or social experiences, but sleep is a basic tenet of health; you will not function properly, cognitively or physically, without adequate sleep,” Moreno explains. "Adequate usually means at least 8 hours. Set strict sleep time rules and practice good sleep hygiene. When you prioritize sleep, other aspects of good health may line up more easily.”
In nature, historically, there were very few ways to store carbs – which were available only for a short time seasonally. The solution to this is that when eating the available fruit in the autumn the sugars switch off the fat burning system and then use insulin to store the sugars as body fat. Carbs signal our body to go into fat storage mode. When the carbs run out then slowly the fat burning more resumes – first of all feeding ketones to the brain and other vital organs and then eventually to the muscles.
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.
Fat isn’t unlimited either. As with wine, it's possible to get too much of a good thing when it comes to healthy fats. The American Heart Association points out that while the Mediterranean diet meets heart-healthy diet limits for saturated fat, your total fat consumption could be greater than the daily recommended amount if you aren't careful. That’s 65 g per day. (32)
The ketogenic diet — or the “keto” diet for short — has been around for decades. Most popularly, doctors have assigned the keto diet to help control seizures in people with epilepsy, according to the Epilepsy Foundation. But in recent years, people have begun turning to the diet in hopes of losing weight and, in some cases, better managing type 2 diabetes. Studies show that metabolic processes are altered when people consume a diet high in fat, such as meat, and low in carbohydrates, such as bread and pasta. The body shifts into a natural metabolic state called ketosis, during which it burns fat rather than carbs for energy, according to a February 2014 review published in the International Journal of Environmental Research and Public Health. Although carb intake varies depending on which version of keto is at hand, people following the plan typically limit the intake of carbohydrates to less than 5 percent of their daily calories, notes the Chicago Academy of Nutrition and Dietetics.
Finding keto-friendly foods can be difficult at social gatherings — so consider bringing your own snacks. “If I know the restaurant where I’m meeting my family or friends, I usually look through the menu in advance and see if there’s something I can eat,” says Lele. “Salads are generally safe, with ranch or another low-carb dressing and a non-marinated protein. There are a lot of hidden carbs in restaurant food!”
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
The crazy thing is it is not hard, if it matters. Sure I can see it being hard for someone who does it to lose weight, then when they get closer to their ideal, they want to have treats, etc. Well, for a type one diabetic there’s no end in sight, this is it, and it’s a relatively complication free life (many people reverse their complications when they bring their A1C down to normal) vs. one with inevitable complications. So, perhaps it was too hard for you after a year (you didn’t say, but I assume you are not a type one diabetic), but that is a choice you can make. Not I.
The Mediterranean Diet is a great way for people who are used to doughnuts in the morning to start feeling the difference that eating real food makes. After a while though, you may hit a plateau with weight or maybe you know you’re capable of having more energy or a clearer mind. That’s where these extra little tweaks come in. With a few minor changes, you can adjust the Mediterranean Diet to help you perform at max power.
2. A strong, healthy heart. Eating Mediterranean decreases practically every heart-disease risk factor -- high blood pressure, cholesterol, and triglyceride levels. When 605 patients who'd had a first heart attack followed the diet for four years, they had a 50 to 70 percent lower risk of having a second heart attack, angina, or a stroke or pulmonary embolism. "There's no single aspect of the diet that keeps your heart healthy," says Dr. Stampfer; it's the synergy of all the diet's elements. Antioxidants in fruits, vegetables, and beans help prevent the atherosclerosis that can make plaque build up in arteries. Omega-3 fatty acids in fish lower blood pressure, arrhythmia risk, and triglyceride levels. Olive oil lessens LDL ("bad") cholesterol. And wine and other spirits in moderation may lower heart-disease risk.
A survey of 1,580 low-carb consumers published in late 2017 by the Journal of Insulin Resistance45 found that while more than 11% of respondents reported using sleep-aids before beginning their low-carb diet, less than 5% reported using them after their diet. Moreover, nearly seven in 10 reported improved quality of sleep after dieting while only 3.4% said their sleep quality had worsened.
I am one of those strange people that enjoys reading about nutrition. I chose this book merely for this "diet" being listed as number one for the past few years. While I completely agree with the majority of the principals there are a few things I found disturbing. No coconut oil? However, margarine, Sugar free jello, low fat dairy products, diet drinks, and artificial sweeteners are promoted in this plan. Seriously? I am by no means a Purist but to put sugar free jello on a daily meal plan?
Lele Jaro has been on a ketogenic diet for over two years to help with her type 2 diabetes, and has successfully got off insulin. She’s been documenting her health journey on Instagram with keto-friendly food ideas, keto tips, and workout motivation. She’s lost over 80 pounds on her journey, and inspires others to try keto to improve their health. Connect with her on her YouTube channel or Facebook.
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Also recognizing what worked 6 months to 1 year ago may not work today. Our bodies change over time and we have to adapt to those changes. So many factors affect your blood glucose levels; you will face hormonal changes, stress related changes, and your pancreas may not be working as well today as it did a year ago and we wouldn’t expect it to. Just as the heart of an 18 year old person is much stronger than it will be at the age of 50 years of age, your pancreas’ function will decline with age with the normal aging process. Many of my patients throughout the years have came to me feeling so defeated because now they have to go on medication or insulin. They are so relieved to hear this may not be due to anything they have caused by overeating or weight gain, it may be just the unfortunate natural progression of diabetes. Until we discover cures for the different types of diabetes, this is what we face.
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.