A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
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.

In addition to its 4 grams of belly-filling fiber, a cup of hearty oatmeal delivers as much protein as an egg. In other words, the popular breakfast food is an excellent weight loss tool. In fact, according to a study in the Annals of Nutrition and Metabolism, scientists found that having oatmeal for breakfast resulted in greater fullness, lower hunger ratings, and fewer calories eaten at the next meal compared with a serving of ready-to-eat sugared corn flakes, even though the calorie counts of the two breakfasts were identical. For an added fiber boost, sprinkle some berries and chia seeds on top of your oatmeal, but be sure to stay away from fattening syrup and sugar.
In a 24-week long intervention study, researchers recruited 84 obese subjects with type 2 diabetes and randomly divided them into two groups. The first group of 42 received a low-glycemic diet with a 500 calorie/day deficit. The second group ate a very low carbohydrate ketogenic diet with less than 20 grams of carbohydrates per day without calorie restriction.
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[58][59] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[60]
The "all meat all the time" low-carb approach or strict veganism can be great options for people who thrive on clear diet rules (and those two are actually the most popular diets out there) but these extremes are not for everyone. If you prefer more of a moderate approach, the Flexitarian diet is the clear winner. The "flexible vegetarian" mindset allows you a healthy balance of plant-based foods, responsibly sourced meats, and quality fats. The best part? It's not super restrictive, so you have plenty of nutritious food options. (Start here: How to Adopt a Flexitarian Diet)

I have been on a low carb diet for over 2 years. I was diagnosed a diabetic with a blood glucose over 400 mg/dl and an A1C of 12. I tried my doctors recommendations for about a year and took all the medications they told me to take. not much changed. they wanted to put me on insulin after a year. I told my doctor that I thought I could control my condition with diet and he said, “you are to far gone for that”.
The aim is far broader than suggested by the article here: It’s not just about what you put in your mouth – it’s also about timing and exercise. There are three ways to be in ketosis – which simply means that “fat burning” and not being dependent on sugars. Fasting puts a man into ketosis in 3 days and a woman by 2 days. Endurance exercise gets you there in a couple of hours. Eating a high fat diet will do it too. The goal however is hidden by the detail – it is to acquire a “Flexible Metabolism”. The aim is to switch on the full fat burning capacity and keep it running – which takes from between 4 to 12 weeks physical adaptation (for the muscles to fully be able to use ketones). The heart runs approximately 27% more efficiently on ketones than on glucose! The brain works better too – Alzheimer’s being referred to by researchers as “diabetes 3”. Once you have a Flexible Metabolism you can consume carbs during or after exercise without dropping out of ketosis – though this depends on your own bio-individuality. I can eat quite a lot of carbs – without losing ketosis – my partner cannot.

First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
This diet plan will be especially important for people with metabolic syndrome, prediabetes, or diabetes. Post menopausal women will find that this plans helps them lose that extra midlife weight that is so troublesome. It will reduce your body's demand for insulin, and reduce the tendency to deposit fat in your midsection. Yes, that's right - this plan will reduce your waist size, which is an important indicator of health risks.

Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[53]
Today’s healthy pasta meals have roots that stretch back to ancient times. Thousands of years ago, people ground wheat, mixed it with water to make a wheat paste, dried it, and then boiled it to go with meals. Today’s consumers welcome pasta to their tables for its versatility and convenience, just as nutrition scientists recognize pasta meals for their place in healthy eating patterns, such as the “gold standard” Mediterranean Diet and the traditional Latin American diet.  Read more
In one week my husband lost 1.5 kg because of Keto diet and recipes. Thank you for the insights and tips. I would like to have a complete recipe for meals everyday and hoping by subscribing I will receive try my mail. I will keep u posted. It takes 2 to tango. The one who wants to diet must be cooperative with the plan and execution while the other person who is preparing the food must be patient to the dieting person. Its not easy to change meals so patience is required
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 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.
According to the official DASH Diet Weight Loss Solution page, this eating plan actually turbocharges the original DASH diet by further reducing added sugars, refined grains, and heavily-processed foods. It also includes some specific guidelines for weight loss, such as making colorful vegetables the center of your meals and adding fresh fruits to your plate whenever you get a craving for sweets.
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.
The improvement in glycemic control occurred while medications for diabetes were discontinued or reduced in most participants (Table ​(Table5).5). During the study, hypertension and hyperlipidemia medication doses were not increased from baseline nor were new agents added, except in 3 individuals. No serious adverse effects related to the diet occurred. One participant had a hypoglycemic episode requiring assistance from emergency services after he skipped a meal but the episode was aborted without need for transportation to the emergency room or hospitalization.
But DASH—which stands for Dietary Approaches to Stop Hypertension—is far from a fad diet. Created by the National Heart, Lung, and Blood Institute (NHLBI), the DASH Diet is designed to improve health in people with high blood pressure, a.k.a. hypertension. (In the U.S., one out of every three adults has high blood pressure, according to the Centers of Disease Control and Prevention.) U.S. News & World Report has named the DASH Diet the best overall diet for the past eight years.
Want to lose weight? Grab a bottle of V8! According to a study published in Nutrition Journal, tomato juice consumption can aid weight loss because it increases resting energy expenditure (REE)—the amount of energy expended by a person at rest. After eight weeks of drinking unsalted tomato juice twice daily, the 95 women in the study (who were each exhibiting some menopausal symptoms) increased their REE by an average of over 100 calories per day.
I was diagnosed with Type 2 diabetes back in June, 2017. They wanted to put me on a special diabetic diet, and have me take two medications. I had done previous personal research into ketogenic diets. I also have a close friend who was diabetic, on meds, as well as medications for high blood pressure. He went on a ketogenic diet, and a few months later was off all of his medications.
This is ALL so confusing and overwhelming. I am not diabetic. I am trying to be proactive about it. I am borderline obese (by US standards) and obese (by Asian standards). I am 50 years old. I was addicted to fat and sugar (especially combined!) through my teens and twenties. I decided to get healthy in my 30s, so I became a Vegan (but an unhealthy/careless one, so my weight yo-yo’ed a lot in my 20s and 30s). In my 40’s I reintroduced animal products into my diet and a number of my health issues went away, but I am still fat. I am considering Keto/Carnivore, but I am concerned that I may just be falling prey to more extreme diets which could set me up for problems (e.g. diabetes) down the road. I guess I am what most would refer to as pre-diabetic (metabolic syndrome). Should I try keto or am I taking too much of a risk?

The keto diet is intriguing because it appears to run counter to the prevailing wisdom about the importance of lowering fat intake to prevent diabetes and heart disease, says a co-author of the new study, Gerald Grandl, PhD, a postdoctoral researcher at the Institute for Diabetes and Obesity at the Helmholtz Center in Munich. ETH Zurich conducted the study with University Children's Hospital Zurich.

Other down sides: There’s an initial period where your body is adjusting to its new carb-free existence, and many people experience symptoms like fatigue, brain fog and nausea for a few weeks. You also end up deficient in important micronutrients, like folate, calcium and potassium, which is why most ketogenic devotees recommend taking multivitamins. Personally, I recommend my clients follow a diet that in its ideal state provides all of the nutrients you need through real, whole foods.
Thank you SO much for this! My husband approached me about the Mediterranean diet being good for depression and suggested I give it a try. But I already knew this was not the best term to describe what I needed, even before reading your article on the subject. However, I did have an idea of what they meant and I have struggled to find recipes that fit the bill. Too many well-meaning people have made it more “healthful” by cutting back on the fat. ANYWAY . . . This little meal plan is going to be immensely helpful to me and I am poking all around the site and your social media. Thank you for sharing!
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.
Slice a 6-inch French baguette roll (3-inch diameter) in half lengthwise. Sprinkle the halves with 1/3 cup 33% reduced-fat shredded mozzarella cheese and bake in toaster oven at 250 degrees for four to six minutes, until cheese is just beginning to melt. Meanwhile, slice two large red tomatoes in 1/2-inch slices. Remove baguette from toaster oven, sprinkle with a little dried basil and dried oregano if desired. Top with tomato slices. For dessert, serve one frozen strawberry milk Popsicle left over from Monday's dinner (8 ounces fat-free milk mixed with 1 tablespoon strawberry drink mix, then frozen).
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
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.
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.
In conclusion, these three meta-analyses indicate that low-carb isn’t a “miracle diet,” but it may be one of the best, if not the best diet, for the management of type 2 diabetes and reversal of the condition in some cases. When people with type 2 diabetes follow a low-carbohydrate ketogenic diet, their health improves, weight is lost, blood sugar and HbA1c levels drop, and other health parameters improve significantly. Even studies that put healthy individuals on a ketogenic diet found similar improvements.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].
Now I have to say, I am not a supporter of rigid plans, however it is important to eat at somewhat regular times so you don’t end up feeling very-very hungry at any particularly moment of the day. Having said that, I also think it is important to be able to actually feel hunger, and look forward to eating a meal.  While adding a snack here and there is good to keep blood sugar and hunger levels in balance, snacking can also backfire. Many times we eat a snack without being hungry or we depend on ready-made snacks such as granola bars, juices, smoothies etc. which not only add quite a few calories but also are a processed food with all that entails.
Basically, the effect of exercise on our weight is vastly overrated. That’s why it’s only number 15 on this list. There are other things you need to take care of first. It’s not a good idea to eat bad food, drink sugar water (so-called “sports drinks”) or be on medications which force you to exercise for hours daily just to compensate. Metaphorically that’s like digging a hole, into which you put your ladder, on which you stand and paint the basement-level windows of your house.
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.
At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin.
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)
We are just two days into 2019, but already the best diet of the year has been named. US News and World Report listed the Mediterranean diet as the best overall diet for 2019 after evaluating 41 of the most popular diets. It was also named best diabetes diet, best diet for healthy eating, best plant-based diet, best heart-healthy diet, and easiest diet to follow.

I am sorry you had this experience. I feel that this educator was not giving you good advice. All my women who want to lose weight are recommended to consume 30 grams of good carbohydrates at each meal, and 15 at each snack. If you were not trying to lose weight, I would have recommended 45. I find this is all it usually takes to begin to lose some weight as you start to get active. Patients set their own goals with motivational help from their Certified Diabetes Educator. Our intent is never to insult, and you should not have gone through that. It sounds that you have now found the right path. There are many CDEs who could help you, so see what tools and motivation others may offer. I wouldn’t let one bad apple spoil the whole bunch. Many CDEs are also diabetic.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.

A slew of articles in recent months have referred to the ketogenic diet as a “fad” or “trend.” It’s “dangerous,” claimed one article, and an anonymous post by the Harvard Public School of Public Health said the diet “comes with serious risks.”1 Yet strangely, these critics seldom cite scientists or doctors who work with the diet, and many—including the Harvard article—cite no medical literature to substantiate their allegations. Without substantiation, many simply rehash long-contradicted, outdated claims.
Of the 28 participants enrolled in the study, 21 completed the 16 weeks of follow-up. Reasons for discontinuing the study included unable to adhere to study meetings and unable to adhere to the diet; no participant reported discontinuing as a result of adverse effects associated with the intervention. All but one of the 21 participants were men; 62% (n = 13) were Caucasian, 38% (n = 8) were African-American (Table ​(Table1).1). The mean age was 56.0 ± 7.9 years.

H. Guldbrand, B. Dizdar, B. Bunjaku, T. Lindström, M. Bachrach-Lindström, M. Fredrikson, C. J. Östgren, F. H. Nystrom, “In Type 2 Diabetes, Randomisation to Advice to Follow a Low-carbohydrate Diet Transiently Improves Glycaemic Control Compared with Advice to Follow a Low-fat Diet Producing a Similar Weight Loss,” Diabetologia (2012) 55: 2118. http://link.springer.com/article/10.1007/s00125-012-2567-4.
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.
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