The primary outcome, hemoglobin A1c, decreased from 7.5 ± 1.4% at baseline to 6.3 ± 1.0% at week 16 (p < 0.001), a 1.2% absolute decrease and a 16% relative decrease (Table ​(Table4).4). All but two participants (n = 19 or 90%) had a decrease in hemoglobin A1c (Figure ​(Figure1).1). The absolute decrease in hemoglobin A1c was at least 1.0% in 11 (52%) participants. The relative decrease in hemoglobin A1c from baseline was greater than 10% in 14 (67%) participants, and greater than 20% in 6 (29%) participants. In regression analyses, the change in hemoglobin A1c was not predicted by the change in body weight, waist circumference, or percent body fat at 16 weeks (all p > 0.05).
The keto diet (also known as ketogenic diet, low carb diet and LCHF diet) is a low carbohydrate, high fat diet. Maintaining this diet is a great tool for weight loss. More importantly though, according to an increasing number of studies, it helps reduce risk factors for diabetes, heart diseases, stroke, Alzheimer’s, epilepsy, and more1-6.On the keto diet, your body enters a metabolic state called ketosis. While in ketosis your body is using ketone bodies for energy instead of glucose. Ketone bodies are derived from fat and are a much more stable, steady source of energy than glucose, which is derived from carbohydrates.

Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”
If you've been trying to eat healthy for a long time, you know how quickly you get sick of chicken breasts and broccoli. Break out of your diet rut with the Middle Eastern diet. It's based on the same principles as the Mediterranean diet but with more of an emphasis on plant-based foods and a different flavor profile. With all the tasty and healthy spices, you'll never get bored of making dinner and you'll get all the same heart-healthy benefits as its geographical cousin's diet.
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.

2. A strong, healthy heart. Eating Mediterranean decreases practically every heart-disease risk factor -- high blood pressure, cholesterol, and triglyceride levels. When 605 patients who'd had a first heart attack followed the diet for four years, they had a 50 to 70 percent lower risk of having a second heart attack, angina, or a stroke or pulmonary embolism. "There's no single aspect of the diet that keeps your heart healthy," says Dr. Stampfer; it's the synergy of all the diet's elements. Antioxidants in fruits, vegetables, and beans help prevent the atherosclerosis that can make plaque build up in arteries. Omega-3 fatty acids in fish lower blood pressure, arrhythmia risk, and triglyceride levels. Olive oil lessens LDL ("bad") cholesterol. And wine and other spirits in moderation may lower heart-disease risk.
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!
Another weight-loss-friendly substitute to keep in mind is favoring salsa over ketchup. While ketchup typically has around 19 calories and 4 grams of sugar per tablespoon, fresh tomato salsa has about 5 calories per tablespoon, no added sugar, and is packed with nutritious veggies. Tomatoes, for example, are loaded with fat-blasting fiber and vitamin C, a deficiency of which has been associated with increased body fat and larger waists. If you can handle spice, toss some jalapenos in your salsa to rev up your metabolism. For more on how you can switch your metabolism into overdrive, check out The 55 Best Ways to Boost Your Metabolism!
The Keto diet versus Plate Method study triggered some challenges and a bit of criticism. In an editorial, Andrew Reynolds, PhD, a postdoctoral research fellow at the University of Otago, New Zealand, suggests that the much better results in those on the ketogenic diet may be due not to the diet itself but to the lifestyle changes and ongoing support that keto diet group received.5
Stephen Colbert may be on to something. UCLA Center for Human Nutrition researchers divided study participants into two groups, each of which were fed a nearly identical low-cal diet for 12-weeks. The only difference between the groups was what they were given to eat as an afternoon snack. One group ate 220-calories of pretzels while the other group munched on 240-calories worth of pistachios. Just four weeks into the study, the pistachio group had reduced their BMI by a point, while the pretzel-eating group stayed the same, and their cholesterol and triglyceride levels showed improvements as well.

Cons: In our experience, capping your calories low will probably mean a lot of internal strife and stress. Plus, we’re big fans of enjoying food instead of fearing it, and 800 calories doesn’t leave much room for satisfied taste buds. Lastly, if you’re currently eating double to triple this amount of food, dropping to a daily caloric intake this low can tank your metabolism and actually slow weight loss more than switching to one of these other diets might. (Curious? Here’s why starving yourself won’t help you lose weight.)

Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar and handling illness.[18] The level of parental education and commitment required is higher than with medication.[43]
The keto diet is NOT what you seem to picture. I laughed at your description as I was eating lamb chops, cauliflower rice, broccoli, followed by cheesecake. How deprived I was! You should relook at what the diet really is. By the way, my cardiologist highly recommends keto. Most people see a drastic decrease in their triglyceride/HDL ratio. Looking at total cholesterol or LDL alone is 20 years out of date! Even the AHA has caught up, and now says that it’s NOT how heart health should be judged.
What the diet advocate says: ‘It essentially means scaling your carbohydrate intake up and down in accordance with your activity levels,’ explains performance nutritionist Liam Holmes (phnutrition.co.uk). He uses the principles of nutrient timing to get elite athletes and CrossFit enthusiasts to their leanest before competitions. ‘The body works harder when it doesn’t have carbs as fuel, so it learns to become a more efficient burner of the fuel once it is there.’
I'm going to give the DASH diet a try. It sounds easy enough but haven't actually tried it yet. I enjoyed the book and am anxious to start the plan. I don't necessarily agree with the artificial sweeteners used. The book does have some good recipes that I want to try. I do think it's a good basic diet that you can adapt to fit your likes and needs. And as always including exercise with a diet will always help. This will hopefully help to accomplish one of my goal for the new year.

You say keto is a highly controversial topic. For those of us following a keto diet, there is no controversy whatsoever because the diet proves itself efficacious very quickly. I think the real controversy comes in because the ADA has been recommending dangerous levels of carbs for decades now, and they would lose face if they had to change their recommendation and admit they’ve been wrong for so long. You say there are not many studies on the keto diet, and I disagree with you. You’ll find the evidence if you look for it. Eric Westman, Steve Phinney, Jeff Volek and many other researchers have written volumes about this.
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.
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.
Sodium reduction is part of the DASH equation, but it’s not the only focus. Eating by DASH  recommendations also increases your intake of potassium, calcium, magnesium and fiber—all nutrients that play a role in cardiovascular health, as well as the prevention of other chronic diseases. It’s thought to be the combination of increasing your intake of these nutrients and decreasing your intake of added sugar, salt, sodium and unhealthy fats that leads to lower blood pressure and a laundry list of other long-term health benefits.
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It is important to note that the research did not analyze whether the diet employed causes obesity, if given long term. The mechanism behind the whole process was undetermined; therefore, the existence of a shared physiological response between low carb and regular carb high fat diets that cause insulin resistance in the liver requires further exploration.

If it all feels a little bit 90s, that’ll be because this was basically the diet that kept Rachel from Friends looking, well, like Rachel from Friends. Think of it as the 20th-century version of no carbs before Marbs. Thankfully though, the old premise of each as much as you want, as long as you don’t go near a carb, has had a makeover. The New Atkins diet reintroduces carbs in phases.
During the 14 days of Phase 1, you will learn how to satisfy your hunger and, as a result, feel fuller longer. To regulate your blood sugar and help curb your cravings, avoid fruit and whole grains, which have a lot of natural sugar, and alcohol, which also contain sugars. That said, you can enjoy 2-3 servings of low-fat dairy per day. This would include 1 cup of skim milk or low-fat yogurt. Avoid regular or even fat-free cheese because they are often high in sodium.
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
The keto lifestyle sounds daunting, but it really is not. One thing many fail to mention is the hormonal shifts that occur that regulate your appetite. Give this a little time, and you will be astounded at how easy it becomes to pass on the stuff you found addictive previously. There are many factors that influence one’s success or failure, and the key is to get the information and support you need, and to stick with it long enough to see the benefits. I fine this way of eating completely sustainable, and I’m in for life.
Now, I know what you are going to say, “I can take a break from the diet anytime.” What do you think happens when you take that “break”? As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketosis or the fat burning state, and your body starts storing fat again immediately. In other words, you immediately start gaining weight. So whatever weight you lost on the diet, you gain back right away. How healthy do you think it is for your body to be in a starvation mode, then in a feeding frenzy, making up for lost time?

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

Emerging evidence suggests that eating this way may offer protective effects for those with and at risk for type 2 diabetes. For one, Mediterranean eating improves blood sugar control in those already diagnosed with the condition, suggesting it can be a good way to manage the disease. What’s more, given those with diabetes are at increased odds for cardiovascular disease, adopting this diet can help improve their heart health, according to a paper published in April 2014 in the journal Nutrients. (4)
Grains and beans are high in lectins, and it’s no surprise that the top allergen foods also have a high lectin content. The lectins in nightshade vegetables can be troublesome for some people, while others handle them just fine. Cooking and peeling removes some of the lectin content in vegetables (but not grains, they’re pretty heat stable), but some super-sensitive people have to avoid them completely.
As a Certified Diabetes Educator, I was taught to educate my gestational diabetes and pregnant patients with diabetes to avoid fruits and dairy before noon. I know this is hard! That’s when you all are craving that glass of orange juice, but that’s the whole point here. We need you to give up that orange juice for the next six or so months for the sake of your baby. Instead, you can have a real orange with lunch; try it with a spinach salad with tuna salad and whole wheat pita. The nutritional value is pumped up by all those vitamins and the spike on your blood glucose will be reduced dramatically by the fiber in the real fruit combined with the protein you had in your lunch. You can even have a glass of milk; you’ve included all of your necessary food groups, and you are still only at 45 carbohydrates for the whole meal!
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?

Pros: Technically a subtype of low-carb diet, the keto diet is unique: By depriving your body of carbohydrates, you not only force your body to become fat-adapted, but also, if you keep protein low as well, elevate your levels of ketone bodies, which is basically a sign your body is running on fat. The keto diet puts you in a unique metabolic state called ketosis wherein your brain burns ketones instead of glucose—and, in doing so, supposedly leads to clearer thinking. Physically, eating such a high amount of fat significantly increases your body’s ability to burn body fat, according to the study analysis. Research also shows keto athletes have a higher VO2 max, and are able to lose fat without losing strength or power.
How many times have you heard a doctor specifically name a diet that fights heart disease and helps you lose weight? By name? We’re always told to eat healthy, maybe you are given a list of foods to add or avoid but from that point it’s on you to bring the meal plan together. Not with the Mediterranean diet. “This diet is for anyone but specifically for those with high blood pressure,” says Susan. “This is a low sodium, low fat, low cholesterol diet. It’s also ideal for those that are at risk for developing cardiovascular disease. It’s also great for weight loss or management, so if you are looking to shed a few pounds this is a great diet to embrace.”
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
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].
“Think outside of the box when you’re preparing what to eat. I wake up every day excited to eat breakfast because I love the foods I've bought and prepared and can't wait to savor them,” Moreno says. Instead of boring oatmeal in the morning, which Moreno calls, “Oliver Twist food,” jazz it up. “Try oatmeal with vanilla protein powder, walnuts toasted in ghee, and cinnamon, that’s much more exciting.”

Now, I know what you are going to say, “I can take a break from the diet anytime.” What do you think happens when you take that “break”? As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketosis or the fat burning state, and your body starts storing fat again immediately. In other words, you immediately start gaining weight. So whatever weight you lost on the diet, you gain back right away. How healthy do you think it is for your body to be in a starvation mode, then in a feeding frenzy, making up for lost time?
There is research that supports the ketogenic diet for diabetes management, while other research seems to recommend opposing dietary treatments like a plant-based diet. Research from 2017 confirms that people with diabetes who followed a plant-based diet experienced significant improvements in blood sugars and A1c, cardiovascular disease risk factors, gut bacteria that is responsible for insulin sensitivity, and inflammatory markers like c-reactive protein.
Recent studies have also shown that garlic supports blood-sugar metabolism, and helps control lipid levels in the blood. What’s more? Eating garlic can help boost your immune system, help ward off heart disease, fight inflammation, increase memory retention, and lower blood pressure, so consider adding some to your next meal. At the very least, it is preferable over salt, which can lead to water weight gain and bloating.
Following are two examples of menus from the book, The DASH Diet Weight Loss Solution. It features 28 days of meal plans, to help you visualize a variety of ways to put together the DASH diet. They are suggestions, and you are free to make substitutions with your favorite foods that have similar nutritional properties. This is part of the way that you will learn how to make the DASH diet into your own personal plan.
Choose Liquid Calories Wisely. Sweetened drinks pile on the calories, but don't reduce hunger like solid foods do. Satisfy your thirst with water, sparkling water with citrus, skim or low-fat milk, or small portions of 100% fruit juice. Try a glass of nutritious and low-calorie vegetable juice to hold you over if you get hungry between meals. Be careful of alcohol calories, which add up quickly. If you tend to drink a glass or two of wine or a cocktail on most days, limiting alcohol to the weekends can be a huge calorie saver.
This is a great site for information, details, recipes, etc… one of the reasons I started looking into this way of eating is my husband suffers from high blood pressure, cholesterol and type 2 diabetes. We are not exceptionally overweight, however could both use to lose 10-15 lbs/ea. I also have facial and ocular rosacea and have heard good things about this way of eating for an overall improvement in numerous areas. Although I may have missed it I haven’t seen anywhere you might have mentioned your weightloss success. Thank you for sharing your wealth of information.

"We recommend against 'dieting', which is invariably a short-term solution," Dr. Gonzalez-Campoy, tells EndocrineWeb, "and since weight loss may be accomplished by a reduction in calories by any means, a ketogenic diet that restricts carbs is simply shifting the calories away from foods that typically demand insulin as in both of these studies.1,2  

And while the diet wasn't designed with weight loss as a primary goal, it's no secret that many of the nutritional factors that influence blood pressure also influence weight, she says. Think: processed foods, trans fats, and excess sugar. According to one DASH study, adults who who followed the diet lost more weight in a span of eight to 24 weeks than those adhering to other low-calorie diets. (Kick-start your new, healthy routine with The Woman's Guide to Strength Training!)

Body Fat Reduction. According to the current research literature, both visceral and subcutaneous fat play a role in the development of type 2 diabetes. [22] To keep our fat cells from fighting against us, we must adopt a healthier lifestyle that prevents us from being in a calorie surplus and gaining weight. The keto diet is one lifestyle change that has been proven time and time again to help us lose fat and improve metabolic health.  [24]
Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed]
The average American consumes approximately 15.5 pounds of pasta each year—and most of it is the refined white stuff. Unfortunately, this type of noodle is usually void of fiber and micronutrients. Spaghetti squash, on the other hand, boasts only about 40 calories per cup—more than 75 percent fewer calories than a cup of plain pasta—and is an excellent source of vitamin A and potassium. Make this simple swap to jumpstart your weight loss and you’ll be fitting into your skinny jeans in no time! For more swaps to save you calories, don’t miss these 25 Food Swaps That Cut 2,500 Calories a Week.
Both the Mediterranean and DASH diets are plant-focused diets, rich in fruits and vegetables, nuts, with low-fat and non-fat dairy, lean meats, fish, and poultry, mostly whole grains, and heart healthy fats. Perfect together. You fill up on delicious fruits and vegetables, paired up with protein-rich foods to quench your hunger. This makes a plan that is so easy to follow. Learn about the Mediterranean diet and the DASH diet plans and browse sample menus.
There are many physiological reasons for eating enough carbohydrates throughout the waking hours to maintain a steady blood glucose level…a couple of important reasons are to minimize the hepatic release of glucose (from the liver) and to help prevent hypoglycemia which can be very dangerous and lead to hypoglycemic unawareness over a short period of time. Each person is different of course..if you aren’t taking insulin, or pills that lower your blood glucose levels, you may not have to worry about low blood sugars. The reality is, most people with diabetes do; it can be very dangerous for some to not get enough carbohydrates at each meal.
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.

The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
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