The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals ; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.
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.
What the diet advocate says: ‘FODMAPS are either absorbed slowly from the small intestine or not absorbed at all,’ says Dr Gibson, a professor of gastroenterology at Monash University in Melbourne, Australia, and the brains behind the low-FODMAP diet. ‘When the FODMAPs move into the bowel, where they are fermented by bacteria, this produces gas and can also cause water to move into the bowel. This stretches the bowel wall, which stimulates the gut.’
“This is a great way of eating that I highly recommend to many clients, and I even model in my own life,” says Elizabeth Shaw, RDN, who is in private practice in San Diego and is the co-author of Fertility Foods Cookbook. “Since the premise of the diet is designed to help people who have high blood pressure, low-sodium foods are recommended. But considering that most Americans exceed their daily sodium levels anyway, it’s not surprising that dietitians recommend this style of eating for treating many different conditions, such as heart disease and obesity.”
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.
You start each day with a heart healthy breakfast. Your vegetable intake is increased. You find yourself making trips to the farmers market to get a better variety of fresh fruits and veggies. You stop eating processed food. And that’s a big one. Let’s talk about bread for example. Besides price and taste, what is the difference between white and whole grain bread?
If you are interested in trying out a ketogenic diet, it’s important to do your research about how to make sure to obtain adequate nutrition and also to be prepared to adjust (or have your healthcare provider help you to adjust) your medication doses. Many people find that their insulin sensitivity changes after starting a ketogenic diet, so it is very important to be on the lookout for changes in blood glucose trends to determine if treatment needs to be adapted.
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.
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).
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.
In case you haven’t jumped on the keto train and are wondering what exactly all the hype is about, here you go: The diet is very high fat and (almost) no carb. The ratio of fat to carbs and protein is 4:1. The goal of the ketogenic diet is to burn fat for energy rather than carbohydrates, resulting in weight loss. And, advocates claim there are many benefits beyond the number on the scale going down.
When compared to the calorie-restrict diet, the subjects who underwent the ketogenic diet experienced a reduction three times greater in hemoglobin A1C (1.5% vs. 0.5%).  In addition to observing greater improvements in diabetes-related markers, researchers observed a greater reduction in medication usage in subjects that underwent the ketogenic diet treatment. Thus, due to their overall findings, the researchers stated that “Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.” 
In the study, the researchers fed mice a ketogenic diet for several days and expected to find a favorable outcome — perhaps weight loss or another indication of improved health. Instead, they found that the liver began resisting insulin almost immediately and the mice were unable to regulate their blood sugar levels after only three days on the diet. (Insulin resistance, meaning that cells in the body don't respond to insulin, is a key characteristic of type 2 diabetes.)
The NY Times Best Sellers, The DASH Diet Action Plan and The DASH Diet Weight Loss Solution, provide real life solutions to make it easy for people to follow the DASH diet. They each have 28 days of meal plans, recipes, guidance for weight loss, how to eat at restaurants, fast food places, etc. and still stay on track. It shows you how to stock up your kitchen for the DASH diet, and how to read food labels to make good choices. And, of course, the meal plans and recipes are all low sodium/low salt. The books show you how to add exercise and other lifestyle changes to help lower blood pressure. The books help you design your own personal "DASH Diet Action Plan" and your own "DASH Diet Weight Loss Solution."
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.)
Cold fried chicken breast (don’t eat the skin or coating). Hint: The chicken doesn’t have to be cold. This could be a fast-food lunch but only if you can choose whole chicken parts. (Definitely do not choose chicken tenders, patties, crispy chicken, or nuggets. They have too much breading for the amount of meat.) Most fried chicken places have coleslaw as a side. When you get back to your office, you can have the carrots and Jell‑O.
"Even though it's called the Mediterranean diet, it's not really a diet," said Atlanta registered dietitian Rahaf Al Bochi, a spokeswoman for the Academy of Nutrition and Dietetics. "It doesn't tell you what to eat and not eat. It's a lifestyle that encourages consuming all food groups but gives more weight to those which have the most health benefits."
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%. The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy and tuberous sclerosis complex.
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.
I, too, am finding the keto diet to be beneficial. My weight is moving down. My recent A1c was 5.7. I am consistently below 90 each morning when I check my blood. I am learning to adapt my cooking to the needs of maintaining this way of eating. I have incorporated walking because now I FEEL like it. I don’t feel deprived. I feel empowered. No medications for diabetes!
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.
What is your opinion on the conflicting opinions about whether or not wine is healthy or harmful? It seems there is a daily article touting research that proclaims wine is health alternating with another article about research that indicates that even moderate intake of wine is associated with cancer or dementia. I’m trying to understand all of this conflicting data with the reality/evidence of Mediterranean cultures that include daily intake of wine. Is it the amount drunk that is key?
I teach ADA. I saw 49 people in 8 months. All except 1 lost weight and had A1C reduction. 16 reversed their condition. All this on ADA diet. ADA works, you just have to follow it. Keto will work also, I just do not believe that it is healthy in the long term. We need more study results, and evidence that it works before we recommend that everyone should go on a keto diet. I would recommend that any of you who are on keto diet, and who are adamant that it works, and that ADA does not, should look for clinical trials and become subjects. We will need to know scientifically that it works, not just by word of mouth. And we will need to see medical evidence that it helps. If there is science behind it, I am sure that ADA will get behind it. Their are medical programs where you can be followed on a keto diet. Look for those.
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)
Wouldn’t it be great if life came with a magic remote control that made the bad parts speed up and the good parts slow down? You could hit FF at the beginning of every workday, and RWD at the end of awesome date. All the vacations, holidays and parties could move at the pace of a Kenny G song, and all the endless conference calls could spin by faster than Nicki Minaj’s hairstyles.
Results of meta-analysis of 12 large studies conducted between 1966 and 2008, covering more than 1.5 million subjects, were published in the British Journal of Nutrition in 2009. The authors concluded that the Mediterranean diet is associated with significant health benefits, including lower mortality overall, and reduced risk of chronic diseases like heart disease, cancer, Alzheimer’s and Parkinson’s.
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.