I am a big fan of the ketogenic diet and many of my patients have had huge success on it. Having said that, it’s not necessarily for everyone. This should be looked at as a long-term strategy, not a short one. Some people simply find the dietary restrictions too difficult to commit to. Since yo-yo dieting is bad for everyone, and can be downright dangerous for diabetics, you should only begin the ketogenic diet if you feel you can stick to it.
I do know a little bit about nutrition (what heavy person doesn't?). I wanted a plan that followed sound nutritional guidelines and had some research to back it up. This one does. Marla does a great job of explaining why the things I learned about nutrition in my 20s aren't working for me in my 40s, and then lays out, clearly, concisely, and with menus and recipes, what *will* work...and it did. I was nervous about cutting down on grains--I attempted the Atkins plan a few times and it just made me sick--but I felt fine. The menu plans are satisfying and tasty, and Marla has really helped me to re-frame the way I think about food.
It is important to note that the research did not analyze whether the diet employed causes obesity, if given long term. The mechanism behind the whole process was undetermined; therefore, the existence of a shared physiological response between low carb and regular carb high fat diets that cause insulin resistance in the liver requires further exploration.
In 3 months, I have lost 23 pounds, gone down 5 points in my body fat percentage, and lost 4.5 inches from my waist...after struggling with my weight for decades. (I received a copy of the of the plan guidelines and sample menus in September through the author's Facebook group.) In addition to the outer changes, my cholesterol level dropped to 121, with a commensurate reduction in triglycerides and LDLs.
Thank you for this info. I will be copying the link to send to some folks ready to jump on this new trend. In fact I had a resident (I am a CDM) come in to our re-hab facility in pretty bad shape. He was unable to speak with me so I spoke with his wife. The man had come in after having a TIA. He was a diabetic, as well. The wife told me that she had her husband 9and herself) on a keto diet. When she saw the size my eyes got for some reason she got angry and very defensive and screamed “Forget everything you have been taught. It is all crap”. I understand when folks are worried abut their loved ones they can get pretty emotional. I asked my standard question about chew/swallowing, UBW and food allergies and quickly left. I spoke with the RD (a CDE) about what had happened. She tried to speak with the resident and his wife and got the same treatment. The RD said to me “He will have another stroke in a week”. He had one in 3 days. Unfortunately with this stroke, he got anew diagnosis of severe dysphagia. SLP tried and tried but he would aspirate on everything. He had to be pegged. He was brought back to the facility. The wife was taught how to feed him through the tube. He left the facility and passed quietly about 3 weeks later. I reached out to the wife on his second stay and we became fairly close. She said she thought she was doing the best thing for him because he was over weight. I get it. She only wanted a healthy husband. She apologized for being so quick when we met. I thanked her for actually educating me on this diet. I was not aware there was such a thing.
"These diets are so restrictive that of course you're going to lose weight fast because you're not eating enough calories to sustain basic activities of your body, let alone any exercise. That's nothing that any person can sustain for the long term," Hogan said. "The weight's going to come back if you do lose any weight, and then it's going to be harder to lose weight in the future."
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.

Without peer-reviewed clinical trials, many of the benefits remain anecdotal. For instance, Weiss himself has been on a low-carb high-fat (though not strictly ketogenic) diet for more than six months, and claims he does feel much better. But he’s clear about what he knows and what he doesn’t. He’s lost weight and his borderline pre-diabetes is gone.  


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).
Readers will enjoy a diet rich in fruits, vegetables, low-fat and nonfat dairy, lean meats/fish/poultry, nuts/beans/seeds, heart healthy fats, and limited amounts of whole grains. Banished are the empty calories from refined grains and added-sugars. The result: improved metabolism, lower body fat, improved strength and cardiovascular fitness--with the diet plan proven to lower cholesterol and blood pressure without medication, and without counting calories!
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
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.
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!
Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T; “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials” (2013) British Journal of Nutrition 110(7): 1178-1187. Accessed 4/23/2018 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD9F975BAFF1D46F84C8BA9CE860783/S0007114513000548a.pdf/verylowcarbohydrate_ketogenic_diet_v_lowfat_diet_for_longterm_weight_loss_a_metaanalysis_of_randomised_controlled_trials.pdf
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.
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.’
Two years in and I am this exact same story. I do agree that if one is not insulin resistant or diabetic and has normal insulin response there are other less restrictive diets that will work. I would also add that people fail and drop out of almost EVERY diet program for one reason or another so that argument is null and void. I am under a doctor’s care and am healthier than I have been in years. My only dietary “sin” is artificial sweeteners and I am not looking back! I have not cheated at all on high carb foods and am rarely even tempted. It is doable if your motivation is there and you have support which is true for any kind of life altering decision.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[22] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[3]

Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.


Dr. O’Brien proclaimed that the benefits of the Mediterranean diet as a push away from using animals as a protein source, introducing more fruits and vegetables in meals, while also cutting out butter in favor of using oils cooking. It seemed simple which made me skeptical. I know that in dieting nothing good is easy. When I got back to office I started my research and was surprised to learn that the Mediterranean diet was endorsed by the American Heart Association and Mayo Clinic.
In 2008, researchers conducted a 24-week study to determine the effects of a low-carbohydrate diet on people with type 2 diabetes and obesity. At the end of the study, participants who followed the ketogenic diet saw greater improvements in glycemic control and medication reduction compared to those who followed a low-glycemic diet. A study from 2017 found the ketogenic diet outperformed a conventional, low-fat diabetes diet over 32 weeks in regards to weight loss and A1c. A 2013 review reports again that a ketogenic diet can lead to more significant improvements in blood sugar control, A1c, weight loss, and discontinued insulin requirements than other diets.
Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
What the doctors never tell you is that you could also just eat completely different and take none of this crap. So that’s what I did. I stopped all of them all at once. Sure I don’t recommend that, but this damn disease and my disgusting visceral fat filled stomach ruined every aspect of my life-professional, relationships, sexual, mental. I am now 41 living back at home having to start from the bottom. I don’t want what the book recommends. I want every disgusting piece of fat off this body so I can excel again. If staying in ketosis every moment for the rest of my life will get me there then that’s what I’m going to do.
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.

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.
I read the book while sitting by the pool that Sunday afternoon and informed my girlfriend that we were going to be starting a new diet on Monday. “Oh really,” she asked. “What is so good about this diet?” I told her about the salads, fresh fruit and vegetable dishes, and her favorite part, how we would be replacing steak night with chicken and much more fish. “This is the perfect diet for summer!”
This diet also works for every type of eater who wants variety in their meals. I don’t know about you, but I’ve never had Pistachio-Crusted Sole much less would I know how to make it. But in the “Mediterranean Diet Plan,” everything I need to know is on page 175 along with substitution tips in case I can’t find pistachios or want to try pecans or cashews instead. I also can see the health breakdown too. “The Mediterranean diet incorporates as lot of nuts, like walnuts, pistachios, and cashews which have a lot of fiber,” adds Zogheib. “Also tuna fish, king mackerel, salmon, all have omega 3 and omega 6 fatty acids. There’s are whole grains, bananas, and one of the best oils to bake with — canola and olive oils. You can replace fatty butter with these oils when baking.”
Nuts. It’s very easy to eat until the nuts are gone, regardless of how full you are. A tip: According to science, salted nuts are harder to stop eating than unsalted nuts. Salted nuts tempt you to more overeating. Good to know. Another tip: Avoid bringing the entire bag to the couch, preferably choose a small bowl instead. I often eat all the nuts in front of me, whether I’m hungry or not.

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


You still have to cap alcohol. The hallmark of a Mediterranean diet is that drinking red wine socially is thought to be one reason why the diet is so healthy. But women should still stick to one glass, and men two glasses. If you have a history of breast cancer in the family, know that any alcohol consumption raises that risk. (31) In that case, talk to your doctor to find out what’s right for you.
Sesame seeds likely aren’t one of those foods you pay any mind to, but the crunchy little buggers have been shown to play a crucial role in weight maintenance and deserve to be tossed into a salad or whole wheat noodle dish. Researchers suspect its the lignans—plant compounds—found in sesame seeds (and flax seeds) that makes them so special. In a 2015 study, women who consumed high levels of lignans tended to weigh less and gain less weight over time when compared to women who didn’t consume these compounds in high amounts.
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.
Dr. O’Brien proclaimed that the benefits of the Mediterranean diet as a push away from using animals as a protein source, introducing more fruits and vegetables in meals, while also cutting out butter in favor of using oils cooking. It seemed simple which made me skeptical. I know that in dieting nothing good is easy. When I got back to office I started my research and was surprised to learn that the Mediterranean diet was endorsed by the American Heart Association and Mayo Clinic.
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.
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.

I think that the experts don’t want to admit that they have been wrong all this time, They all screamed low fat/high carb which is a miserable, unsatisfying way to eat. Who wants to eat a potato with plain yogurt? Gross! She mentions that you are missing out on vital nutrients, but where is the mention that you are giving up things your body needs when you limit fats too? Keto is the only way to eat where you feel satisfied. I would eat cereal and be starving an hour later. How is that helpful? I can eat bacon and eggs (no toast), and be perfectly content for hours. It takes more food preparation, but I truly believe now that bread (whole grain or not) is the enemy of man.
That doesn’t mean keto causes diabetes; it’s amazing for most diabetics. However, if your cells are great at processing fat, but suck at processing glucose or carbohydrates, you won’t be able to run at full power, and parts of your body that prefer glucose over fat — like the glial cells in your brain that handle immune function and synaptic pruning — don’t work as well over time.
Slice 4 ounces raw chicken breast into small chunks to skewer on a kabob stick. Marinate at least 30 minutes to overnight in 1/4 cup fat-free Italian dressing. Slice remainder of white onion and green pepper from lunch into chunks; set out 10 grape tomatoes. Alternate pieces of marinated chicken, onion, pepper, and cherry tomatoes on skewers and grill. Serve with one 6-inch whole-wheat pita pocket, toasted over the grill. Spread pita with 2 tablespoons hummus. Finish with 1 cup fat-free milk mixed with 1 tablespoon strawberry drink mix. For added refreshment, freeze the flavored milk into a Popsicle mold the night before and enjoy this as a healthy dessert! Make three Popsicles and save the remainder for Tuesday's and Sunday's desserts.
If Doctor’s recommend Keto to their patients that less drugs and no kick back from pharmaceutical companies, they need to keep people medicated because pharmaceuticals run this entire country. I followed a strict diabetic diet when my husband was diagnosed with Type 2 NEVER could keep his blood sugars under control still would be 220 after a meal.. Keto has brought that down to 95-98 AFTER a meal.
If you ate a hearty breakfast, you won’t be hungry until lunch. It’s best to brown-bag it because you can control the ingredients and portions, but if you eat out, look for grilled fish and salad as a menu option. Don’t eat at your desk while writing a report, but go to the park with a friend or join your co-workers in the lunch room. Bringing leftovers is also a good lunch option.
Be choosy about carbs. You can decide which ones you eat, and how much. Look for those that are low on the glycemic index (for instance, asparagus is lower on the glycemic index than a potato) or lower in carbs per serving than others. Whole grains are better choices than processed items, because processing removes key nutrients such as fiber, iron, and B vitamins. They may be added back, such as in “enriched” bread.
I can tell how passionate you are about this subject. As you can see on one of my reply’s above, CDE’s do not recommend the same number of carbs for every person we see; we use an individualized approach. It varies depending on the person’s height, bone structure/muscle mass, amount of weight they may need to lose (or gain) and the amount of exercise they may or may not do per day/week.
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.
The food options available on the DASH diet closely mirror the eating plan recommended in the US Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, like fish and poultry. (3) Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which in excess has been linked to poorer heart health and heart failure, according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases. (4)
The low glycaemic index treatment (LGIT)[48] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[3] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
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.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
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