Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided.
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]
A relatively new offering, the Nutritarian diet is based on maximizing the amount of healthy vitamins, minerals, and trace nutrients in your food, balancing your hormones, and avoiding toxins. The plan—created by Joel Fuhrman, M.D., author of The End of Dieting—is nutrient-dense, plant-rich, and includes anti-cancer superfoods to help you not just lose weight but live a long, disease-free life. (P.S. Follow these guidelines to make sure you're absorbing all the nutrients from your food.)

Hi, Esther! Thank you so much for your kind comment. I am so glad you found The Mediterranean Dish and hope you’ll enjoy cooking some of the recipes here! I should preface my answer here by saying that I am not a dietitian or a nutritionist, what I share here is mainly from my experience as someone who grew up in the Mediterranean area and have continued to eat the Mediterranean way now as an adult living in the USA. So please always check with your health care provider or a registered dietitian if you are looking for professional advice or a specific diet plan to follow. But I’ll answer your questions as best as I know how.
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).[18]
You’re a diabetic counselor and are talking about being worried about not being able to eat birthday cake? Hell I’ve been on keto since July 2016 and haven’t felt any urge to go back, simply because I feel so much better. Also the diet is really not all that restrictive, you can make desserts using stevia/erythritrol, coconut/almond flour, etc. I had ketogenic pizza the other night and it turned out great. Lots of great resources out there for food options. I’m not diabetic myself, but I used to be prone to hypoglycemia and keto has eliminated the issue since I’m not dependent on glucose. There are a lot of wrong ways to do keto though, and doing the diet correctly has a moderate learning curve.

The DASH diet has sometimes even been described as an Americanized version of the famous Mediterranean diet, according to the official DASH diet website. But as healthy as the DASH diet is, it's certainly not restrictive. It includes an eating plan rich in fruits, vegetables, low-fat and nonfat dairy, lean meats, fish, poultry, nuts, beans, seeds, heart-healthy fats, and limited amounts of whole grains. These delicious and nutritious foods join forces together to help your overall health improve. An added perk? You can also shed some unwanted pounds on the DASH diet — especially if you follow the DASH Diet Weight-Loss Solution plan.
In 3 months, I have lost 23 pounds, gone down 5 points in my body fat percentage, and lost 4.5 inches from my waist...after struggling with my weight for decades. (I received a copy of the of the plan guidelines and sample menus in September through the author's Facebook group.) In addition to the outer changes, my cholesterol level dropped to 121, with a commensurate reduction in triglycerides and LDLs.
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A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[19] and followed-up by a report published in 2001.[20] As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction and 3% were seizure-free.[Note 7] At twelve months, 55% were still on the diet, 23% had a good response, 20% had an excellent response and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three and four years was 39%, 20% and 12% respectively. During this period the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free but had had an excellent response.[20][21]

Coconut oil may be high in saturated fat, but that doesn’t mean you should write it off completely, especially when it comes to weight loss. In fact, a study of 30 men published in Pharmacology found that just two tablespoons per day reduced waist circumference by an average of 1.1 inches over the course of a month. What’s more? At roughly 117 calories per tablespoon, coconut oil (which has a versatile high smoke point) is an ideal cooking companion so long as you don’t use it every day and rotate in other cooking oils such as heart-healthy EVOO.
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.
Keep eating low carb to continue losing weight, feeling good and becoming healthier!Try making any of our hundreds of recipes available on the site. We make sure each and every recipe is delicious, nutritious and will keep you under your daily carb limit, even if you go for seconds. In addition, we provide step-by-step instructions to make the process as easy as possible. If you ever run into any issues or have any questions, be sure to leave a comment or contact us directly! We’re always happy to help.
“Regardless of how solid they are, your diet and exercise plans won’t work if you aren’t sticking to them. You’ve made a commitment to yourself, so come through with it,” Roussell says. As you plan your meals or snacks, Roussell suggests putting an X over it on your menu map. If you skip a meal or eat something that isn't in your plan, circle that meal. At the end of each week, count the number of meals you ate according to your meal plan and divide that number by the total number of meals, snacks, and post-workout smoothies you had planned, then multiply it by 100.

Both groups experienced no notable adverse effects in their health. In the 29 subjects who successfully completed the calorie-restricted diet, researchers observed an average 16% reduction in fasting glucose, 2.7 reduction in BMI, and loss of 6.9 kg of bodyweight. [9] However, in the 21 subjects that successfully completed the very-low carbohydrate ketogenic diet, subjects experienced an average 19.9% reduction in fasting glucose, 3.9 decrease in BMI, and loss of 11.1 kg of bodyweight. [9]


It appears that a ketogenic diet is generally safe when implemented correctly. One must be careful to obtain all the necessary nutrients by eating a variety of foods, such as non-starchy vegetables, seeds, and nuts, and also consume adequate protein and essential fatty acids. Provided that the need for vitamins, minerals, amino acids and fatty acids is met, there is no reason to suspect that the ketogenic diet is unsafe.
The DASH diet often flies under the radar, especially when compared to buzzy diets such as the Keto diet, but it’s one of the most widely-respected diets out there. U.S. News & World Report has named it the “Best Diet Overall” for eight consecutive years in its annual diet rankings, and it’s recommended by the American Heart Association, who used it to develop their 2010 Dietary Guidelines.
For me, I chose to become a CDE because I had worked as a Registered Nurse first on a medical unit, then in a Medical ICU. These are the units where most of the people with diabetes are, so I had seen every horrific complication that diabetes can cause. When I had a chance to become a Diabetes Educator…to actually help PREVENT some of those horrible complications…I jumped at the chance!
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.
Eating out is possible on the DASH Diet, but proceed with caution. Restaurant meals are notoriously salty, oversized and fatty, so you’ll need to be conscientious if you dine out. NHLBI suggests avoiding salt by shunning pickled, cured or smoked items; limiting condiments; choosing fruits or vegetables instead of soup; and requesting the chef find other ways to season your meal. You can also drink alcohol moderately on the DASH Diet.
These carbohydrate recommendations are not PER DAY, they are per meal. This is the major difference between Ketogenic diets and a consistent, low carbohydrate diet CDEs advocate for. 30-45 carbs per meal is considered a low carb diet. Eating this in the form of a Mediterranean diet is what I recommend and what my article outlined. In a perfect world, we try to have people steer clear of anything artificial or processed when possible. Just eat fresh foods, like our grandparents did, who never had these types of health problems.
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Now, about that whole low-fat and low-sugar thing. It can be tricky come dessert time, but Gorin has a hack for surviving that as well: "One way to feel like you’re getting the dessert that you crave while still following the diet is to eat a fruit-based 'nice cream,' like my chocolate-banana recipe. By combining frozen bananas and unsweetened cocoa powder, you'll wind up with a treat that resembles the texture of ice cream yet contains no added sugar and also counts toward your daily fruit servings."

Flexibility. A flexible plan doesn't forbid certain foods or food groups, but instead includes a variety of foods from all the major food groups. A healthy diet includes vegetables and fruits, whole grains, low-fat dairy products, lean protein sources, and nuts and seeds. A flexible plan allows an occasional, reasonable indulgence if you like. It should feature foods you can find in your local grocery store and that you enjoy eating. However, the plan should limit alcohol, sugary drinks and high-sugar sweets because the calories in them don't provide enough nutrients.

“When we measured fasting plasma levels, we found low insulin and low glucose, which is good — not suggestive of diabetes,” he says. “However, when we challenged the animals with glucose — giving them a relatively large amount of glucose, as they would get by ingesting a meal — we found that their plasma glucose levels went higher than mice on normal chow and stayed high longer.”
Similar to the CICO diet, the Body Reset has gained popularity via social media, and there isn’t any definitive research that suggests the approach is safe and effective. Celebrity trainer Harley Pasternak created the plan, which is essentially a three-phase liquid diet comprised of smoothies and moderate exercise. While U.S. News notes you may lose weight on the diet, it may be tough to stick with, and isn’t safe for people with diabetes and heart disease. (38)
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
You’ll find that in their meals, they emphasize a plant-based eating approach, loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish. It’s a diet known for being heart-healthy. (1) "This diet is rich in fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil," says Nancy L. Cohen, PhD, RD, professor of nutrition at the University of Massachusetts in Amherst. On this plan, you’ll limit or avoid red meat, sugary foods, and dairy (though small amounts like yogurt and cheese are eaten).
What the expert says: ‘Atkins will result in quick weight loss as the body uses all the carbohydrate stores adults tend to have. But limiting carbs will mean you could be lacking in fibre and b vitamins like niacin, thiamine and b6. Aside from cutting out a major food group, Atkins tends to result in eating a lot of food that’s high in saturated fats, which is linked to raised cholesterol and heart disease.’
I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.

The MIND diet, or Mediterranean-DASH Intervention for Neurodegenerative Delay, is a sort of hybrid between the DASH diet and the Mediterranean diet. It features foods meant to slow the progression or development of Alzheimer’s disease, the most common form of dementia and an incurable neurodegenerative condition that more than 5 million Americans are living with, according to the Alzheimer’s Association. (12) Some research backs up this notion, including a study published in September 2016 in Alzheimer’s Dementia that found a link between following the MIND Diet and a reduced risk of the disease. (13)
I’m sorry…no we don’t. Sure, more studies will happen, and more information is always good. But, we KNOW that keto works. You can argue that all you want…but in truth, facts don’t care about your feelings. There are plenty of studies, both in groups and in individuals, that prove beyond any reasonable doubt that going on a proper keto diet WILL improve your life as a diabetic, and will often allow the person to reverse diabetes completely (type 2, obviously). Not to mention the weight loss and the myriad of other health benefits it provides.

^ 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.


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.
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