The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals [10]; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.
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. 

I’m almost positive that you are being trolled at this point… I’m so sorry Marye. You really must absolutely dread sharing your strokes of brilliance with the no-carb/low carb/keto community as I’ve noticed almost all of them expect GF to apply and when it doesn’t they go ape-crap insane about it then you end up with this comment section which is America at its finest. Thank you for the awesome recipe!
Thank you, Wenda! Yes, the nutrition info is based on 6 donuts. If you keep the ingredients the same but make more (smaller) donuts out of them, the macronutrients per donut would be lower. If you just multiply the ingredients by 4 to make 24 donuts that are the same size as mine (increase the # of servings on the recipe card to 24), then the nutrition info per donut would stay the same.
In summary, the LCKD had positive effects on body weight, waist measurement, serum triglycerides, and glycemic control in a cohort of 21 participants with type 2 diabetes. Most impressive is that improvement in hemoglobin A1c was observed despite a small sample size and short duration of follow-up, and this improvement in glycemic control occurred while diabetes medications were reduced substantially in many participants. Future research must further examine the optimal medication adjustments, particularly for diabetes and diuretic agents, in order to avoid possible complications of hypoglycemia and dehydration. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
Donuts were never a food we had around the house growing up. Even though my parents were far from low carb, they did eat real food and didn’t buy much that was processed. I’m not going to lie, though. I would have happily eaten donuts elsewhere whenever given the chance. It’s too bad that a keto low carb donuts recipe like this one wasn’t an option back then!
I had to make a few changes though. First, what makes a donut taste like a donut is nutmeg. I added a few gratings and cut the cinnamon down to about half. Second, I live in South Korea and almond milk almost always contains sugar and is very expensive. I used heavy cream and then added a splash of water when the batter was very thick. Third, I don’t have erythritol, but I do have a stevia and erythritol blend so I used that.
I've been on the search for low carb crackers for dips and chicken salad for years...I was excited to find these but a little surprised by the expensive price tag. I figured I'd give them a shot anyway. I really like these crackers - they remind me of Mary's Gone Crackers but less crispy. I wouldn't choose to eat them alone - they definitely need a dip or chicken salad to go with them or else they're pretty bland, besides the seed taste. The only problem was that over half of the bag was broken which made it impossible for me to dip them into anything chunky. For $10 per box, they should have them in a tray or something to eliminate this mistake. Unfortunately, I won't buy them again unless the price drops by at least half.
Hi Linda, The carb counts on product packaging is accurate (they have to be, to abide by U.S. laws), though they are sometimes rounded down to the nearest gram. If your goal is weight loss, for some people these products can cause a stall, but others tolerate them fine. I personally avoid packaged products as they tend to be highly processed and contain artificial ingredients, but have not looked at this one specifically. We are gluten-free so don’t buy products with wheat, but I am a strong believer in each person doing what works best for them!
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
I’m trying your recipe for the first time. It is very similar to a bun recipe that I make with psyllium husks so I am incorporating the method from that into this recipe. I made a few slight changes… I added garlic powder ground Rosemary and oregano, one quarter cup ground flaxseed, one tablespoon apple cider vinegar. I only used 3 eggs, and increased the Water by 2 tablespoons. By adding apple cider vinegar and the baking soda, they create a very light effervescent foam as they interactwhen I add the warm water, which acts naturally to the raise the bread, thereby allowing me to decrease the eggs. I added the extra water due to the extra dry ingredients. I’m very confident that this will work out very well. It always works with my buns so I’m eager to test this out. Thank you again for the base recipe.
If you’re someone who loves to bake, you may think that starting a low carb diet means your favorite pastime is now off-limits. You can’t have flour and you can’t have sugar, so you can’t possibly make muffins and cakes and cookies, right? Well sure, if you want to define baking in those narrow, high carb terms, then I suppose you might be right. But if you’re ready to explore a whole new world of healthy low carb ingredients, stay with me.
Similar to our results, three studies noted that diabetes medications were reduced in some participants[6,8,9], although details were provided in only one study. We also discontinued diuretic medications during diet initiation because of concern for additional diuresis incurred by the diet. This concern was based on the theoretical effects of the diet [17], observed effects of the diet on body water by bioelectric impedance [18], and practical experience with the diet [19]. Until we learn more about using low carbohydrate diets, medical monitoring for hypoglycemia, dehydration, and electrolyte abnormalities is imperative in patients taking diabetes or diuretic medications.
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.
Carbohydrate: Most of what determines how ketogenic a diet is will depend on how much carbohydrate is eaten, as well the individual's metabolism and activity level. A diet of less than 50 or 60 grams of net (effective) carbohydrate per day is generally ketogenic. Some sources say to consume no more than 20 grams of carbohydrates per day, while others cite up to 50 grams, and many recommend no more than 5 percent of calories from carbs. However, athletes and people with healthy metabolisms may be able to eat 100 or more grams of net carbohydrate in a day and maintain a desired level of ketosis. At the same time, an older sedentary person with Type 2 diabetes may have to eat less than 30 net grams to achieve the same level.
The importance of dietary CHO is so well ingrained that the concept is taken for granted. In fact, basic macronutrient guidelines are predicated upon the idea that the central nervous system (CNS) requires a minimum of ~130 grams (~520 kcal) per day to function properly (i.e., to maintain optimal cognitive function). As a result, the minimum recommended daily intake of CHO reflects this idea (7). Similarly, most contemporary texts on sports nutrition emphasize the outsized role of CHO in optimizing both athletic performance and recovery (9). Frequently referred to as the “master fuel,” recommendations range from 3 – 12 grams per kilogram of bodyweight, per day. As an example, the recommended daily intake for a 180-lb athlete would be 246 – 982 grams, with a caloric equivalent of 984 – 3,928 calories. In marked contrast, the KD would recommend a maximum of just 50 grams (~ 200 calories) per day for the same individual.

Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.
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.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
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.
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
Made from dried and defatted coconut flesh, coconut flour has a high fiber content, with 8 grams of carbs and 5 grams of fiber in two tablespoons. To use the flour, replace up to 20 percent of the regular flour in a recipe with coconut flour and add an equal amount of liquid. For example, if a bread recipe calls for five cups of all-purpose flour, use 4 cups of the all purpose flour and one cup of coconut flour plus one cup of water. You can also use the flour alone for breading.
It's not the easiest plan to follow, but the theory of ketosis as a possible prevention against disease is gaining attention from cancer specialists. Tumor immunologist Dr. Patrick Hwu, one of the leading cancer specialists in the U.S., has followed the keto diet for four years, although he prefers to call it the fat-burning metabolism diet, or fat-burning diet. More research is needed to prove its benefits, but Hwu, the head of cancer medicine at MD Anderson in Houston, believes in it after seeing improvements in his own health.
You can substitute half of the spelt flour for half of the flour called for in your recipe. This will help to keep the texture of bread when baking spelt bread. For total carbohydrates, it comes in at almost 27, with a net carbohydrate count of just under 22. The GI is getting up into the midrange, so this bread will start to raise blood sugars more at 55-67 than the previous four choices on our list.

And, very unlike generic, boxed spaghetti, shirataki noodles come pre-packaged in liquid, portioned out in a plastic bag that gets refrigerated. The noodles are watery and emanate a faint, fishy odor (though they're 100 percent vegan), which comes from the plant they are made from. Shirataki noodle manufacturers recommend rinsing, draining and drying the noodles before using them in dishes -- this'll help reduce the smell. Nevertheless, the pasta alternative is a smart choice for those looking for something gluten-free, low-carb or lighter in calories.
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.
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?

I bought this as an alternative to the Medi-Fast Oatmeals. This one has similar caloric, protein, fat, and carb content, with lots of vitamins, without the price tag you get with MediFast. I liked the taste of it and will buy it again as a result. The nutritional content is better than any of the Quaker Oats products involving Oatmeal, and for someone who is constantly battling obesity, having a thick bowl of oatmeal is a welcome addition to my diet.
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.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]

Quite by coincidence I started Keto around the same time as you. I’m 48 and had been struggling with hormones. I’ve lost 10 pounds, not bragging as I had far more to lose than you. I have 2 questions. First, I’m struggling with getting all of my fat in. Never thought I’d tire of avocados. Do you have any good fat bomb recipes? I’ve tried many online and they just don’t taste good at all. Hoping with all your experience you may have some ideas. Most websites have the same recipes as others.


Because I don’t think it does work as well. If you use it that way and you like it great but I can’t recommend it because I didn’t like the texture the times that I tried it in this recipe. Each recipe is tested several times… usually by several people… and this one everyone who tried it liked the original better than the xanthan gum. SO… now you know why I keep saying there’s no substitute. 🙂
Try to replace all soda and juice consumption with something that has no sugar or only trace amounts of sugar. Switch out fruit juices for low-carb smoothies and tea. Tea comes in a variety of flavors that can help you get through the day if you get tired of water. There are a variety of different smoothies you can make for a meal replacement or as a quick snack as well.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
Brenda, here is the link to the article. From what I have been reading the diarrhea is not uncommon. I had been using KCT oil in my coffee and smoothies, that compounded the problem. I have tried several of the suggestions this article suggested and it has been a great help. My wife and I were wondering what fat sources are you using. We have been trying to get more fat into our diets. We do use butter, sour cream, full fat dairy products, and changed our hamburger meat back to 85-15, most of the time. Super love your articles, they show you care. That is what is missing in today’s world.

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.

We know from our research in blue zones longevity hotspots that the longest-lived people in the world eat a whole food, plant-slant diet that is highlighted with whole grains, beans, nuts, and leafy greens. Their diet is 90-95 percent plant-based and oftentimes about 50-65 percent of their daily caloric intake comes from carbohydrates. These are not highly processed carbohydrates like white bread or sugary drinks, but whole foods like sweet potatoes, beans, whole grains, and fruits and vegetables.

Supplements: MCT oil and fish oil, ensuring they are USDA-organic, hexane-free, and non-GMO. One important thing to note: MCT oil delivers beta-hydroxybutyric acid (BHB), which is the most important ketone body, and its benefits can be gained without fasting or even carbohydrate restriction. While the full benefits of a ketogenic diet will only be realized if you adhere to the diet in its entirety, incorporating MCT oil into your current diet and supplementation is a good way to benefit from ketone bodies on a smaller scale.
Emmy-award nominated screenwriter Brynne Chandler is a single mother of three who divides her time between professional research and varied cooking, fitness and home & gardening enterprises. A running enthusiast who regularly participates in San Francisco's Bay to Breakers run, Chandler works as an independent caterer, preparing healthy, nutritious meals for Phoenix area residents. Her work has appeared in The Houston Chronicle and San Francisco Chronicle, among other places. She is hard at work on her first cookbook which combines simple, fresh recipes with science-based herbal medicine.
Must say, however, that the shape of choice (for most pasta-like results) are the cavatelli. Both because the ridges help the sauce to stick better, and for the resulting texture and mouthfeel. Though you’ll need to procure a (9 bucks!) cavatelli & gnocchi board. Cavatelli are very similar to gnocchi in shape (which you can make too!), though slightly thinner and with more of a bite.  

I’m afraid there won’t be a straight substitution ratio because they behave a little differently. Not as different as coconut flour vs almond flour, but flaxseed nonetheless will have a different protein/fat/water ratio so will act in cakes and baking in a unique way. Saying that I love experimenting. I would begin by using a lower amount of the flaxseed to whichever recipe you decide to try, then mix and see what the result is. It may be that you need some extra liquid, an extra egg or a little more flaxseed. Sorry, that’s probably not the easy answer, but in the long run, if you get to really know how these new flours world – bam – you’re away!

2. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566 

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