The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]
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!
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
Shirataki noodles are available in many shapes -- spaghetti, fettucini, macaroni -- and can be purchased plain. Products like Miracle Noodle and NoOodle Noodles sell this type, which tends to be extra-slippery, nutritionally void (they are mostly made up of water) and close to calorie-free. Other brands, like House Foods and Nasoya's Pasta Zero blend the yam flour with tofu or chickpeas, which adds just a few calories and grams of carbohydrates and fiber.
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]
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
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]
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
These didn’t come out right but that was my fault. I didn’t have a large enough baking pan so that my silpat would lie flat which caused the batter to pool in the middle and it took a long time to cook (11 minutes) and I had to keep pulling it out of the oven, cutting off the cooked part, etc. Having said that, they were pretty good even though some of them were kind of thick. I made beef and noodles and simmered the noodles in the crockpot on low for about 20 minutes. I ordered a new pan and will try this recipe again because I think it will be good if made correctly. Also, I doubled the recipe 2 oz of cream cheese, 4 eggs, and 1/2 tsp of vital wheat gluten. Thanks so much for posting..
From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
Still, whole wheat flour comes in about midway on our list of flours based on carbohydrate content, so it’s got a little less than 45 carbohydrates per half cup, and comes in mid-range for GI at 69, You may find that you want to sneak whole wheat flour into your recipes, by adding a little at a time and working up to where you have mostly whole-wheat bread.
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.
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Once you start eating this very low amount of carbs, you’re body will become keto adapted. You are starving it from the carbs therefore it needs to find a source of fuel. When you’re in ketosis, your body will no longer have the carbs it once used to fuel your body. It will have to resort to using your own body fat for fuel. This is amazing because you’ll lose body fat if that was your goal and many other benefits you’ll see below.
^ 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.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]
I could not get chicken noodle soup off of my mind. I didn’t want zoodles. I didn’t want that weird textured low carb pasta. I wanted tender, slurpy egg noodles drifting in a rich broth surrounded by pieces of chicken. The only way to deal with that kind of craving is to find a way to satisfy it – so I hit up some of my favorite blogs for noodle recipes.
To help you get acquainted with making keto-friendly baked goods, we decided to put this article together with all the info you’ll need to get started. Below you will find the many low carb flour options you can use on keto, how to utilize them correctly, and some of our favorite low-carb flour recipes. After reading through this guide, you will have the information you need to make the keto-friendly version of the high-carb food that you’ve been craving.
For cavatelli: cut dough into 4 pieces, roll out into even-sized logs and slice off even-sized pieces. This will ensure evenly-sized pasta. Lightly dust the board and pasta pieces with coconut flour. Place a piece on the board and using a knife press the dough towards you, angling the knife tip upwards as you press (see post for gif images), making the pasta curl into shape. 
Just made these. They were absolutely delicious. I used coconut sugar and I will definitely be making them again. Thank you so much for sharing this recipe , this was the first time I ever made donuts in my life. I actually just lost 45 lb and these were perfect because they weren’t too sweet which I really enjoyed but they tasted fantastic and the recipe was super simple

^ 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.


From pancakes to muffins, quick breads, cookies, cakes, pie crusts and sandwich bread, low-carb baked goods are all possible with a low-carb flour. You'll have to do some experimenting to see which flour is right for your specific baked products, and be prepared for both successes and failures. An all-purpose, low-carbohydrate blend takes much of the guess work out of the equation, but also removes the adventure from your quest. Be sure to follow all directions when replacing all or some regular flour with a low-carb variety.
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!!!
As you will see, simple keto meals begins with the healthy fat consideration first, making sure plenty of low-starch veggies surround the fat along with a moderate protein source. Wild-caught salmon, as a high-fat fish, is a perfect keto choice, and easy keto meals can be a fatty cut of healthy protein like salmon or lamb served with plenty of green veggies.

I love hearts of palm, I am steering away from pasta and other carbs. Hello? Made for me. Bought two cans. Made one two hours after delivery (with shrimp and a pesto-fredo sauce) and it was awesome. Delish. Fantabulous. I did not plop it into boiling water so I didn't get a chance to try it "softened" more like pasta and I don't really feel the need to. It was it's own experience and one I will keep buying into. Please buy this so they can keep making it, maybe they can try other pasta types as well. I'm partial to pappardelle


I’m afraid I don’t. I have never used peanut flour and would hate to guess a conversion for you. And as you may know, almond flour and coconut flour are completely different beasts so are used completely differently to one another. If you are about to throw it away anyway, maybe try experimenting with it, you have nothing to lose (other than some eggs and butter perhaps).
If you’re following a low-carb diet, it’s tempting to limit breakfast cereal to a sprinkling on your Greek yogurt -- and with good reason. Because grains are carbohydrate-rich, there are few truly low-carb cereal options, and many boast upwards of 40 grams per serving. As of October 2015, the FDA hasn’t defined what “low-carb” means in terms of grams or percentage of calories. However, with a little detective work, you can find hot or cold cereals with 20 grams of carbohydrates or fewer per serving, which can fit into some lower-carb diets.
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.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
This is the best keto bread recipe out there, in my opinion. I make it every week. The psyllium husk is brilliant and really makes this like more traditional bread. I add a TBL of swerve to help counter any egg taste too. Comes out great every time. Sometimes I add cheddar cheese and that’s delicious too! I love this bread. Thank you for sharing the recipe! It’s a winner!

Hi Liz, Low carb bread doesn’t rise as well as one made with wheat flour, but it shouldn’t be quite that short. Some factors that might contribute include the age of your baking powder and how well the batter is mixed – the mixing process helps create air bubbles. Also, did you use baking soda or baking powder? They are not the same. Baking soda needs something to interact with, in this recipe I use baking powder. More baking powder *might* help, but is risky because using too much can cause it to fall even more flat.
This is the best keto bread recipe out there, in my opinion. I make it every week. The psyllium husk is brilliant and really makes this like more traditional bread. I add a TBL of swerve to help counter any egg taste too. Comes out great every time. Sometimes I add cheddar cheese and that’s delicious too! I love this bread. Thank you for sharing the recipe! It’s a winner!
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf.
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