In my food shopping we save about $40 a week even though we eat seafood twice a week. A fillet of salmon or swordfish that feeds two is about the same price of the cut of steak that I would grill for myself. Preparing snacks on Sunday night also means no more trips to the office vending machine for that late-day snack. “I joked around with a couple of colleagues last week in my presentation,” Susan mentioned. “I said, ‘You know, we’re paying for diabetes, we’re paying for high blood pressure. Why not invest your money and diet in food sources that are good for you body?'”
As I wrote in op-eds for the Wall Street Journal61 and Medscape,62 the Lancet Public Health study is based on very thin data. The questionnaire underlying the report left out questions regarding popular foods, such as pizza and energy bars, and did not consider alcohol consumption. Moreover, the “low-carb” diet group in this study included people eating up to 37% of calories as carbohydrates—not low-carb according to the latest science. Ultimately, this is the kind of data that can show association but not establish causation, which means it is the kind of data one can use to generate hypotheses but not prove them. This kind of data would never be considered sufficient to approve a drug, for instance. The same standards should be applied to diet. Quite a few researchers, including myself, had our critiques published in Lancet Public Health.63 The authors replied but did not respond to most of the criticisms.
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[34] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[35] On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism.[9] A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[36]
I know it is hard when you have been taught something, and believed it, and taught it to others…only to be shown that what you have been taught is not the end all be all that you were led to believe. It sucks. But, you can choose to ignore the truth, and continue to follow the incorrect path. Or, you can look at the facts, and realize that what you have been taught is not the truth…and you can take a new path, which will lead many to wonderful new lives.
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)
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
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.
Many diet plans cut out entire food groups, which can create nutrient deficiencies as well as health problems. For instance, if the diet is very low in carbohydrates and you have type 1 diabetes or type 2 diabetes, it’s probably not a good fit. And if it’s too restrictive and you’re pregnant or breastfeeding, it’s not a good idea, either. Keep in mind that pregnancy is not a time for weight loss. Speak with your doctor before making any changes to your diet if you are pregnant or breast-feeding.
The ketogenic diet tries to bring carbohydrates down to less than 5 percent of a person’s daily caloric intake – which means eliminating most grains, fruit, starchy vegetables, legumes and sweets. Instead, it replaces those calories with fat. That fat is turned into ketone bodies, which are an alternative energy source: besides glucose derived from carbohydrates, ketones from fat are the only fuel the brain can use.

As Tammy points out, diets are diets, and many people nowadays think/feel that diets are a “time/value-based goal”. “If I just get my weight down, or if I just fix this, then I’ll be all set…” WRONG!!! There in lies the first problem. How long can it be maintained? Well that’s a good point. The real question is, how long is one committed to changing their life, and how strong is their desire to do it. ALL things that one wants to change in life, require a change in to the way their living and/or perceiving life. They require a life-style change. One could attempt a Mediterranean diet, and yet relapse back to “normal” eating after 3mos, 1yr, 3yrs, etc.. It doesn’t really matter if the change isn’t first on the mental and emotional level. Unfortunately, many first-world daily diets (namely American) incorporate many foods that are addictive which can cause cravings. And yes, the cravings are scientifically prove-able, and have been proved. We grow up thinking that it’s “normal” to have your cake (since its the carb of debate lol) and eat it too, because why?… Well because that’s how they were raised. Simply as that. Conditioned living if you will. There are many cultures on this planet that DO NOT grow up eating as many carbs and sweets as the American Diet, and do perfectly fine without all the sugars and carb cravings. And incidentally, they also lead healthier lives too… Go figure.
Similar to Greek yogurt, research has shown eating eggs for breakfast can make you feel more full and help you eat fewer calories throughout the day, meaning they’re quite the secret weapon for weight loss. Nutritionally speaking, one large hard-boiled egg (about 50 grams) contains less than one gram of carbs and remains an excellent source of protein. Eggs are also loaded with amino acids, antioxidants, and healthy fats.

Adequate food records were available for analysis in a proportion of participants at each of the 4 timepoints (Table ​(Table2).2). Participants completed food records at a mean of 2.5 and a median of 3 timepoints. In general, comparing baseline to subsequent timepoints, mean carbohydrate intake decreased substantially and energy intake decreased moderately while protein and fat intake remained fairly constant.


When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar and handling illness.[18] The level of parental education and commitment required is higher than with medication.[43]

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.
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.)

In the study, researchers fed mice (!) a keto diet for three days (!), and then ran a glucose tolerance test. They noticed that while the mice on a keto diet had a lower fasting blood glucose, it got higher after the glucose tolerance test and there were signs of a reduced effect of insulin compared to mice on regular mouse chow. That’s basically it.
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.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.

Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[18] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[30] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[3] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[50] Other formula products include KetoVolve[51] and Ketonia.[52] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[52]
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.
Incidentally , there’s a very informative article on the bbc website about one of the last remaining hunter/gather societies left in the world, living in Tanzania. They have amazing gut health and no t2d. Would you like to guess at the type of diet they follow? This would be the caveman diet that the writer mentions, and yes these people might not live as long as us but the cause of death is never a lack of motivation to stay on a keto diet.
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.

Burns fat: You can drop a lot of weight — and quickly — on the keto diet.[3] Ketones suppress ghrelin — your hunger hormone — and increase cholecystokinin (CCK), which makes you feel full.[4] Reduced appetite means it’s easier to go for longer periods without eating, which encourages your body to dip into its fat stores for energy. Learn more here about the keto diet and weight loss. 


The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
I read in the news that the DASH diet was supposed to be THE top-rated diet by experts, so I took a closer look with this book. I was disturbed instead by recommendations of processed low fat cheeses, low fat yoplait yogurt (so much sugar and un-pronounceable ingredients I don't even understand why this was suggested), and sugar-free Jello. I prefer a whole-foods, plant-based, low processed approach - so this diet definitely isn't for me. I think I'll keep looking.
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.

Forget old low-carb diet plans that focused on processed protein bars and shakes. This year, the keto diet got high marks for low carb. Keto, short for "ketogenic," is all about training the body to burn fat for fuel. How? By eating fat—and lots of it. Most keto diets recommend getting at least 70 percent of your daily calories from fat and the rest from protein. The goal is to eat as few carbohydrates as possible. Proponents say it helps them drop weight fast with little or no hunger in addition to perks like more energy and mental clarity. (Interested? Here's everything you need to know about the keto diet.)

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.
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions. Vertical Health & EndocrineWeb do not provide medical advice, diagnosis or treatment. Use of this website is conditional upon your acceptance of our user agreement.
As far as the Ketogenic Diet is concerned, I think I am going to have to make a full about-face. As you said, for some people like yourself, you were unable to eat in moderation and feel it is due to your genetic makeup. This is probably true…to add insult to injury, in addition to genetics, it could also be an inflammatory process going on due to the sugary drinks and processed foods we are eating causing obesity and a host of other issues.

Some of the concerns are around micronutrients — supplementation of electrolytes, vitamins, and fiber is often required on low-carb diets, Zeratsky says. And sometimes, these diets can actually lower the blood sugar of a person with diabetes to the point where it’s too low, which is also dangerous. (Low-carb diets are not recommended for those people with type 1 diabetes or anyone on insulin due to that risk, experts note.)
Cortisone as an oral drug is another common culprit (e.g. Prednisolone). Cortisone often causes weight gain in the long run, especially at higher doses (e.g. more than 5 mg Prednisolone per day). Unfortunately, cortisone is often an essential medication for those who are prescribed it, but the dose should be adjusted frequently so you don’t take more than you need. Asthma inhalers and other local cortisone treatments, like creams or nose sprays, hardly affect weight.
Check the nutrition labels on all your products to see if they’re high in carbs. There are hidden carbs in the unlikeliest of places (like ketchup and canned soups). Try to avoid buying products with dozens of incomprehensible ingredients. Less is usually healthier.Always check the serving sizes against the carb counts. Manufacturers can sometimes recommend inconceivably small serving sizes to seemingly reduce calorie and carb numbers.
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.
WH verdict: It’s still a diet by any other name, but props to Weight Watchers for acknowledging that there’s more to being healthy than ‘weight’. The new platform really does consider all aspects of wellness. And with plans to partner with Alexa and Google Assistant to help track your progress, WW could be to 2019 what Weight Watchers was to the early noughties.
Net carbs is simply total carbs minus fiber and non-digestible sugar alcohols, like erythritol. (This doesn’t apply to high glycemic sugar alcohols, like maltitol.) We don’t have to count fiber and certain sugar alcohols in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. (Read more about sugar alcohols here.)
DASH was first introduced at a meeting of the American Heart Association in 1996 and later published in the New England Journal of Medicine in 1997. [2] The DASH trial randomly assigned 456 people to different diets to test the effects of dietary patterns on lowering blood pressure. The authors surmised that eating a diet with many different foods with blood pressure-lowering nutrients would show a greater effect on blood pressure than eating single nutrients, such as found in supplements or in a limited diet. Three diets were tested: 1) a control diet, or a standard American diet, 2) a fruits and vegetables diet, similar to the control diet but providing more fruits and vegetables and less snacks and sweets, and 3) a combination diet rich in fruits, vegetables, nuts, and low-fat dairy foods with reduced amounts of saturated fat, total fat, and cholesterol. The last two diets were richer in nutrients associated with lower blood pressure, such as potassium, magnesium, calcium, fiber, and protein. All three diets provided about 3000 mg sodium, which is more than the recommended amount from the Dietary Guidelines for Americans but less than the average sodium intake for Americans. [3]

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)


With this eating style, you’re looking at a lot of menu planning and preparation. A review published in August 2017 in Nutrients suggests the diet could lead to weight loss, but the Academy of Nutrition and Dietetics warns the plan could also cause certain nutrient deficiencies, such as in calcium and vitamin D. (3,4) And, therefore, according to an article published in the January–February 2016 issue of the Royal Australian College of General Practitioners, anyone at risk for osteoporosis should avoid it. (5)

When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
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.
The Mediterranean diet is rooted in an abundance of fresh plant-based foods including fruits, vegetables, nuts, seeds, beans, and legumes, with olive oil being the primary source of monounsaturated fat. Fish and seafood follow as a primary source of protein with moderate amounts of poultry, dairy, and eggs to follow. Red meat and sugary treats should be consumed relatively rarely and in moderate portions.
As far as weight loss is concerned, I have heard great things from many who have switched to eating the Mediterranean way. Some were able to see results in just a few weeks…feeling better and losing a moderate amount of weight. From my personal experience, the only time I wasn’t eating the Mediterranean way was during my early years in college. I attended college in Michigan, and naturally, I ate whatever was available in the school cafeteria. Freshmen year, I gained nearly 30 lb. But lost it all without much effort in 2 months, when I returned home that summer and started to eat Mediterranean again. It’s important to say that the Mediterranean lifestyle is really a way of living, and one we commit to longer term, not necessarily a quick diet for the sake of losing weight. I always mention too that I have no medical or professional background to lend in the area of weight loss. If that is priority, a registered dietitian or someone with that kind of experience would be of help.
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.
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.
There’s also some evidence that it might help with type 2 diabetes. “An emerging body of research is finding that a keto plan may have some real benefits thanks to its ability to improve the body’s ability to use insulin and also help control appetite, which can result in easier weight loss,” says Karen Ansel, R.D.N., co-author of Healthy in a Hurry.
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