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).
Yes, peanut butter is high in calories, but if you stick the real stuff—a tasty combo of peanuts and maybe a touch of salt—the legumes can work their weight loss magic. In addition to providing you with belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein, peanuts also contain genistein, a compound that helps turn down the genes for obesity and reduces your body’s ability to store fat.
^ 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.
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.
The study, which was conducted by ETH Zurich in conjunction with University Children's Hospital Zurich, involved feeding mice two different types of diet (a ketogenic diet and a high fat diet, which causes the liver to become resistant to insulin) and then performing standard metabolic tests on them. Using specialized procedures the researchers were able to determine the effects of internal sugar production from the animal (mostly the liver), and sugar uptake into tissues (mostly the muscle), during insulin action.
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.
WOW. I guess I must be a very special, highly motivated patient then. I, of course, would never have said that about myself. My high motivation is trying to get over the hatred of food that being Diabetic gave me. I don’t feel that way anymore, and am finally happy cooking, again. (My doctor DID tell me exactly that, BTW. Even to the extent of telling me to not include the tsp of agave that I was having in my coffee once a day because sugar is sugar.)
But what I think is funny is that the keto diet has been staring us in the face forever. Look at Inuit tribes that survived off of blubber in a region that grows next to nothing most of the year. Yet their people didn’t die out or show signs of metabolic disorders or heart disease until introduced to the modern western diet that prioritizes carbohydrates over fat. Here is an interesting link, however I find the conclusion disheartening and frankly more than a little suspicious. (Basically the people in charge decided to drop the study and introduced a bunch of “what about…” questions to obfuscate a clear pattern in observation across many indigenous people from across the face of the planet and decided the outcome “wasn’t enough” to introduce into public policy…)
When it comes to the "best" diet for most people, this one consistently ranks at the top of every list. If you can't afford a cruise to the Mediterranean (yet!), at least you can eat like the beautiful, long-living, and famously healthy people from the region. The Mediterranean diet teaches you to eat like a Sardinian, one of the "blue zones" identified by researchers as having a high number of people living past 100—by eating more fish, olive oil, healthy fats, and fresh vegetables. The point is to have not just a longer life but also a healthier and happier one, whether you're trying to lose weight or not. (Really—research shows that you can reap the benefits of the Mediterranean diet without cutting calories.)
It seems like everyone is talking about the keto diet — the high-fat, low-carb eating plan that promises to turn your body into a fat-burning machine. For that reason, keto has surged in popularity over the past year as a lose-weight-fast strategy. Thank Hollywood A-listers and professional athletes like Halle Berry, Adriana Lima, and Tim Tebow who’ve publicly touted the diet’s benefits, from shedding weight to slowing down aging. Here’s everything you need to know about going keto.
Although the research has yet to discover all of the mechanisms behind why the keto diet is so helpful for diabetics, these four factors do seem to play a significant role in reducing the severity of type 2 diabetes while also helping with the management of type 1 diabetes. If you’d like to learn more about this topic, consider checking out our article on the keto diet and insulin resistance.

Two additional shortcuts that can easily be worked into a DASH diet plan are meal prepping and batch cooking—both of which are important for quick, healthy eating. Meal prepping doesn’t have to mean cooking a full meal, either. It’s just preparing components that can be used to toss together a quick meal—like baking chicken breasts, roasting vegetables, and cooking a whole grain like quinoa. You can also minimize time spent in the kitchen by buying weekly salad greens, bags of pre-cut veggies, and prepping produce at the start of the week.
The following weekend I was looking for a book on this diet at Barnes & Noble in Colonie Center. A title caught my eye, “The Mediterranean Diet Plan,” written by Susan Zogheib. After reading the book’s introduction I quickly skimmed through the background of the diet and stopped at the diet plans. I smiled. I thought to myself, “I could totally do this!” I skipped ahead to the recipes. At that moment I knew I had found my diet plan! The book has four, four-week diet plans complete with recipes for every meal that are structured on the level of comfort you have with making the switch. One month of meals AND recipes, I couldn’t wait!

Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

Throughout this article, we looked at the data and the principles behind how low-carb dieting affect patients with diabetes, but we never addressed what you can do about it directly. If you’d like to learn about practical strategies that may help you reverse insulin resistance and improve your blood sugar and HbA1C levels, I recommend reading these articles:
Cheese isn’t traditionally thought of as something you consume to encourage weight management, but calcium-rich Parmesan, when eaten in moderation, can help stave off sugar cravings that can easily lead to weight gain. How does that work, you ask? The native Italian cheese contains the amino acid tyrosine (a building block of protein) which has been shown to encourage the brain to release dopamine without any unhealthy insulin spikes. What’s more? The combination of calcium and protein found in dairy products such as Parmesan has been found to increase thermogenesis—the body’s core temperature—and thus boost your metabolism.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
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.

Fits in with the principles of eating and activity that I would recommend to clients: lots of produce-based meals and calcium-containing foods three times daily and exercise. Recipes look tasty. I would not necessarily recommend the lead-in period, but I like the meal plans main phase for losing weight as well the maintenance phase. I would recommend to friends and family as well


Since avocados are packed with nutrients and healthy fats that can stimulate weight loss, it’s no surprise that avocado oil acts in a similar fashion. When Penn State University researchers compared those who consumed avocado oil with those who consumed a flax-safflower oil blend, they found that those who used just three tablespoons of avocado oil daily lost nearly two percent of their belly fat in just one month.
The ketogenic diet seems straightforward. Unlike a typical low-calorie diet, however, a high-fat diet requires careful monitoring. In fact, you may start the diet in a hospital. Your doctor needs to monitor both blood glucose and ketone levels to make sure that the diet isn’t causing any adverse effects. Once your body adjusts to the diet, you may still need to see your doctor once or twice a month for testing and medication adjustments.

It also may help stave off chronic diseases, like heart disease and type 2 diabetes, as well as act protectively against certain cancers. (34) The diet is also a boon to mental health, as it’s associated with reduced odds of depression. (34) There’s even some data to suggest it can be supportive in relieving symptoms of arthritis, according to a paper published in April 2018 in the journal Frontiers in Psychology. (35)
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.
The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.

In a bowl, combine 1 1/2 cups low-fat yogurt (any flavor), 1 large egg, 1 cup whole-wheat or buckwheat pancake mix and 3/4 cup fat-free milk. This recipe makes five servings (each serving is four small pancakes). Have one serving now, and pack away four individual servings in the freezer for upcoming meals. Serve with 2 tablespoons light maple syrup, 1 cup fat-free milk and 1 cup fresh strawberries.
You can certainly still eat red meat once in a while, but choose leaner cuts. Lamb is often the red meat of choice in Greece and other Mediterranean countries. You might like to try: Kofta Kebobs; Grilled Lamb Chops with Mint Quinoa; or Moussaka (Greek eggplant and lamb casserole). For special occasions, I highly recommend Leg of Lamb with Potatoes.
While the ketogenic diet is straightforward, it does require careful monitoring. You should begin by having your doctor check your blood glucose and ketone levels. Once you’ve been on the diet for some time and your body has adjusted to using fat for fuel, it’s still a good idea to see your doctor once a month for testing and to determine if your medications need any adjustments. And, even though you will most likely see your symptoms improve on this diet, be sure to regularly monitor your blood glucose at home, ideally before and after meals.

After initiation, the child regularly visits the hospital outpatient clinic where he or she is seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[18] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[3] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[18] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[44]
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.
On the flip side, hypos can be an issue, especially early on…and if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80.  It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.

Fat isn’t unlimited either. As with wine, it's possible to get too much of a good thing when it comes to healthy fats. The American Heart Association points out that while the Mediterranean diet meets heart-healthy diet limits for saturated fat, your total fat consumption could be greater than the daily recommended amount if you aren't careful. That’s 65 g per day. (32)

In the short term, you may lose a modest amount of weight over a year span and are likely to keep it off it you continue to eat following the diet. (6) If eating in the Mediterranean style prompts you to consume more fruits and vegetables, you’ll not only feel better physically, but your mental health will get a lift, too. Research shows that people who eat more raw fruits and veggies (particularly dark leafy greens like spinach, fresh berries, and cucumber) have fewer symptoms of depression, a better mood, and more life satisfaction. (36)
“It came to another frustration point that medication really isn’t helping,” Lofton says. “I had tried many other things, like a weight loss program. I tried looking into bariatric surgery, and was very frustrated that all these things — like watching my food intake and my servings, 60 grams (of carbs) per meal — all of that wasn’t really making a difference.”
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if there is little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Almost half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones and is no longer considered beneficial.[2][3]

Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.
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