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Urine ketone data were missing in a median of 4 participants (range 0–8) at any given visit. The proportion of participants with a urine ketone reading greater than trace was 1 of 17 participants at baseline, 5 of 17 participants at week 2, and similar frequencies at subsequent visits until week 14 when 2 of 18 participants had readings greater than trace and week 16 when 2 of 21 participants had readings greater than trace. During the study, only 27 of 151 urine ketone measurements were greater than trace, with one participant accounting for all 7 occurrences of the highest urine ketone reading (large160).
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]
^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
I am a recent convert to using freeze-dried fruit and if you try this amazing crunchy granola you will see why. The fruit has a much more intense flavor than fresh berries and helps to add that fruity note to the nuts and coconut flakes. It also makes this cereal more child-friendly because the fruit turns the milk pink! This granola can also be formed into bars to give you a boost of energy through the day.

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.
Yes, the psyllium husk powder is required for this recipe. I try to provide alternatives or substitutions where possible, but in this case other ingredients won’t have the same effect. The psyllium husk powder gives this a true bread texture. You could possibly reduce the amount a bit, but not remove it altogether. I hope you get the chance to try it!
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.
Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
Soba noodles: In many Japanese dishes, fiber-rich soba noodles are the star player. While they’re similar in texture to traditional long noodles, their nutty flavor makes them a great fit for savory and slightly sweeter dishes. At 24g of carbs per cup, they’re a higher-carb option than veggies, but still lower in carbs than a cup of regular spaghetti which has around 43g of carbs.
Today we tackle low carb flour alternatives. There are a few wheat-based flour products on the market that have somehow magically been de-carbified. You are free to use these if you wish, but I steer clear of them. I stay away from most things with wheat as it is, but I did try these out a few times and I can’t say that they live up to the promise. They don’t taste very good, they don’t rise well or hold together well, and you have to ask yourself: what sort of processing do they go through to reduce the carb count so much?
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.
The ingredients above are usually quite expensive and might take some experimenting to get the hang of using. The low-carb or keto way of eating by no means require baking. If you don’t miss bread you certainly don’t need to replace it with a low-carb version but if you do miss bread or maybe just miss the baking itself the recipes below might be of interest to you.
I really appreciate this article. I have done low Carb for the most part for over 15 years and was able to keep my weight down. Now that I have gone through menopause is just keeps getting harder. I try doing keto but tend to fall off the wagon a lot and go back to low Carb or Weight Watchers. Simple ideas would be great. I think some keto bloggers make it seem that you have to create difficult recipes. Thanks for all you do.
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.
i made these for my husband and me today. I used a blue silicone donut pan that i purchased from amazon. I followed the recipe exactly. I oiled the pan with coconut oil. I let the batter sit for 10 minutes before putting it in pan, like one of the other comments suggested. I let it cool for 20 minutes and they came right out…perfect. He had one at 3:00 and just now another at 9:00. He’s not happy about being on keto most days, but his comment after eating both times was: good, very very good! Thank you so much for sharing your life and time with us.

A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
Kelp noodles: Made from seaweed, kelp noodles are low in carbs, calories, and fat. They’re also a great source of calcium. Kelp noodles have a basic bland taste and texture, which makes them great for soaking up and showing off complex flavors. While they’re often featured in Asian dishes, they work well as pasta replacements in other cuisines, too.
This is such a great addition to breakfast. With that said I tweaked it a bit by adding a bit more butter and vanilla. After cooling I pressed it into a spring-form pan to use for a cheese cake, end result was great. Guests couldn’t believe their desert was carb free gluten free. I think the possibilities for this recipe is endless, nuts, chocolate shavings or chunks my husband added cranraisins. Thank you so much for posting.

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.

My favorite sugar-free low carb BBQ sauce is a family recipe that I tweaked to make keto friendly. It is simple to prepare without a lot of added ingredients that aren’t necessary. You can find my recipe here. If you are looking for convenience, there are several brands that make a sugar-free variety that can be ordered from Amazon or you may find in your local stores. The only brand of store-bought sugar-free bbq sauce I have tried is by G. Hughes. They offer several different varieties, but I prefer hickory. I might be a little partial, but my homemade BBQ sauce makes this recipe taste much more authentic and flavorful.


Net carbs is simply total carbs minus fiber and non-digestible sugar alcohols, like erythritol. (This doesn’t apply to high glycemic sugar alcohols, like maltitol.) We don’t have to count fiber and certain sugar alcohols in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. (Read more about sugar alcohols here.)
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.
Hi Cathy, are you adapting these recipes yourself or are they already developed using coconut flour? From experience, it takes a lot of attempts to get it right (but fun too, it brings out the scientist in me). Coconut flour requires a high number of eggs for volume, thickening, protein, binding, and structure. I would be worried if there was too much avocado in there as that is just adding a soft ingredient that gives no structure. The sweet potato would add volume but unless there is enough eggs and coconut flour in the recipe, again it won’t add to the solidity of the final recipe. Psyllium I add purely to get a better crumb texture. It swells and thickens and helps bind all the other ingredients together nicely. Scones – they won’t have risen because of the lack of gluten (yay), but I quite like heavy scones as a personal choice. I started baking using recipes that had already been developed using these low-carb flours, and start by adjusting the flavours only not the ratios of the bulk ingredients. You will soon get the hang of them. Start with my flourless berry sponge, I use these ratios all-the-time! Yum.
Not in the mood for cake? Brownies definitely come second on that list of delicious treats that we want once we turn to a ketogenic diet. You can easily make keto brownies that you can fully enjoy without having to fight against the craving to have more. Besides using almond flour and other mixtures of flours, you can make them out of avocado as well.
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.

I’m new to this type of baking. My husband is borderline diabetic, so I decided to try more low card recipes, by eliminating wheat flours from our diet. I’ve tried some other bread recipes that didn’t deliver the expected results, but this one did. And its so simple to make. My husband remarked that the texture reminded him of rye bread, and asked it there was something we could add to give it more of a rye bread flavor. I did a little research and discovered that caraway seeds would do the trick. I partially ground about 2 teaspoons and soaked in warm water for a few minutes, then drained before adding it to the batter. It worked!
Made these donuts this morning, and they are delicious. The simplest and one of the best low carb donut recipes that I have tried. I did add a scoop of whey protein powder for structure, and that worked great. I used Swerve in the donuts and a small amount of Truvia (which contains a little sugar–but okay in this tiny amount per donut) for the topping. I got 8 donuts out of the recipe, but I think I actually could’ve gotten 10. I have two 6-cavity nonstick Wilton donut pans like the ones pictured in your link. Great recipe, Maya. Thanks!
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
I really like these. Luckily I had all the ingredients on hand and made them last night. I did use a tsp. Of molasses with erythritol for the brown sugar substitute. Now, I will say that they don’t taste like oatmeal as much as they do look like it. Since I don’t know of any way to make them taste more oatmealy I might try some other flavourings in the future like adding apple pie or pumpkin pie spices. Anyway thank you very much for this well thought out and very tasty recipe . And if anyone is wondering, chopping the almonds by hand worked out fine.
It can sometimes be difficult to find a cereal that actually fills you up till lunch, so a keto-compliant granola can be the answer. This one is deliciously crunchy and has a warming flavor from the cinnamon and tastes great with your favorite nut milk. Nuts can be a great source of goodness and energy, so this can also be eaten as a snack when you need a little something to keep you going.
Made this today for my husband. It is delicious. I used coconut oil (the hard kind) and added 1 tsp of cinnamon. Only problem is that it did not crisp up. It’s more “bendy” than crispy. Not dry enough. Definitely baked it long enough. Should I use less coconut oil next time. Any ideas. Thanks. I will definitely make again because the taste is awesome.
Protein: When people first reduce carbohydrates in their diets, it doesn't seem as though the amount of protein they eat is as important to ketosis as it often becomes later on. For example, people on the Atkins diet often eat fairly large amounts of protein in the early stages and remain in ketosis. However, over time, some (perhaps most) people need to be more careful about the amount of protein they eat as (anecdotally) the bodies of many people seem to "get better" at converting protein into glucose (gluconeogenesis). At that point, each individual needs to experiment to see if too much protein is throwing them out of ketosis and adjust as necessary.
Just wanted to post in case others share my initial trepidation about trying the recipe. I avoid anything super high maintenance, but was intrigued by the positive reviews, so I gave it a try. Success! I did everything the recipe said not to (used a silicone pan and cheap almond flour that was definitely not ultra fine, and I have no idea how old my baking powder is), and they still turned out great! I did liberally butter the silicone pan to make sure I could get the donuts out and also added a smidge of xanthan gum to help hold them together.
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.

Hwu believes risks of cardiovascular disease and diabetes — which are both associated with high blood pressure, glucose and cholesterol — may be reduced by following the ketogenic diet, based on research. A recent study from Johns Hopkins found a ketogenic diet was not only safe, but effective for adults who had certain severe forms of epilepsy, supporting previous research.


Almond flour recipes typically require more eggs and more leavening agent to help them rise properly. I also like to add a little dry protein, like whey protein powder, as I find this can help [with rising?].  Almond flour recipes may also contain less oil and liquid as well, to account for the high fat content of the nuts. In my experience, low carb, gluten-free batters are thicker than their conventional counterparts. Resist the urge to thin them out, as you may end up with a soggy mess.
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.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
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.

LOW CARB & WHOLE-GRAIN BREADS: Lower-carb breads and tortillas can be a great source of fiber; look for those with at least 4 grams of fiber per serving. Look for 100 percent whole-grain bread (the term “multigrain" doesn't ensure it is all whole grain; check the ingredient list). Spread your toast with two tablespoons of a natural peanut butter for another 1.9 grams of fiber.
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!
I’ve been seeing a lot of recipes on pinterest that use peanut flour (not touted as low-carb necessarily)…was wondering if it would be good for baking keto recipes. There are carbs in it but if you bake something and only eat a serving, I’m thinking it might not be too carby. Not sure how it does as a sub for other flours that others use for keto recipes.

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.
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
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.
Health's contributing nutrition editor Cynthia Sass, RD, MPH, suggests looking for cereals that are made with nuts, seeds, coconut, a little bit of fruit, natural sweetener (think honey or agave syrup) instead of added sugar, and spices for flavor. Although many of these cereals may be gluten- or grain-free, you can also look for flaked whole grain varieties.
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