Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)
Providing additional support Paoli et al. (17) examined the effect of a modified KD diet (~55% fat, 41% protein, and 4.5% CHO) on performance and body composition in gymnasts. In a crossover design, researchers compared independent 30-day dietary regimens consisting of “normal diet” (WD; 46.8% CHO, 38.5% fat, and 14.7% protein) and modified KD in nine elite male gymnasts. There were no significant changes from pre to post during either dietary intervention for measures of physical performance, indicating the absence of significant dietary CHO did not negatively impact physical ability. The post-KD measurements, however, saw a significant decrease in fat mass (pre: 5.3; post:

If there is a certain amount of glucose available in the blood, the body will choose to burn that as energy before it burns fats. This obviously prevents you from entering ketosis. While the general recommendation for most people is to shoot for 40 grams of carbs or below on a daily basis, this is actually somewhat relative to the individual. I will often go by percentages, saying that between carbs, proteins, and fats, carbs should make up between 5-10% of total calories.
Carbs in fruits and veggies do count, but you don’t add up the carbs and sugar. Sugar is already included in the carbs – it’s just listed separately on labels because some people want to see a breakdown of how much of the carbs are sugars (versus other, complex carbs). If it says 2g carbs and 2g sugar, it means there is 2g total carbs and all of them are sugar (in this case).
If you are wondering what the heck a daikon radish is, don’t worry, I was in the same boat this time last year. My first experience with daikon radish was in my CSA box. I actually got a purple daikon radish and had absolutely no idea what to do with it. So I pulled out all my cookbooks and found a recipe in my Inspiralize Everything cookbook (affiliate link).
Protein can turn into carbohydrates via a metabolic process called gluconeogenesis (making new carbs) and will do in people at varying degrees. Protein turning into carbohydrates means you’re not in ketosis. However, this is generally an overblown statement that only happens at the extreme cases when you are drinking a lot of liquid protein shakes. 
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18] 

It is easier than ever to eat all of your favorite foods while following a low-carb ketogenic diet. All you need is the right combination of low-carb flours and ingredients to make delicious keto-friendly breads, cookies, cakes, hamburger buns, etc. At this point, I’d be surprised if there are any high-carb recipes that cannot be made into a healthier, low-carb version.
While there are many almond-flour pastas advertised as low carb, be sure to triple-check the label. Many brands contain more carbohydrates than you’d believe. Al Dente Carba Nada contains over 24 grams of total carbohydrates, or 17 grams net carbs[*]. Fiber Gourmet, also advertised as low carb, contains over 40 grams of total carbohydrates per serving and 3 grams of sugar[*].
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.

While there are many almond-flour pastas advertised as low carb, be sure to triple-check the label. Many brands contain more carbohydrates than you’d believe. Al Dente Carba Nada contains over 24 grams of total carbohydrates, or 17 grams net carbs[*]. Fiber Gourmet, also advertised as low carb, contains over 40 grams of total carbohydrates per serving and 3 grams of sugar[*].


I have made this twice, both in the microwave. I have a tall coffee mug and it seems to work fine. I used Golden Monk Fruit Sweetener once and Swerve confectioners once and both were good. First time I microwaved for a full minute – a little dry but still delicious. Second time for 55 seconds and still a tad dry, but again, still delicious. Next time, I’ll shoot for 50 seconds!
If you are trying to get the kids to eat healthier and not rely on sugary cereals you might find this keto one will win them over. It has a great texture from the nuts and seeds and has a sweet warming flavor from the cinnamon and sweetener. This cereal is great with your choice of milk or can be made a bit more filling by adding in some fresh berries.
Hits the spot! I love traditional cereal and this definitely satisfied my tastebuds!! I will say I did realize how important it is to not over pulse, and to create a thin layer when placing in the oven. For the first few minutes I had a thick, maybe 3/4 inch layer, and I ended up thinning it out after reading reviews. I think in total I baked mine for 25-28 minutes. It was a little soft after coming out of the oven, but like you said it hardens after it cools. I added cinnamon, and wish I added more (I love a strong cinnamon flavor). 

Hi Maya! I’ve been trying to lose weight on a low fat diet, to no avail, so I’m trying Keto. I came across your recipe while looking for almond flour bread recipes. (Love the occasional turkey breast half-sammie for lunch or the occasional toasted slice for breakfast). Yours appears to be a very carefully thought-out recipe which I’m anxious to try. I really like how you explained things so thoroughly, gave tips. There’s nothing like learning with the benefit of others’ tried and tested experience. I’m not rating this recipe since I haven’t tried it yet, but based on your effort alone, it gets five stars! Many thanks, Alice
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.
The ketogenic diet has recently become very popular, and many food companies want to cash in by putting a “ketogenic” or “low carb” label on a new product. Be very cautious of special “keto” or “low-carb” products, such as pastas, chocolate bars, energy bars, protein powders, snack foods, cakes, cookies and other “low carb” or “ketogenic” treats. Read all labels carefully for natural low carb ingredients. The fewer ingredients the better.
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?
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
Just found your website! What an incredible help it is for me. I just converted to a low carb diet a couple of weeks ago, and must admit began struggling with some of the foods we love as a family and didn’t want to give up. Plus the information about almond flour increasing inflammation was eye opening. I have both rheumatoid and osteo – arthrits and recently it has really acted up. Now I know why. I will use coconut four more now! Thank you.
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.
This keto granola can be made in big batches and stored for use during the week, but it takes just a couple of minutes to throw it together so can be made fresh each morning. This makes a perfect energy-rich start to the day if you are no-sugar, and the slow release of energy will boost your system till lunch. Serve with nut milk of your choice – almond milk or coconut milk work well here.
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.
I’ll be the first to admit it, I’m kind of obsessed with Big Mac sauce. What can I say? That special sauce is magical! These easy Low Carb Big Mac Bites were inspired by the Low Carb Big Mac Bowl I made recently. You know Melinda and I love bite size appetizers and who doesn’t like food-on-a-stick at a party? Say hello to these awesome mini bunless burgers served with a creamy, tangy special sauce :). 
This is so incredibly helpful! My doctor told me I’m at high risk for Diabetes and that he would bring me back in 3 months for repeat labs. He told me to go on a low carb diet and without realizing it, I ended up doing the keto diet. I was determined to lower my carb intake even more and I haven’t had over 20g net carbs since I started. This is a lifesaver. Thank you!
After trying literally DOZENS of Keto bread recipes, I have FINALLY found something I can use as a burger bun! Other recipes were great for biscuits or rolls and such, but didn’t work for a burger bun – and SO EASILY! I added a tiny bit of garlic powder and topped them with TJ Everything Bagel spice, baked them in a muffin top pan and they are AWESOME! Finally – after all this time having to have my cheeseburger without a bun – last night I had a burger AND a bun! Woohoo!!! Next time I will try adding some yeast, just for the flavor. THANK YOU SO MUCH for the GREAT recipe!!!
Hi Maria, Did you use all the same ingredients and amounts? If you did they should be sweet, but I do think they need the coating for the best flavor and sweetness on the outside. That being said, everyone’s sweet tooth is different so you can add more sweetener next time if you want to. I usually don’t recommend canola oil – use butter, coconut oil, or avocado oil instead to grease. Heavy cream should be fine to sub for almond milk, but you might need a tad more since it’s thicker.
Hi!! I have been following you since I started Keto…. Dec 26, 2017. I have lost 41 lbs since then and in the last 3 weeks I can not seem to get the scale to move nor are the inches changing… I am 58 yrs old and lightly active (I work in retail and am on my feet all day.. 10 hrs per day… operating register, stocking soda, candy… putting grocery truck away) I have been running my macros at 16 carbs (I do not do net) fat 97gm and protein is 78gms which is for my calorie intake of 1258 5/70/25…. I am at a total loss as to what steps I need to take…but for the most part I generally only get in 700-900 calories per day… I am just not hungry. Days off are nightmares…. it seems all I want to do is eat… I have NO “bad” foods in my house… I mostly eat veggies on my days off… asparagus, broccoli, zucchini, cabbage, radishes cooked in an oil of some sort olive, avocado, sesame……. I dearly love tomatoes but eat them sparingly.
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.

The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?

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.
A classy twist on the average turkey burger, this nutritious recipe comes together quickly—the mushrooms roast in the oven for 12 minutes while the turkey cooks on the stovetop—looks complicated (read: serve when you have friends coming over), and tastes delicious. Packed with protein, thanks to turkey, plenty of potassium courtesy of the mushrooms, and crazy tasty. What more do you need?

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.
By incorporating the foods we offer into your diet, we find many people are able to stick to their diet longer because it provides greater variety, they are able to have foods that they wouldn't be able to make at home (even with serious chef inspired dedication), and in many cases the cost of the item is significantly cheaper than if you were to attempt to create it at home. We've heard some horror stories about spending big bucks on bread machines, ingredients, hours of lost time, and only winding up with a poor tasting loaf.
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.
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.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
While low-carb simply describes a vague behavior pattern that is subject to each person, ketosis is an objective and measurable fat-burning state of the human body. It is when the body’s metabolism switches gears to burn fat for energy instead of sugar. It is this metabolic state in which people experience the full benefits of a ketogenic lifestyle.
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