Coconut flour and almond flour are two of the most commonly used flour alternatives in low carb cooking and baking. Most people have a preference of one over the other. I will admit that my go-to is almond flour much of the time because I’ve become so comfortable with it. Or a mix of the two, which I find can give keto cakes and muffins a really great consistency. But I do love my coconut flour pancakes! And I  love to experiment and play with all my options…coconut flour, almond flour, peanut flour, sunflower seed flour…you name it, I’ve tried it (and if I haven’t, I certainly intend to!).
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin. 

I made this. It’s excellent! I had to sub with xanthan gum (estimating the conversion from psyllium husk powder – i used 2 tsp of xanthan gum) and it’s still great. I made Alaskan monte cristos with it that were fantastic. (Low carb french toast dredge and griddled the bread, then griddled again with ham and swiss like making grilled cheese then a bit of sugar free raspberry jelly on the side.) Next I substituted coconut flour (1/2 a cup) for the almond flour and made it again because I liked the original recipe so much. I added 1/4 cup extra warm water and 2 tbsp melted butter to the dough. I was a little off on the conversion for bread but ended up with an excellent pound cake. So… I whipped up some low carb cream cheese icing to put on it the topped that off with non-sweetened coconut shavings. OH MY GOODNESS!!! To have coconut cake again! It was excellent! I estimated the cake ended up being about 100 calories for a 1/2 inch slice and about 2.5 net carbs. Anyway, thanks for the recipe and I enjoyed playing with it some.
Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.
If you're in search of carb-free noodles that perfectly mimic the taste and texture of regular spaghetti -- a true miracle -- keep looking. Like pasta, shirataki noodles are mostly neutral in flavor and can absorb the tastes you cook with. But, shirataki has a slimier consistency and you won't be able to choose the hardness of your pasta -- al dente or otherwise -- because the noodles are already "cooked."
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
I am thankful for you and for Maria Emmerich as well. Your biscotti recipe and a few others make my low carb life possible and enjoyable. Maria E’s bread with psyllium recipe is another that keeps me happy and healthy. Thank you both. My life is revolutionized in these past 2 years and I couldn’t have sustained low carb eating without you. Your almond tea cake recipe was my first venture into almond flour and erythritol, etc—low carb cooking and eating would just be too drab and boring for me without your recipes.
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Carolyn Ketchum writes All Day I Dream About Food, a food blog that focuses primarily on low carb, gluten free recipes. She has a Masters in Physical Anthropology and Human Evolution from Arizona State University and has an extensive background in higher education administration. She currently lives in the Boston area with her husband and three children. You can check out her experiments with low carb baking at All Day I Dream About Food.
Supporting these results, Naude et al. (15) found a similar outcome in obese adults with and without type 2 diabetes. This meta-analysis of 19 randomized, controlled trials compared dietary interventions using standard CHO recommendation (i.e., 45 – 65%), low-carbohydrate/high protein (LCHP) and low-carbohydrate/high fat (this group, although not specifically stated, met the criteria for KD). Results demonstrated significant weight loss among all groups in the short-term (3 – 6 months) and long-term (1 – 2 years), with no significant difference among dietary interventions. The authors concluded that weight loss interventions using CHO restriction are equally effective as isocaloric diets of standard CHO recommendation.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. 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 12 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.[21][22]
I received these today. They came packed with cold packs that were not cold at all. The tracking info shows that they were delivered at 3pm and I arrived home at 5pm. It was if they were not refrigerated at all. Tried the original crust tonight anyway. Very tasty. The crusts are small and one crust is pretty much a meal for one person but worth the money especially if you ever made cauliflower crust from scratch.

Praise God, Brenda for your success! You look fabulous and show your beauty inside and out. Thank you for the encouragement. I, too, have experimented with both low carb and keto for years. I am your age and I understand the “food journey,” which leads to better health and overall well being. I have fibromyalgia and other immune disorders and have found that keto is best for me, as well in terms of energy, pain, and weight loss/management. I exercise daily and weight train in a fasted state with no problem. I fast regualarly, not eating for 14-19 hours, and I am not hangry nor hungry. I truly believe intermittent fasting, a keto diet, and exercise are the keys to true success for weight loss and maintance. Thank you for sharing your story, pictures, and delicious recipes. Most of all thank you for being an inspiration and building up your followers. Keep pressing on! God bless you, Amy
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.
I ditto that. I’m starting the keto diet, but am struggling to get my macros right. I usuaslly end up with too much protien and not enough fat. A daily “menu” to try to copy would be great! I”m 59, almost 60 and have about 20 to get off. My birthday is October and would like to have this gone by then! Thank you for all you do. I love reading your posts!!
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
I remember years ago loving the Monterey Chicken at Chili’s Restaurant Grill & Bar. Then, they took it off the menu, and it has been just a distant memory ever since. Since starting Keto, I have thought about making a keto friendly version. In fact, I did post a very lazy crockpot version of the recipe that is keto friendly/low carb, which is delicious, but I missed the skillet version like Chili’s Restaurant.

The ketogenic diet is an incredibly powerful tool that can be wonderfully effective in treating a variety of health issues facing modern society. By allowing the body to burn fat for fuel, the ketogenic diet can not only lead to sustainable weight loss, but it actually pushes the body to use an alternative and potentially superior fuel source. If you are just starting a ketogenic diet, use the tips outlined above and stick with it; it can be a challenging transition, but there are many, many benefits of long-term adherence to this diet.
I don’t make pancakes often and never waffles, but I have definitely used it for the crepes A LOT. The key to the crepes is that the liquid is super thin–like cake mix, not like brownie mix. The xantham gum is really not a huge amount for the full recipe. It is under 1 TBSP per cup of other dry ingredients. Let me know if you like it better with the wheat gluten. Thanks for writing!
Almond Meal is made slightly different than almond flour. Instead of blanching the almonds to remove the skins, the skins on the almonds are kept on. It’s a little bit coarser than almond flour and still bakes the same. For baked goods, I like to use a super fine ground almond flour but I will equally use almond meal as it seems to perform just as well in most recipes, at a reduced cost.
Hi all, keto here. This recipe “works” fine. I formed cute little cavatelli by pressing/rolling little cylinders of the dough off the tines of a fork. I fried them as directed and they kept their shape perfectly during frying and saucing. But the texture was still mush to the tooth. Also the coconut taste is present on the tongue, even though I cheated and floured the fork and my thumb with AP flour while forming the cavatelli. The coconut taste clashed with my bolognese sauce.

This cereal, made by Nutritious Living, comes in four flavors – original, strawberry, vanilla-almond, and maple pecan – and has just six grams of net carbs per serving. These cereals also have 12 grams of protein and six grams of fiber to keep you feeling full until lunchtime. Despite the sweet-sounding flavors, Hi-Lo cereals have just one gram of sugar per serving. The cereal is made with soy grits, wheat gluten, soy protein, corn bran, rice flour, and corn meal.
A computer program such as KetoCalculator may be used to help generate recipes.[47] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil, or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas, and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower, and green beans are all equivalent. Fresh, canned, or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[37]
Haven’t ever really eaten turnips? It’s time to give them a second look. They’re inexpensive and their natural sweetness makes them seem like a real treat. Leave the skins on the turnips before roasting to make this already super-easy recipe even quicker. Try them alongside your favorite burger or sandwich recipe for a fry that’s a vegetable in disguise.
I too have been following you for a long time, trying your recipes and loving most of them. I am 4 days into the keto diet. I have not looked at the scale yet, but I kinda feel like my clothes fit a bit better. I am not in ketosis though…I was glad to hear that it took you a bit longer to get there so I don’t feel like I am doing it wrong. I am 62 and 5 foot 2 and I just can’t seem to keep my protein low enough. Too much meat I am guessing. I am trying to stay at 1330 calories, 105 grams of fat, 20 carbs, and 76 protein. I am very interested in learning what you eat in your typical meals for the day. I use the free version of My fitness pal.
The Keto diet is high in fat, moderate in protein and extremely low in carbs. It’s a highly effective diet as it takes into account accurate tracking of your meals, to find the right body balance, followed by charting your goals! I’m a big fan of the low-carb diet. Not only has it been shown to be more effective than a low-fat diet, but it bestows many additional health benefits over a typical diet.
"Avoid inflammatory oils like safflower, sunflower, corn, or soybean oils and opt for whole food cereal or granolas with limited ingredients, which tend to be made from nuts, seeds and occasionally whole oats or puffed rice," says Kelly LeVeque, RD, a celebrity nutritionist who works with Jennifer Garner and Jessica Alba, and author of Body Love. One of her faves: This grain-free granola from Thrive Market, which has a blissfully short ingredient list but tons of flavor.
Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP, Oleaga A, Moreno B, Casanueva FF. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes. 2016 Sep 19;6(9):e230. [PMC free article: PMC5048014] [PubMed: 27643725]
This paleo low carb bread recipe with almond flour came about somewhat by accident during my Sunday meal planning. Lately I’ve been making the flattened version of my 4-ingredient almond flour biscuits to use for sandwiches each week, but since I’ve been wanting to create an almond flour bread recipe, last weekend I decided to attempt that instead.
Thanks for posting about the psyllium Sarah,, I tried psyllium flakes 10g and they turned out great. Not even very fragile. It just gets thick so the batter doesn’t self-level, I had to do my best, and the thick spots required 1 extra minute in the oven. Used immediately in a skillet lasagne- just ground beef, jar of pasta sauce, mozz cheese and cream cheese. Definitely wouldn’t have been much of a lasagne without the “pasta”! So these noodles are my hero 🙂
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.
Love your blog and recipes, thank you! Congratulations on doing keto – I’ve been sugar, dairy, grain and pretty much all carb free for over a year keeping my carbs to under 30 grams per day. My question is about coffee…did you give it up? I was drinking way too much coffee with heavy cream so I finally gave that up for Califia almond/coconut creamer sugar free of course! Did you give up coffee during the keto trial?
So rather than giving one-size-fits-all dietary advice or weaponizing the word “balanced” it might be better if the medical community suggested that there are Individual differences that need to be considered. This might also help those lay folk who have had success with one dietary lifestyle or another also realize that what’s valid for them may not be good advice for others.

This was very good general. I would love to see a menu plan of what you actually ate between low crab(like a sample day) and Keto. I also found it encouraging that it took you moths to be keto adapted even though you were already doing low carb. Is this because you found it hard to cut out the carbs? I have been trying to do Keto for weight loss and clear mind and focus since the end of December. I did well the first week, then had a bad day and got back to it.. I have a good week and then a bad day and that’s been my cycle for 3 months. SO I have lost some weight 12lbs, but I really need to lose more. Nothing else worked for me to lose weight, My body really likes to hold onto its fat, most likely due to that it doesn’t process stress well and I have a high stress lifestyle. Any suggestions would be much appreciated. Thank you, I love your blog.

The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]


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.
Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.
Melanie, curious to know what the quality of the foods you are eating? Organic? Grass fed Beef/butter? What oils are the using for fats? And do you think you are getting enough dark leafy greens, which give you the nutrient density needed to detox well? toxins stored in fat cells can cause issues with weight lose. looking into these topics and some light tweaks may help you with your goals! Best of luck!

If you grew up in Canada like I did, you probably spent a large portion of your formative years eating Quaker Harvest Crunch for breakfast. I was never that much of a cereal fan, but a bowl of that granola from the orange box was always welcome. In fact, I was happy to eat it any time…breakfast, lunch or dinner. It was so good, so crunchy and so, so sweet. Addictively sweet.  I shudder now to think of how much sugar was in what I assumed back then was a healthy option. No wonder I liked it so much.
Almond flour is a great low carb pasta alternative. It contains 1.6 grams of carbohydrates and 1.6 grams of dietary fiber, resulting in zero net carbs[*]. White, bleached, enriched flour contains over 76 grams of total carbohydrates with only 2 grams of fiber[*]. Almonds are also an excellent source of healthy fats, vitamin E, manganese and magnesium[*].
From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table ​(Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).
Thank you so much for giving me back bolognese! Low carb eating wasn’t really a hard switch for me except missing Italian food. I doubled the recipe and used a 9×13 pan to bake them. The most unusual thing was that the center set before the edges, usually it’s the other way round. These noodles topped with bolognese, served with keto garlic bread, I though I was in heaven!
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.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
These products all tend to differ a lot between different brands which unfortunately makes low-carb baking a bit tricky. For example, some brands of ground psyllium husk powder color the dough purple. It doesn’t seem to affect the taste but makes the outcome a bit more… purple. The amount of carbs in almond and coconut flour can also vary quite a bit between different brands. Read the labels and choose the best one available.

If you’re new or just still learning the ropes for the keto diet food list, your biggest questions probably revolve around figuring out just what high-fat low-carb foods you can eat on such a low-carb, ketogenic diet. Overall, remember that the bulk of calories on the keto diet are from foods that are high in natural fats along with a moderate amount of foods with protein. Those that are severely restricted are all foods that provide lots of carbs, even kinds that are normally thought of as “healthy,” like whole grains, for example.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.

Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.
Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
Want perfectly uniform mini burger patties? Try using a lid from a small jar, or a cookie cutter, as a form for your ground beef. You’ll have to find one that is the right size (slightly larger than you want the burger to be once it is cooked) but once you have it you’re good to go. Line the lid with plastic wrap to keep the ground beef from sticking inside of it!

The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
While these sources have lower carbs, they typically have higher fat contents. For example, most nuts are calorically dense with fat, though most of it is good fats such as monounsaturated and polyunsaturated varieties. If someone is trying to reduce his fat intake as well as his carbohydrate intake, then it may be a good idea to look into low-carb flour varieties that also are low-fat, such as soy flour.

The goal of the KD is to sufficiently deprive the body of CHO to achieve physiological or “nutritional ketosis,” a metabolic state which is characterized by blood ketone levels between 0.5 and 3.0 mmol/L (26). This “switch over” point, however, is not seamless and may take up to several weeks for individuals to become “keto adapted” (18). Supporting this idea is a significant amount evidence indicating that a “keto adapted” body has little reliance on glucose for CNS function (8,14,16) or as a source of energy for exercise (17,18,25,27).
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.

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.

Rest assured, not everyone experiences this side effect of the ketogenic diet and, if you do, it will abate on its own; furthermore, there are some simple preventative steps you can take to lower your likelihood of “catching” this flu. As you adopt a ketogenic diet, make sure you replace electrolytes, eat enough fat to meet your total caloric needs, drink plenty of water, and exercise as you are able. It’s very important, however, to ensure that you aren’t relying on sugary sports drinks to replace electrolytes, as all that added sugar will prevent your metabolism from entering ketosis. Ultimately, electrolytes play a crucial role in our health and many Americans do not consume them at adequate levels, so it is very important to monitor your intake of these nutrients regardless of whether or not you are an adherent of the ketogenic diet.


Most low-carb diet authors don't recommend bothering with it. Even many of those who think a ketogenic diet is a good thing just assume that a very-low-carbohydrate diet (under about 50 net grams of carbohydrate) is ketogenic. On the other hand, many people have found that monitoring their ketones, at least for a while, provides valuable information.
^ 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.
Rest assured, not everyone experiences this side effect of the ketogenic diet and, if you do, it will abate on its own; furthermore, there are some simple preventative steps you can take to lower your likelihood of “catching” this flu. As you adopt a ketogenic diet, make sure you replace electrolytes, eat enough fat to meet your total caloric needs, drink plenty of water, and exercise as you are able. It’s very important, however, to ensure that you aren’t relying on sugary sports drinks to replace electrolytes, as all that added sugar will prevent your metabolism from entering ketosis. Ultimately, electrolytes play a crucial role in our health and many Americans do not consume them at adequate levels, so it is very important to monitor your intake of these nutrients regardless of whether or not you are an adherent of the ketogenic diet.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]
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