The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
These are great additions to the low carb pantry. No need to give up wonderful baked goods and live low carb. I use them all the time. I have also tried many of Carolyn’s recipes that use nut flours and coconut flour. They are awesome! You can easily take them to parties where people are expecting flour-baked goods and fool them. Thank you Carolyn for your many contributions to the low carb lifestyle!
Hi Jan, Sorry they didn’t work for you. It’s hard to say what happened without being in the kitchen with you. Did you use exactly the same ingredients and amounts? Also, if they were not cooked, then they probably needed to be in the oven for longer. If they were clumpy, it’s also possible that the almond flour wasn’t fine blanched (it needs to be) or the batter wasn’t mixed well enough. Hope this helps.
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 who 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 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 children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]

Hi Jan, Sorry they didn’t work for you. It’s hard to say what happened without being in the kitchen with you. Did you use exactly the same ingredients and amounts? Also, if they were not cooked, then they probably needed to be in the oven for longer. If they were clumpy, it’s also possible that the almond flour wasn’t fine blanched (it needs to be) or the batter wasn’t mixed well enough. Hope this helps.
If you love eggplant, this recipe’s for you. If you don’t love eggplant yet, you will after whipping up this pasta-free dish. It comes together quickly for a lasagna that’s got all the flavor of the familiar version without the carbs. It’s also insanely flexible: peel or don’t peel the eggplant and make the slices as thick (or thin) as you like. Use jarred pasta sauce to speed things up even more.

As a newbie to Keto, and after perusing many Keto websites, I find yours to be the most satisfying in many ways. Your recipes are down to earth desirable substitutes for the things we hate most to switch from in a regular diet. And I was thrilled to see your breakdown of the carb friendly items in these easy to use tables. It is very difficult at first to dial in the macro percentages needed daily, because one might focus on a low carb item, to add for the day, only to find out that the protein blows your schedule. So tables are a very concise and effective snapshot of what one might add in any meal segment. I would love to see similar tables reflecting the protein in different food groups and also one reflecting sugars. With those three printed out and in front of me, it would be a lot easier to navigate the landscape. Thanks for the time and effort you put into this.
The trick to working with coconut flour is accepting the fact that it requires a lot of eggs to give it structure and a decent consistency. It can be a little shocking to see half a dozen to a dozen eggs in a recipe, but as you try it out, you will see that it works. The end results are rarely too eggy or rubbery. You will also be surprised to see how little coconut flour is used in most recipes. It’s incredibly dense, but expands remarkably with the added eggs and liquid, so you typically only need about a third of the amount you would need with conventional flour or nut flours.

I have been reading all the above comments about the gluten verse other ingredients. As a pastry chef, the information that has been missing here is that not only is gluten a protein, it is also the “elastic” that holds the pasta together. 80% of the proteins in flour are called glutenin and gladin. When combined with liquid, they form the elastic substance called gluten.
Hi Cathy, are you adapting these recipes yourself or are they already developed using coconut flour? From experience, it takes a lot of attempts to get it right (but fun too, it brings out the scientist in me). Coconut flour requires a high number of eggs for volume, thickening, protein, binding, and structure. I would be worried if there was too much avocado in there as that is just adding a soft ingredient that gives no structure. The sweet potato would add volume but unless there is enough eggs and coconut flour in the recipe, again it won’t add to the solidity of the final recipe. Psyllium I add purely to get a better crumb texture. It swells and thickens and helps bind all the other ingredients together nicely. Scones – they won’t have risen because of the lack of gluten (yay), but I quite like heavy scones as a personal choice. I started baking using recipes that had already been developed using these low-carb flours, and start by adjusting the flavours only not the ratios of the bulk ingredients. You will soon get the hang of them. Start with my flourless berry sponge, I use these ratios all-the-time! Yum.
I’d heard recommendations of using only egg whites with psyllium, but whole eggs are more convenient. Besides, egg yolks are a natural leavener, so including them, makes the bread rise better in combination with the baking powder. Fortunately, whole eggs worked! It turns out that my friend, Lisa from Low Carb Yum, used whole eggs in her coconut flour psyllium husk bread, too.
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?

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Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
I made these this morning but subbed coconut milk in for the almond milk since I didn’t have any on hand. I also used a little less sugar substitute since I hate that cooling effect it has and I added some ground cloves and nutmeg. They were SO good! I’ve tried a few keto recipes and have not had too much success, but this one is GREAT! Even my son who is super picky really loved them.
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).

Hi Lee, A blender might also work, if it’s powerful enough to chop up nuts. You’ll still want to use a pulse-stop-pulse method, and may need to stir between pulses. Otherwise, you can also try chopping up the nuts and seeds before mixing with the other ingredients. If you go that route, the resulting granola texture will be a little different compared to a food processor. I used a food processor partly because it makes both prep time and cleanup a lot faster, but also because that way you get a mix of larger chopped nuts and finer powder. I hope one of the other methods works out for you!
Several studies have investigated the potential of LCD or KD on weight loss. For example, Brinkworth et al. (2) compared one year of low-fat (LF) vs. LCD diet in adults with abdominal obesity. Subjects were randomly assigned and diets were isocaloric, with moderate energy restriction. Both groups realized significant weight loss, however, there was no significant difference between groups, suggesting that a LCD was equally effective as a LF diet.
Cinnamon toast crunch is the best cereal by a long shot and I can guarantee this by asking anyone and everyone if it was a part of their childhood, and even adulthood. It is, without fail, the cereal I see the most people purchase when I am at the grocery store. We knew that if we were going to attempt a low carb cereal we would need to pick one that everyone could undoubtedly agree upon as the best, so we decided on Cinnamon Toast Crunch.
So I replaced a lot for these donuts. Replaced butter with coconut oil. Replaced sea salt with table salt. Replaced erythritol with stevia. Used imitation vanilla. And used sweetened almond milk. The donuts came out okay. Obviously not comparable to wheat flour, not as soft. And I used stevia/cinnamon for the toping along with melted coconut oil which I didn’t like. The donut is definitely a great replacement for diabetics, which is why I’m making them. I’m not sure how the erythritol tastes as a topping but the stevia was not great. I made 6 decent size MUFFINS. Yeah I filled the donut pan too high and they look like muffins. What I plan on doing is using the little divot (the hole that was cooked over) and filling it with sugar-free preserves. That will be amazing. A much improved desert over toast with jam. So it is pretty good, but not as great as “real” donuts.
Check nutritionally-complete low-carb menus with under 50 grams of net carbohydrate per day to see what a ketogenic diet could look like. These menus are, however, going to be too high in protein for some people to remain in ketosis, and some of them may be a little high in carb if you have very poor carb tolerance. Keep in mind that ketogenic diets should always be tailored to the individual.
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]

I think I might have been in ketosis sooner but after 1 month I took my blood test at night and I was surely in and I had felt all the good effects of it too, like no hunger between meals etc. It wasn’t difficult to reduce the carbs to 20 net because you’re replacing it with good healthy fat which is so filling. I think my body likes to hold on to the fat as stubbornly as yours and I agree stress doesn’t help, but I have always been a slow loser. I’d suggest taking measurements and body fat and pictures so you can see the difference. If you really think you’re not progressing you may have to reduce calories too.
Elisabeth Almekinder, a certified CDE and expert in Diabetes Self-Management Education Program, grew up in a small town in the piedmont of NC. During her time at St. Andrews Presbyterian College, she developed a love of writing and obtained a BA in English. After obtaining her nursing degree, her first job out of school was on the vascular surgery floor, where she saw many people with diabetes lose their limbs. She worked as an RN for 22 years in public health in South Carolina. In her spare time away from educating people about diabetes, she continues her passion by writing about diabetes.

My favorite sugar-free low carb BBQ sauce is a family recipe that I tweaked to make keto friendly. It is simple to prepare without a lot of added ingredients that aren’t necessary. You can find my recipe here. If you are looking for convenience, there are several brands that make a sugar-free variety that can be ordered from Amazon or you may find in your local stores. The only brand of store-bought sugar-free bbq sauce I have tried is by G. Hughes. They offer several different varieties, but I prefer hickory. I might be a little partial, but my homemade BBQ sauce makes this recipe taste much more authentic and flavorful.
Hi Joellen, It doesn’t rise as much as a wheat bread but does a little. The almond flour being frozen might have made it worse, I’m not sure – I don’t store mine there since I go through it a lot. I’m glad you like the texture. If you want a taller loaf, you can multiply the recipe by 1.5 or even double it, but would need to increase the cook time and probably cover it to prevent browning the top too much before the middle is done. 

I swap out the Erythritol and 100% cacao for 2 squares of 90% cacao (I’ve been using a Lindt candy bar; they were on sale). I use just a bit over 1/8 tsp. of baking powder. I add a touch of pink Himalayan sea salt. I microwave it for 42 seconds (1100 watts), Set a Tbsp. of peanut butter on top, make my coffee (gives the peanut butter time to soften/melt), dump the measuring spoon out and spread it around a bit. Absolutely perfect. (note: this is a VERY DARK CHOCOLATE TASTING CAKE, if you don’t usually eat dark chocolate, you will want to stick with the original recipe!)
I recently started using Carbquik and overall, I'm pleased with it. I'm on a low-carb diet, and my dining options have really opened up! So far, I've made cheese biscuits, pizza dough, and pancakes. The pizza dough isn't great, but if you use the right kind of pizza pan and roll it thin enough, it's certainly acceptable and it beats not being able to have pizza at all.
The ketogenic diet, or keto, relies on using your fat as fuel, instead of glucose from carbohydrates or protein. Simply put, the daily ketogenic diet consists of 75 percent fat, 20 percent of protein, and a teeny allotment of carbohydrates, about 5 percent. This balance of macronutrients is intended to put your body in a state of ketosis, which suppresses the release of insulin and blood glucose levels. The benefits of ketosis to your health are improvements in biomarkers like blood glucose, reduction of blood pressure and decreased appetite due to fullness linked to consumption of fats.
After initiation, the child regularly visits the hospital outpatient clinic where they are 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[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] 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.[19] 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).[45]
It was worth the try since so many of the recipes on this site are wonderful — but I’ll make a little real pasta for an occasional cheat day, or I’ll just add lots of sauteed mushrooms to the bolognese sauce and just have a bowl of sauce. If I try this again I’ll shape the dough into small gnocchi and serve with a butter- or cream-based sauce. That might work because I won’t be thinking “pasta.”
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]
First, you DO NOT need a silica mat. I made these in a huge oven-safe frying pan sprayed liberally with cooking spray and it worked great. After the five minutes cooking time, I took the pan out of the oven and just let it sit. Everything firmed up nicely, I lifted one edge of the “noodle” and the whole thing peeled out beautifully. I rolled it up and sliced into fettucine and it worked AWESOME. I also added a pinch of Kosher salt, a pinch of black pepper, and a half pinch of garlic powder to the batter. ABSOLUTELY PERFECT. These are NOODLES folks, not slimy oddly-textured whatever-the-hecks, but real noodles. The texture is just right. These are what I’ve been looking for forever. God bless you for this!!!!!. We’re having pot roast for dinner, and while my girls have noodles with their sauce, SO WILL I!!!!!!

If you’re one of the lucky people that have a dehydrator, you can take serious advantage of it by dehydrating thin slices of vegetables overnight (normally 12 hours) to get crisp, perfect vegetables that you can eat as snacks. Do this with zucchini, radish, or jicama. If you’re not lucky enough to have a dehydrator (like me), then you can easily make cheese chips in the oven and flavor them with your own spices!

Non-GMO low-carb pastas are a good option if you're concerned about the potential effects on your health of consuming genetically altered ingredients. Though there are competing views in the scientific community with regard to the long-term safety of regular GMO consumption, many choose to eat only non-GMO products as an extra-cautious measure. Similarly, organic low-carb pastas that include ingredients that haven't been treated with or exposed to chemicals are easy to find.
Hi Mona, While I can’t offer medical advice, I definitely think this bread is better for you than regular white or wheat bread. But, 5-6 pieces a day might be pretty high in calories and displace other nutrients as a result. I usually recommend focusing on a diet of whole foods, especially vegetables, eggs, meat, and healthy fats, with smaller amounts coming from nuts, nut flours, dairy and fruit. Of course each person’s needs are different and your doctor would know better than me what is best for you.
At 60 minutes, the bread showed as done with a toothpick. Removed it from the oven and it sank down the center. I waited 15 minutes. Cut a piece off and it was wet, like not done in the center. I baked it 15 more min and it stayed the same. Is it supposed to be wet/moist like, maybe it’s oily from the coconut oil? If it’s supposed to be completely dry but moist, not wet, then something went wrong.
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].

I just made these and followed the advice of another comment. I added a scoop of vanilla whey protein and a scoop of sour cream. I did not have a donut pan so used my regular sized muffin tins. I buttered the tins very generously. I filled half full and it made 10. I shortened the baking time to 13 minutes which was perfect. I made a glaze of heavy whipping cream and powdered swerve for half and the cinnamon sugar combination for the other half. They are fabulous!

The only issue with keto, is really that I’m afraid that it might be hard to up my calories to a maintenance weight now that I’ve gotten a taste preference for the rich assortment of foods with no carbs in them. I’m satisfied with less calories than I will need after my excess fat is burned off… but , maybe I bet my body will send more hunger signs once there isn’t anymore body fat in the cupboard to use instead of what goes down my throat.
Try to replace all soda and juice consumption with something that has no sugar or only trace amounts of sugar. Switch out fruit juices for low-carb smoothies and tea. Tea comes in a variety of flavors that can help you get through the day if you get tired of water. There are a variety of different smoothies you can make for a meal replacement or as a quick snack as well.
Ketogenic cereals can be a bit of a challenge, so why not try out this blueberry one! It is crunchy and delicious and has all the slow release energy you will need to get through the morning. This makes a great after-school snack for kids and helps them get away from sugary snacks. If you like this one you could experiment with other flavors – for example, try cherry extract instead of blueberry!
I make this recipe ALL the time. It’s so good and I’m always bummed out when run out of it. Luckily it is so quick and easy to make. It’s a great low carb cereal and I always double or triple the recipe. (Note…I use half the butter per batch and just mix it longer in my food processor until it all comes together and it comes out perfect every time.)
I was a vread and sweet person as well. Once you start you will not believe that you don’t crave those things. It was not hard as I thought but what helped with the lack of cravings is starting my day with the coffee, ghee and tablespoon of coconut/mct oil. I don’t do heavey cream . Once you begin youll see thats the least worry you will have. You can do it

From the study itself: “Mortality increased when carbohydrates were exchanged for animal-derived fat or protein and mortality decreased when the substitutions were plant-based … Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.”

One of the central questions new adherents to the ketogenic diet must answer is whether or not they want to incorporate meat into their new diet. It is entirely possible to consume adequate levels of healthy fats whether you approach the diet as an omnivore or a vegetarian, so this decision is largely a personal one. However, if you choose to incorporate meat into your version of the ketogenic diet, it is crucial to ensure it is grass-fed, organic, and free of antibiotics. Furthermore, it is important to focus primarily on above-ground leafy vegetables, with meat serving as a side dish. An example of the perfect plate for a keto omnivore would be a sizeable portion of colorful, above-ground leafy vegetables covered with a healthy fat like olive oil, paired with a 3-5 oz serving of high-quality meat.
Place sheet pan in a preheated oven at 475°F and lower heat to 350°F. Bake for 5 to 8 minutes. Watch closely as you need to avoid overcooking. If small bubbles start to appear, lower heat to 300°F and continue baking for 2 to 3 minutes until all sides and center are done. (You can test for doneness just like testing a cake with a toothpick, if you wish).
If you are a coconut lover you will really love this hot cereal in the morning. This is one of the best breakfast cereals you can have, especially on a colder day, as it gets you filled up and heated up at the same time. It has a rich coconut flavor which is complemented by the vanilla and is sweet enough to satisfy a sweet tooth, and with only two grams of carbs in each serving, it is definitely low.

If you are trying to get the kids to eat healthier and not rely on sugary cereals you might find this keto one will win them over. It has a great texture from the nuts and seeds and has a sweet warming flavor from the cinnamon and sweetener. This cereal is great with your choice of milk or can be made a bit more filling by adding in some fresh berries.
I am post menopause and I did lose about 40 lbs. Then I stalled and stalled. I was too hot all the time and was having sleep issues. I added more carbs and was better. I attempted keto/ low carb again in January. Two weeks in I had the same symptoms. It is not uncommon. It works well for some but not for me and a few of the other women at my gym. I liked what I was eating and I stuck to it through the stall but no. With the guidance of my trainer I have modified it, lost weight and feel great. Sleep helps!
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