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.


One of the easiest traps to fall into when starting a ketogenic diet is the assumption that all fats are healthy. It is not uncommon to see new adherents loading up their plates with industrially harvested bacon, exclaiming, “I’m keto, so it’s healthy!” In reality, because ketosis repositions ketones as your primary fuel source, ensuring you consume healthy fats becomes even more important on the ketogenic 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.


Measuring blood ketones is the most reliable method. There is a home blood test you can use, but the strips can be very expensive. An alternative is to measure ketones in the urine with a dipstick test, which is much more accessible and inexpensive. However, this method is much less reliable and as time goes on and the body adapts to ketosis, it becomes even less reliable.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
It’s a habit to enjoy a brie cheese for desert instead of a piece of chocolate cake but each are favored deserts in France. I’m personally more satisfied after a 350 calorie sized wedge of brie than the same number of calories of cake.. which will give me sugar crash and .. really I’d like two slices of cake(I’ve got a sweet tooth that once I get going it wants to keep being fed)
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
The information you share, including that which might otherwise be Protected Health Information, to this site is by design open to the public and is not a private, secure service. You should think carefully before disclosing any personal information in any public forum. What you have written may be seen, disclosed to, or collected by third parties and may be used by others in ways we are unable to control or predict, including to contact you or otherwise be used for unauthorized or unlawful purposes. As with any public forum on any site, this information may also appear in third-party search engines like Google, MSN, Yahoo, etc. Your use of this site is governed by Harvard University and its affiliates Terms of Use located at www.health.harvard.edu/privacy-policy and may be amended from time to time.

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.

Out of 63 comments so far, only 3 people actually said that they tried the recipe, and only one of those rated it. Yet there were 16 other ratings from 3 to 5 stars from folks who didn’t make the recipe but weighed in to ask a question or say some form of “these look great, I’ll have to try this”. And there were 10 questions about using some particular thing or other to replace the gluten, even though it was clearly spelled out from the beginning that nothing could be used as a substitute. Yes, you are a saint, lol!

Ok, this is about the smallest amount of vital wheat gluten that you can get but it will last forever if you keep it tightly sealed in the freezer. You can even give my low carb yeast bread a whirl as long as you have the gluten around. Also – these low carb egg noodles would be almost impossible to make without a silicone baking mat to put over the baking sheet. Parchment didn’t work very well because the batter didn’t spread right.


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
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]
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

I was doing LCHF (under 20 carbs most days) , Type II diabetic on a little insulin, After less than 3 mos I brought my A1C from 10.9 down to 7.1…….off to a great start. Now…..I am not only diabetic, I recently had open heart surgery (quadruple bypass),meaning “cardiac diet”. Do you know of any diabetic/cardiac people that are doing Keto? Curious about high fat for cardiac. (FYI: My Doctors are following me closely so know what I’m doing.)


Hi Brandie, If you used pulp from making almond milk, that is likely the issue. This would be almond meal, not finely ground blanched almond flour. Homemade ground almonds generally aren’t as fine as the store bought blanched almond flour, and this affects the texture in baked goods in a pretty big way. Not using fresh baking powder would definitely contribute as well. Sounds like a good idea to add some baking soda and cider vinegar to compensate, but I haven’t tried it. Try it with super fine blanched almond flour next time and it should definitely rise more.
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].

You deserve a medal for this recipe!!! I made it earlier today and it is absolutely AMAZING! It exceeded my expectations! It’s so delicious! It made enough to completely fill an extra large rectangle Tupperware. I was obsessed with natures valley granola before I went Keto and this is the same exact look and texture but this tastes even better! I’m so excited about this because I was getting sick of eggs for breakfast lol. Thank you, thank you, thank you!
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.
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 🙂
So, recently when I was craving Monterey Chicken and didn’t have time to wait for the chicken to cook in the crockpot, I made a low carb skillet version that turned out just like the one I remembered. It was extremely flavorful and delicious! All in all, it took about 25 minutes from start to finish since I had already cooked the bacon earlier in the day and my homemade low carb sugar-free BBQ sauce was already in the fridge.
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

Congratulations on your keto success! i started keto on September 2, 2017 after reaching my highest weight ever of 192. As of this morning, I’ve lost 50 pounds, weighing 142. I’ve struggled with weight my entire life, & never thought I would be this size or weigh this little. I have never felt better! My hormones are stabilized (I’m 60, so I have the perimenopausal thing going on); my acid reflux is almost completely gone; my arthritis symptoms are gone; I’m sleeping MUCH better; and my skin isn’t dry! I started keto for weight loss, but now I know the weight loss is a perk. I’m never “hangry” and have been able to incorporate 24 – 48 hour fasting into my weekly regime with no difficulty. I do intermittent fasting every day, eating all my food in 8 – 12 hours daily. My “food obsession” is gone; yet, I love eating more than I ever did pre-keto! I eat only when I’m hungry (not by a clock) and stop when I’m satisfied. I agree that a lot of docs still are not on board with keto. A great book to understand keto from a medical perspective is Jimmy Moore’s Keto Clarity. I think the reason some people don’t do well on keto is they have a difficult time embracing the idea of eating “this much fat”. Happily, I’m an “all or nothing” person, so when I started keto, I jumped in – and found that the fat fills me up faster & keeps me full longer so I don’t have cravings. When I do want something sweet, I make a keto treat – but it’s not every day or even every week. Most of the time, I’m super happy on my bacon, sour cream, cream cheese,and fattier meats! I am keto for life – there is no reason to go back to eating any other way!
Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
As I mentioned already, the body will burn sugar for energy before it burns fat. Most people will do very well in the range of 0.8-1.2 grams of protein per KG of bodyweight they have. To convert your bodyweight into KG, simply take your weight in pounds and divide it by 2.2. This number can then be multiplied by 0.8 and 1.2 to determine your protein range.
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.
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.
I don’t know anyone doing keto with cardiac issues, but yes for diabetes. I’ve noticed though many doctors are not promoting keto at all and it’s disappointing to be honest. I hope you’ll find out what works for you or at least your doctor will research it before saying it isn’t a good idea. Anyway, sound advice can be found from Jimmy Moore who has been doing keto for years and years and his website and podcasts are full of interviews with doctors. He’d probably be the best source of info for your condition. Best of luck to you!
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.
As I mentioned already, the body will burn sugar for energy before it burns fat. Most people will do very well in the range of 0.8-1.2 grams of protein per KG of bodyweight they have. To convert your bodyweight into KG, simply take your weight in pounds and divide it by 2.2. This number can then be multiplied by 0.8 and 1.2 to determine your protein range.
Hi Louise, I haven’t tried that product so can’t say for sure if it’s a good choice, but it sounds like it is if the recipe worked for you – which is great! Feel free to add herbs, spices, or garlic powder if you want some flavor to the bread. I kept it plain to be used for many different applications. The number of slices will depend on how thick you cut them and the size of your pan.
I doubled the recipe because I knew I was going to double the soup recipe. I will say that the first batch had a few issues but the 2nd batch turned out great!! On the second batch I let them bake for about a minute and then I opened the oven and king of tilted the pan around a bit to make the batter spread out more evenly because either it just wants to pool together (I did use silpat and a heavy duty cookie sheet) or my oven isn’t level. That second batch turned out perfect!!!
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)

If you’re counting your carbs, it’s important to check the labels of the foods you eat. You should look for the term “total carbohydrate,” which includes starches, sugars, and fiber. This can help you balance the number of carbs you eat during each meal. Spreading your carbs evenly throughout the day helps ensure your body has a steady supply of energy to power you during the day.
These tasty mini burgers are perfect for parties because they can feed your low carb AND carb-loving guests and no one will even miss that bread. Make them for tailgating parties, game day parties, summer picnics, or just a fun weeknight dinner for the family. Once you dip those little burger bites in that special sauce you’re going to be going back for seconds! 

Thanks for your quick reply. Yes, BP is fresh. My batter wasn’t runny either. In fact I was going to add some more liquid but decided to leave as it was. The only other thing it could have been is that I live at 5100′ elevation and it was cold and snowing the day I made them. I am going to make them again and see what happens. I am not giving up! 🙂
I’ve been doing keto on and off for a year. Before that, I explored eliminating “inflammatory” or “reactive” foods based on another eating program. I have Celiac and autoimmune issues and I think one of the reasons people stall with Keto is because they are eating too many typically “inflammatory” foods–foods that your body has a harder time digesting and as a result create systemic inflammation which, in turn, cause weight loss plateaus. For those trying to fight through a Keto Plateau, I would suggest eliminating ALL dairy (try subbing ghee for butter), artificial sweeteners (including stevia and erythritol) and all nuts for 5 days. I know it sounds close to impossible but all three of these Keto staples are some of the biggest culprits of inflammation in the body. I found this suggestion on another Keto website and tried it and dropped 6 lbs in 5 days. Another typically inflammatory food is Eggs. If you can’t eliminate all of these foods at once, try eliminating one at a time for a minimum of 5 days and see if there is any movement on the scale. For those who have stalled, chances are at least one of your Keto staples is holding you up. Good luck!
×