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)?

Creaming the butter properly with the sweeter is paramount here to build a nice structure for the cookies (think rise and crunch!). And creaming with sweetener, in case you haven’t done it before, takes a bit longer to incorporate than with good-old sugar. But don’t give up, and keep going until you’ve got the sweetener well incorporated into soft and fluffy butter.
I have only been on a Keto diet for a couple of weeks, but I have found some great recipes on your site and have loved them all! Today I made these donuts and then frosted them with your Low Carb Keto Cream cheese frosting. I followed both recipes exactly as written and had great results. Thanks so much! I thought I would never be able to give up sweets, but now I do not have to and I am so relieved.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
Once I tried it, though, it quickly became a favorite throughout my childhood. But instead of breakfast, one of my favorite parts of the day was sitting down with a bowl of cereal in the afternoon – be it with my latest art project, in front of the TV, or even a homework assignment. I had the house to myself, and that “me time” between school and evening activities was this introvert’s bliss.
First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
One of the most powerful tools available to individuals on the ketogenic diet is fasting. Caloric restriction forces the body to burn through all of its available carbohydrates. Therefore fasting serves as an excellent kick start for getting the body into ketosis. Furthermore, periodic fasting while the body is in ketosis helps maintain that state because it keeps carbohydrate levels in the body negligible. Not to mention, fasting has been practiced by many cultures for thousands of years, and has numerous health benefits, generally, and is an incredibly powerful tool for improving brain health, specifically.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
For those who prefer to weigh ingredients rather than volume measure everything, here are my weights: using Honeyville almond flour, 2 cups is 6.5 ounces; and NOW brand psyllium husk you need 1 ounce. (I have the husks so I ground some to a fine powder in my coffee/spice grinder and measured 1/4 cup of the powder, which weighed 1 ounce or 31 grams. In future, I will just weigh 31 grams of husks into the grinder and know I have the right amount.) A quarter cup of coconut oil, like other fats, weighs 2 ounces.
In relation to overall caloric intake, carbohydrates comprise around 55% of the typical American diet, ranging from 200 to 350 g/day. The vast potential of refined carbohydrates to cause harmful effects were relatively neglected until recently. A greater intake of sugar-laden food is associated with a 44% increased prevalence of metabolic syndrome and obesity and a 26% increase in the risk of developing diabetes mellitus. In a 2012 study of all cardiometabolic deaths (heart disease, stroke, and type 2 diabetes) in the United States, an estimated 45.4% were associated with suboptimal intakes of 10 dietary factors. The largest estimated mortality was associated with high sodium intake (9.5%), followed by low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%), low intake of omega-3 fats (7.8%), low intake of vegetables 7.6%), low intake of fruits (7.5%), and high intake of artificially sweetened beverages (7.4%). The lowest estimated mortality was associated with low polyunsaturated fats (2.3%) and unprocessed red meats (0.4%). In addition to this direct harm, excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains,  fruits, and vegetables.
I really appreciate this article. I have done low Carb for the most part for over 15 years and was able to keep my weight down. Now that I have gone through menopause is just keeps getting harder. I try doing keto but tend to fall off the wagon a lot and go back to low Carb or Weight Watchers. Simple ideas would be great. I think some keto bloggers make it seem that you have to create difficult recipes. Thanks for all you do.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Hi Roseanne. It can be hard to start especially when stressed out. Here is an idea to help you ease into a low carb lifestyle. First, know that I am not a nutritionist nor a doctor. There were times I thought I would go out of my mind without a piece of low carb cheesecake in the morning. I’m not a big egg eater and that saved my life until I found how easy quiches were to make and how much I loved them. If you are craving something, eat something – as long as it is low carb. There were days I ate all day long – there were also days I ate very little. For me it was all or nothing. Cheat days didn’t work for me because they brought back cravings. If you are stressed out and need something sweet – make a protein smoothie with ice (look at my smoothie bowl recipe). It is much better to go a little over your calories and carbs than to have a pig out. I hope these simple ideas help. Have a wonderful week and good luck. -Kim
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!
These low carb egg noodles have the texture of homemade egg noodles. Although they aren’t gluten free they have 0 carbs for a generous serving. They are easy to make with just three ingredients! Use them any way you’d use regular pasta; in soups, casseroles, and with any low carb pasta sauce. They are especially good with the easy Alfredo Sauce recipe right here on Lowcarb-ology.
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.
I tried to make the egg noodles and it was a total failure. Followed the directions without any substitutions.’ Not sure what happened. The texture was off. It was nearly impossible to remove from the pan and I used the latex mat and sprayed as well. It was mushy and seemed undercooked. I was disappointed because I had made the sauce and was ready to eat. It looked like the mixture was set and cooked, Perhaps my oven is off.

Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
The macronutrients of zoodles are about 5 net grams of carbohydrates, zero fat and around 3 grams of protein per cup. The health benefits of zoodles make them perfect for anyone diagnosed with diabetes, trying to lower their blood sugar or otherwise following a ketogenic diet. They are packed with a number of vitamins and minerals — vitamins A, C, B and potassium to name a few[*].
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.
You can find all my recipes on the main landing page of my website. There’s a search bar at the top and you can type anything you’re looking for, if I’ve made a recipe for it you’ll see it. Also there’s a tab at the top of the page that says recipe index and a ton of categories for you to find what you’re looking for. If you want to never miss a new recipe, I post twice weekly, you can subscribe to my website by adding you email address in the middle of the landing page, that says, Never Miss a Recipe. Hope that helps!
Nutritional ketosis has been proposed as a mechanism through which hunger may be suppressed. A recent meta-analysis investigated the impact of diet on appetite and shed some light on this possible phenomenon (11). The meta-analysis included 12 studies which investigated the effect of either a very low energy diet (VLED: defined as <800 calories per day) or ketogenic low-carbohydrate diet (KLCD: defined as CHO consumption of <10% of energy or <50 g/day, but ad libitum consumption of total energy, protein and fat). Interventions ranged from 4 – 12 weeks and weight loss was from 5.0 to 12.5 kg. In all studies nutritional ketosis was confirmed in VLED and KLCD via circulating levels of β-hydroxybutyrate. Interestingly, both groups reported decreases in appetite. The results of this meta-analysis are noteworthy in two regards. The VLED groups were clearly and significantly hypocaloric, suggesting a state in which hunger should be increased, not decreased. Similarly, the KLCD groups experienced simultaneous reductions in weight and appetite, while eating an ad libitum diet. The results of this meta-analysis provide support for the theory that nutritional ketosis may exert an appetite suppressing effect.

There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
A creamy, cheesy alternative to typical mac and cheese, it’s not a stretch to think this version is preferable to using elbow pasta, no matter what your relationship with carbs may be. Boil cauliflower, whisk up a cheese sauce, and throw it all in the oven. For a fancier twist, use your favorite non-cheddar cheeses or a combo (mozzarella and pepper jack, anyone?)
I’ve done the micro version for slices and it was quite good. Today trying the loaf recipe – but with the micro version and this one my mix never comes out like a batter – more like a moist dough. Any ideas what I may be doing wrong please? I have to say though that you are wonderful giving me a non carb bread – my husband loves bread and needs to lose weight. Many thanks!
I am trying to get back into keto. I did it before and I was so happy when I lost 10lbs (I did the keto for a month). I am ready to go back to this lifestyle. All this information is very helpful, I have written it all down so it can be easier for me to remember what is allowed and what is not. Looking forward to get back on this keto journey. Thank you for all the great info.

Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
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. 

Nutritional ketosis has been proposed as a mechanism through which hunger may be suppressed. A recent meta-analysis investigated the impact of diet on appetite and shed some light on this possible phenomenon (11). The meta-analysis included 12 studies which investigated the effect of either a very low energy diet (VLED: defined as <800 calories per day) or ketogenic low-carbohydrate diet (KLCD: defined as CHO consumption of <10% of energy or <50 g/day, but ad libitum consumption of total energy, protein and fat). Interventions ranged from 4 – 12 weeks and weight loss was from 5.0 to 12.5 kg. In all studies nutritional ketosis was confirmed in VLED and KLCD via circulating levels of β-hydroxybutyrate. Interestingly, both groups reported decreases in appetite. The results of this meta-analysis are noteworthy in two regards. The VLED groups were clearly and significantly hypocaloric, suggesting a state in which hunger should be increased, not decreased. Similarly, the KLCD groups experienced simultaneous reductions in weight and appetite, while eating an ad libitum diet. The results of this meta-analysis provide support for the theory that nutritional ketosis may exert an appetite suppressing effect. 

After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
Thank you for such a through list. I have been wondering how to count the spices used in cooking and now I know. I do have one question though that I can not find the answer to. When breaking down the macros for a recipe how do you count items that are listed as having fewer than 1 carb? Do you just count it as one? I am in a stall and wondering if I am not accounting for enough carbs.
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).
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.”
Foods that are low in carbohydrates are a smart choice for people who have certain medical conditions. Carbohydrates are broken down by the digestive system as sugar, which makes high-carb foods a risky bet for diabetic patients. Low-carb pasta is less likely to cause blood sugar spikes than regular pasta since its carbohydrate content is made up mostly of fiber, which the body does not convert into glucose. Of course, if you have any condition that affects your diet, you should always consult with your doctor before consuming new foods.
Consequently, when you begin a ketogenic diet, it acts as a metabolic stressor on the body. In the process of relearning how to burn fat for energy, a mild metabolic stress is inflicted upon your mitochondria. This stress is just powerful enough to kill off old and dysfunctional mitochondria which stimulates the growth of new and more powerful mitochondria (5). The end result is more energy and a higher level of vitality.
A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss. 

A creamy, cheesy alternative to typical mac and cheese, it’s not a stretch to think this version is preferable to using elbow pasta, no matter what your relationship with carbs may be. Boil cauliflower, whisk up a cheese sauce, and throw it all in the oven. For a fancier twist, use your favorite non-cheddar cheeses or a combo (mozzarella and pepper jack, anyone?)
I am very new to this diet, but I must say I am so impressed. No snack cravings were the first surprise! I am already gluten intolerant so was bummed out to learn of all the flours that are way too high carbs especially rice flours! But already I have tried many recipes even found one made with almond flour taste just like the cheddar biscuits at red lobster! Heading out, I saw you mentioned oat fiber.. what can you use this in?
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).

I began my low carb diet (around 50 net per day) almost 3 months ago. I have only lost 2 lbs. I need to lose at least 30. I am 62 years old and in good health. Everything I have read leads me to believe that I am doing everything correctly. I even make my own Keto bagels! What do you think could be the issue? I tried going down to less than 20 carbs but I just cannot do it. Thanks for any help you can provide.
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
So today I was sitting here getting some work done and occasionally looking out the window. The roses on the trellis are pretty actively in bloom and the trees are loaded with bright green leaves. The colors are bright against a glowery gray sky, though and it looks chilly. It’s not in the least – I think the high today is going to be 81F – BUT it LOOKS that way.
But I just made some biscuits from an old cooking book, which had Almonds grounded (so I just used my almond flour) & I switched sugar for some xylitol & then thought I’d use the Coconut flour in place of ordinary Plain Flour! I did it cup for cup, so it was 2/3 cup……remembered about needing more liquid, so I added an egg (receipt already had 150g butter, which I put in 160g) They taste nice, but I think maybe I should have reduced the coconut flour, after reading your points, or added another egg, or more butter, what would you do? They also have an almond on top. thanks, Pam
By the way, I love how simple this recipe is! I love that it uses whole eggs instead of separated since I’m really bad at separating the yolks from the whites, and if you use more whites than yolks then you have to find another use for the yolks and it’s a pain in the neck. I went keto on summer last year and when I decided to start baking my own bread and went looking for almond flour bread recipes, I chose this one for its simplicity

Sunflower seed meal and pumpkin seed meal are ideal options for those who are allergic to any of the nut flours we mentioned above. These seed flours are high in vitamins and minerals such as vitamin E, copper, thiamine, selenium, and phosphorus, and relatively low in net carbs (less than five net carbs in every 1-ounce serving), making them a healthy keto-friendly option.
Psyllium husk powder is what you’ll need, and you can find it on Amazon. Flaxseed Meal is another ingredient you can use to provide a slightly chewy texture. Although I feel that it’s not as good as psyllium (as it gives a slightly gelled texture), many people have used it successfully in place of psyllium. Make sure you grab a pack or 3 from Amazon. It’s super cheap and lasts a long time!
Low-carb pasta will make a welcome addition to your pantry if you happen to be watching your waistline. Traditional pasta is extremely high in carbohydrates, containing more than most people need to feel satisfied. And, it's so easy to overeat! Low-carb pasta makes it possible to enjoy your favorite flavors without all of the extra calories, so you can indulge and still make progress toward your goal weight.
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