In regard to serum measurements, the mean fasting glucose decreased by 17% from 9.08 ± 4.09 mmol/L at baseline to 7.57 ± 2.63 mmol/L at week 16 (p = 0.04) (Table ​(Table4).4). Serum sodium and chloride levels increased significantly, but only by 1% and 3%, respectively. Uric acid level decreased by 10% (p = 0.01). Serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001). Increases occurred in both high-density lipoprotein (HDL) cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (10%) but these changes were of borderline statistical significance (p = 0.08 and p = 0.1, respectively). The following blood tests did not change significantly: total cholesterol, potassium, bicarbonate, urea nitrogen, creatinine, calcium, thyroid-stimulating hormone, and hemoglobin.
Obviously, it’s still possible to lose weight on any diet – just eat fewer calories than you burn, right? The problem with this simplistic advice is that it ignores the elephant in the room: Hunger. Most people don’t like to “just eat less”, i.e. being hungry forever. That’s dieting for masochists. Sooner or later, a normal person will give up and eat, hence the prevalence of “yo-yo dieting”.
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook [11] detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]
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.
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Carbohydrate Restriction. To help people with diabetes manage their blood sugar levels, doctors will typically prescribe a diet that mostly consists of low glycemic index foods. [23] However, according to the research, restricting overall carb intake to the point of following a keto diet may be the best way to improve the many biomarkers relevant to diabetes. [24] In fact, this dietary strategy has been proven to be helpful for the management of type 2 diabetes and type 1 diabetes.
January 6, 2016 "What makes a diet best? In Best Diets 2016, the latest set of exclusive rankings from U.S. News, the DASH diet beat out 37 others.  To be top-rated, a diet had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease. The government-endorsed Dietary Approaches to Stop Hypertension (DASH) snagged the top spot."
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
If you’re on the ketogenic diet, be sure to test blood sugar levels throughout the day to make sure they are within their target range. Also, consider testing ketone levels to make sure you’re not at risk for DKA. The American Diabetes Association recommends testing for ketones if your blood sugar is higher than 240 mg/dL. You can test at home with urine strips.
This diet plan focuses on foods that are sources of protein and fat, which will help to keep you feeling full which may help you eat less overall. However, the keto diet is not a license to eat as much bacon and cheese as you want. It is even more critical to make good choices while on this diet because following a strict keto diet could result in vitamin and mineral deficiencies. And while the diet does eliminate many processed and ‘junk’ foods, it also limits many fruits, vegetables, and other important fiber-rich carbohydrate foods, which provide many health benefits.
Thanks for posting this Edward. While I agree that the thought of a lifetime without any sweets or any grains sounds miserable, it’s even more miserable every time I see a number above 120 on my meter, which is guaranteed to happen every time I eat even a few bites of one of those foods. Yeah, it’s stressful (and cortisol is just as much of a pain as T2D), but I want a better life and a life off of drugs. I was on three orals and two shots of insulin daily.
A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]
Calorie Restriction. Most of the research on type 2 diabetes supports the use of calorie restriction for improving many of the metabolic issues that contribute to the condition. [19] [20] Both the keto diet and low-calorie diets have been shown to help reduce insulin resistance, and many researchers postulate that being in a calorie deficit is the key variable behind these positive effects.[19] [20] For most of us, the keto diet is the better option to experience the benefits of calorie restriction because it allows you to cut your calories naturally without eliciting strong hunger pangs and cravings.

Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.


Starting on a ketogenic diet can influence your exercise performance in multiple ways, both positive and negative. During the first 1-2 weeks (the “adaption period,” which I will get back to later), you will most likely see a decrease in energy and athletic performance across the board while your body adjusts to the new diet. This is perfectly normal and should NOT be a cause for concern or make you abandon the diet.

When Steve contacted TheDiabetesCouncil, he wanted to know where to find information on meal plans for the Ketogenic Diet. There are many resources online where you can search for meal plans for the Ketogenic Diet. There are also many books you can purchase at your local bookstore. The Atkins Diet is the most well- known Ketogenic Diet in its Induction Phase which is the first 2 weeks in this diet.
Your recipes sound wonderful. I have tried a few. I am a senior living alone and adjusting them can be a challenge. Let’s face it eating the same thing several days in a row can make even a good thing boring. Another thing you and most others posting recipes forget is some of us have very little to spend on food so reading your recipes is many times the only dream of good food.
In regard to serum measurements, the mean fasting glucose decreased by 17% from 9.08 ± 4.09 mmol/L at baseline to 7.57 ± 2.63 mmol/L at week 16 (p = 0.04) (Table ​(Table4).4). Serum sodium and chloride levels increased significantly, but only by 1% and 3%, respectively. Uric acid level decreased by 10% (p = 0.01). Serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001). Increases occurred in both high-density lipoprotein (HDL) cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (10%) but these changes were of borderline statistical significance (p = 0.08 and p = 0.1, respectively). The following blood tests did not change significantly: total cholesterol, potassium, bicarbonate, urea nitrogen, creatinine, calcium, thyroid-stimulating hormone, and hemoglobin.
Ok, let’s break this down. So with this study you have a decent number of participants…I would love to see 1000, but 105 is certainly better than 20. Many ages, races and socioeconomic backgrounds were represented. There were a closer number of males versus females included in the study. Lastly, they were followed for a longer period of time, a full year.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]

This high-fat, adequate-protein, low-carb fad diet sends the body into a state of ketosis, in which the body uses stored fat for energy. Research published in Clinical Cardiology suggests the ketogenic, or “keto,” diet can be an effective weight loss method, but to be successful, you must follow the plan consistently with no cheat days — otherwise, you’re just eating a high-fat diet that may be high in unhealthy fats for no reason. (1) (A pro tip? If you're planning on doing the diet, consider perusing this complete keto food list and reading up on the healthiest fats for keto diet followers.)
Have Protein at Every Meal and Snack. Adding a source of lean or low-fat protein to each meal and snack will help keep you feeling full longer so you're less likely to overeat. Try low-fat yogurt, small portion of nuts, peanut butter, eggs, beans, or lean meats. Experts also recommend eating small, frequent meals and snacks (every 3-4 hours), to keep your blood sugar levels steady and to avoid overindulging.
Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.

“Tremendous Results”….guess that’s why the diabetes nationwide gets worse every year, because of the stellar advice your kind is giving out. I’ve been on the virta clinic for two months and already went off insulin, Janumet and Jardiance, which I’ve been on for 10 years, with blood sugars between 80 and 150. The advice you give makes people get sick slower. The ketogenic approach deals with the real issue, carbohydrate intolerance. If you are lactose intolerant you stop ingesting lactose. Type two diabetes is simply carbohydrate intolerance. Stop eating the carbs and the symptoms go away. I think you meet to cite some of the other research out there I’ve read in other books and the work the Virta Clinic has done. In my opinion you’ve cherry picked data to suit your preconceived beliefs.

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.
One aspect that is not often mentioned is carb cravings. Before I started a keto diet, every day I would have serious starchy- or sweet- carb cravings that were uncontrollable and HAD TO BE satisfied. The high-fat keto diet has pretty much eliminated those carb cravings. It is wonderful to not be under the control of those cravings anymore. I think the high success rate of keto diets is that you are not hungry and have no cravings.
He also told me that I was in horrible shape, that I would need a lot of medication, and that because I was T2, insulin would do nothing for me. I still remember walking out of the building after. I felt like shooting myself. My brother had just gone blind from retinopathy 2 months earlier. There was no hope for me. High numbers were inevitable. Complications were inevitable.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram (EEG) shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[45]
The Mediterranean diet isn’t a regimented plan, like South Beach, the Blood Type Diet or any others; it’s more a way of eating. After World War II, researchers began studying the eating patterns of 13,000 middle-aged men in the US, Japan, Italy, Greece (including Crete), the Netherlands, Finland and Yugoslavia. They noticed that those in countries whose diets had been restricted by the deprivations of the war had lower rates of heart disease compared to American men. Moreover, residents of Crete enjoyed the best cardiovascular health, leading scientists to conclude that their diet — fruits, vegetables, grains, legumes and fish — played a major role.

Walnuts are packed with tryptophan, an amino acid your body needs to create the feel-great chemical serotonin. (In fact, Spanish researchers found that walnut eaters have higher levels of this natural mood-regulator.) Another perk: "They're digested slowly," said Dr. David Katz, director of the Yale Prevention Research Center. "This contributes to mood stability and can help you tolerate stress."


A keto diet was/ is not just used for diabetics. It is a very useful tool for epilepsy. It is extremely successful in reducing the number of seizures per day, mainly in children but also in adults. I am sure that followers of the epilepsy diet, which has been used since the 1920s have not all starved to death. Iwould also think that the followers of this diet are also motivated to stay on it, not eat a slice of birthday cake and keep all thier brain cells.
My pick for the healthiest meal plan for diabetes? My favorite is the Mediterranean Diet. It’s high in fiber, low in saturated fats and includes no processed foods which is the challenge for all of us at this point in history. If we could all eat like they do in Italy and Greece! Think of Sicily and the coasts of Greece where their diet consists of fresh fish, fresh fruits and vegetables, nuts, beans, seeds, olives and olive oil, lean meats such as chicken and pork, some eggs and little red meat. The American Heart Association recommends it as well as the American Diabetes Association as being one healthy diet choice for people with diabetes.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more calories than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein and carbohydrate is then evenly divided across the meals.[36]
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
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.

A majority of the meal planning for the Mediterranean diet consists of fresh fruits and vegetables. A sample days meal menu consists of: a pumpkin-gingerbread smoothie for breakfast, Macaroni with Milk (Macoroni oil-Hali) for lunch, and Trout with Wilted Greens for dinner. Your suggested snacks during the day: Mango-Pear Smoothie, cashews and raisins, low-fat ricotta cheese with peaches, hummus, and seed and nut snack bars.

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.
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?
Though the ketogenic diet is quite safe and even beneficial for diabetics, there is sometimes a chance a patient can develop diabetic ketoacidosis. Anytime you change your body’s primary energy source from carbohydrates to fat, your blood becomes flush with those ketones we talked about. And, anytime there are too many ketones, there is a potential risk for developing ketoacidosis. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare.
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?'”
Obviously, it’s still possible to lose weight on any diet – just eat fewer calories than you burn, right? The problem with this simplistic advice is that it ignores the elephant in the room: Hunger. Most people don’t like to “just eat less”, i.e. being hungry forever. That’s dieting for masochists. Sooner or later, a normal person will give up and eat, hence the prevalence of “yo-yo dieting”.
Being in optimal ketosis for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are NOT part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.
I’m Dr. Caroline Apovian–the medical nutrition expert for DASH for Health.   I bring over a decade of experience in helping people lose weight to the DASH diet program. I use the successes my patients have had to help the people using this system achieve healthy weight loss. You won’t find any claims here that weight loss is easy and effortless, but the DASH diet makes it simple. When you first log in, you will calculate how many calories you should be eating each day. From there, you will get access to your DASH eating plan. You can track your food intake, exercise and weight all in the DASH for Health system. Also, you can receive real-time progress reports that show you how you are doing.

The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?
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