One of the most important ingredients is abundant physical activity. The base of the Mediterranean diet is an abundance of fresh fruits, vegetables, olive oil, beans, nuts, legumes, and whole grains. Next, add in fish and seafood at least twice a week, followed by some poultry, eggs, and dairy, especially fermented dairy like yogurt and cheese. The very top of the pyramid is reserved for a small amount of red meat and sugary treats (in small portions and for special occasions).
Type 2 diabetes is one of the most pressing challenges of our time and its ultimate cause has not been fully understood. Ketogenic diets, which are low in carbohydrate and high in fat, are known to lead to weight loss and have been considered to be healthy. These findings raise new questions about ketogenic diets and whether or not they are actually healthy.
A total of 316 individuals from the TypeOneGrit community were included in the study since they met the three eligibility criteria: having type 1 diabetes, taking insulin, and following the Bernstein low carb diet for at least three months.2 The clinical data were gathered using an online survey and confirmed with data obtained from medical charts and feedback from the patients' doctors; parents provided data for the participating child. The participants came from the United States, Canada, Australia, and Europe, of which 57i% were female, 42% were children (under 18 years), and 88% were Caucasian. 2
Case in point, Steve Richert has Type 1 Diabetes and his September 1, 2015 blog The Ketogenic Diet and Type 1 Diabetes: What I Eat. He gave it the good old college try and has fearlessly came back and showed us all his results. His cholesterol increased, which just like mine, was due genetic factors, but was exacerbated by the Ketogenic Diet. So, what’s the best part of Steve’s story? He’s coming close to being right in line with what I would recommend for him! Moderation and the mediterranean diet; he’s currently trying a modified ketogenic diet or really a modified mediterranean diet. Brilliant and exactly what we all should be doing!
As for the substance, it’s been getting results since Atkins was a twinkle in Jennifer Aniston’s eye. But the re-brand includes WellnessWins - rewards for small, positive behaviours which are proven to lead to healthier habits - as well as FitPoints – a system designed to encourage activity choices based on what will have the healthiest impact on you.
I have T2D and IBS and my blood sugar readings were degrading. I was going to have to take a second daily dose of Metformin and the first one already played havoc with the IBS. I started a low-carb diet because my T1D husband had been inspired by a podcast by Sam Harris with scientist Gary Taubes, author Why We Get Fat, Good Calories, Bad Calories and the Case Against Sugar, and started dumping the majority of his carbs a month previous. He had cut his insulin use literally in half and lost 15 pounds. He was feeling better and visibly had more energy. I was resistant to the diet and even the idea of it. I have been on Atkins and Sugar Busters and while I did fine on Sugar Busters back in the day, Atkins was too fat-based and that was the opposite of how I had been raised to think about dieting. I knew that the Diabetic diet given to me by the Diabetic Educator had never been enough and I get carby binge cravings even though it offers plenty of carbs and calories. I also knew that it’s a cycle for me-eat more carbs, want more carbs, and never really feel satisfied. On top of that, when my stomach hurts I seek carbs, and it hurts quite often. I did Weight Watchers and the Diabetic diets because they let me “cheat” and have my carbs while dieting. To be fair, just the act of tracking my food improved my outcome on either. But I got mad at WW when they upped the points for carbs on their system and made it so I couldn’t eat cake for lunch if I wanted to. Not that I made a practice of it, but it was principle of the thing. Long story short, I was pretty doubtful that I would be very successful on Atkins or Keto. To humor my husband I began a low-carb diet that started out as Atkins 20 or Keto and has morphed to more of an Atkins 30-40 for my personal comfort while using Keto, Atkins, and Paleo recipes and ultimately cutting all gluten. That means 30-40 net carbs per day, rather than per meal and a lot of natural non-processed foods. The first week was quite terrible. But even through the Keto Flu I recognized that my IBS symptoms felt better. I started to suspect that if I felt that bad just from quitting carbs that maybe there was more to the idea of sugar addiction than I wanted to believe. I’m six weeks in now and I’m losing a steady pound a week plus my sugars have dropped radically. A pound a week might not sound like much but it’s more than I’ve lost in 10 years. I have PCOS and insulin resistance so I’ve had a fasting blood sugar that ranged from 109-113 since my early twenties. It was flying high around 160-170 before the diet, now I’m reading between 119-139. Even more than that, my IBS symptoms stabilized. I’ve been tracking all my food using the free Atkins meal tracker so I started trying to narrow the foods that caused flare ups. I’m lactose intolerant but I knew that and used lactose free products or Lactaid for the cream based dishes. I had my gall bladder removed and so have always put down my symptoms to an inability to process dairy and fats. Big surprise to find that a higher fat, higher dairy diet was making my symptoms disappear. Gluten is the only common factor so far. Celiac? Just a food sensitivity? I don’t know, but that will be the next investigation. It is an investigation that I would never have thought to start on the Diabetic diet. Like the author, I’m very fond of cake and carbs. Luckily there are low-carb, no-gluten recipes for muffins and cakes. They aren’t exactly the same and some are definitely better than others, but they are out there. Plus, there is nothing wrong with having true birthday cake once a year if that is really what you need and if you don’t have a reason to avoid it, like binge symptoms or IBS flare ups. My husband let himself have a piece of cheesecake the other day and felt physically awful for two day after, plus he had to use a lot of insulin to counter the spike. It’s a pretty good deterrent. Just a side note but I had other symptoms of inflammation as well. My ankles were swelling to golf ball size and painful, it was difficult for me to stand and walk comfortably when this happened. While they haven’t stopped completely, the discomfort has gone way down as has the swelling and frequency. What’s my point? I’m not a salesman for a particular diet. Everyone is different and some people might respond very well to Keto and/or Atkins while others may not need anything that extreme. I’m not knocking the Diabetic diet. My dad lost 150 pounds 38 years ago on a very low calorie/low carb Diabetic diet that gradually increased and he has kept the weight off all this time and kept his blood sugar steady with medication, but has not had to go to insulin even at age 84. Also, he was a smoker, a diabetic, had hemochromatosis and was over 300 pounds with an apple body shape. He has had some fall out from this-he didn’t stop the smoking until a heart attack 20 years ago and that didn’t help. But he has made it to 84 and when he walked into his doctor’s office 40 years ago I’m guessing the doctor wouldn’t have put any money on that survival rate. Unfortunately, it looks like I need the lower carb version and will continue to need it to manage my symptoms. I didn’t want it, that’s for sure. But Diabetics are locked in a death struggle with Diabetes and it won’t give up just because we are tired or want our sugar. So for me, it has to be Very Low Carb for Life. Others may find they need this too and discouraging them from trying it is not doing them any favors. Hopefully I will continue to find this sustainable. I just need to keep reminding myself that I am more fond of my feet and my vision than my birthday cake.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.
Interested in following a more historical approach to eating? The Primal Blueprint is similar to the Paleo diet, which has roots in how our long-ago ancestors supposedly ate. This plan ditches grain, sugars, and processed foods while focusing on clean eating with plenty of protein (both animal- and plant-based), lots of vegetables, fruits, and healthy fats. The Primal Blueprint acknowledges other health factors too, advocating for lots of low-intensity activity, some high-intensity exercise, strength training, and plenty of sleep.
My principal hope in this article is to provide journalists with a resource to do what basic journalism demands, namely to ensure that stories are scientifically balanced and accurate. At the end of this post I provide contacts for some of the credentialed experts who helped me compile this research. Reporters, please seek out these or other low-carb diet experts so you can provide accurate, up-to-date information for your readers.
2- Eat more vegetables, fruits, grains, and legumes. The base of the Mediterranean diet pyramid should make up the base of every meal. When you can, opt for vegetarian entrees like this Cauliflower and Chickpea Stew; Spicy Spinach and Lentil Soup; or Spanakopita (Greek Spinach Pie). Rely more on satisfying, flavor-packed salads to make up a good portion of your plate. Some ideas: Kindey Bean Salad; Mediterranean Chickpea Salad; Greek Salad; Bean and Lentil Salad.
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. 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.
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted. It involves a consultation with the patient and their caregivers and, later, a short hospital admission. Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.
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.
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)
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.
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.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.