Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
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.

Almond flour works well as a wheat flour substitute. Because it is so dense and crumbly, you'll need an extra egg to give baked goods rise and structure. Lower the oven temperature by 25 degrees Fahrenheit and allow food to cool completely before serving. A 1/4-cup serving of almond flour has 6 grams of carbohydrates and 3 grams of fiber. At only 5 grams of carbohydrates per 1/4 cup, hazelnut flour is another low-carbohydrate option. It is a good source of vitamin E and healthy fats. Replace up to 30 percent of wheat with hazelnut flour in baked goods such as pie crust and cookies.


Although the KD has shown promise as an alternative dietary strategy for weight management, it should be approached with caution. Acutely, the KD causes physiological changes which may manifest as the “keto flu,” a set of symptoms which commonly includes headache, nausea, gastrointestinal upset and fatigue. A recent study by Urbain et al. (22) illustrates this point, as they state, “Consistent with other studies, our subjects complained about headache, gastrointestinal symptoms, and general weakness mainly during the 1-week metabolic adaptation phase to a KD.” While these symptoms typically resolve within the first one to two weeks, this may present an unpleasant barrier for many individuals to overcome.


I remember years ago loving the Monterey Chicken at Chili’s Restaurant Grill & Bar. Then, they took it off the menu, and it has been just a distant memory ever since. Since starting Keto, I have thought about making a keto friendly version. In fact, I did post a very lazy crockpot version of the recipe that is keto friendly/low carb, which is delicious, but I missed the skillet version like Chili’s Restaurant.


Adequate food records were available for analysis in a proportion of participants at each of the 4 timepoints (Table ​(Table2).2). Participants completed food records at a mean of 2.5 and a median of 3 timepoints. In general, comparing baseline to subsequent timepoints, mean carbohydrate intake decreased substantially and energy intake decreased moderately while protein and fat intake remained fairly constant.
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.
I have been on the Atkins diet for the past month and a half (with great results!) But, I am not too crazy about the taste of the Atkins low carb baking mix. I decided to give this one a try, and I am so glad I did! I have read thru some of the other reviews, and for the most part, it was given high marks. I'd like to add to that five star rating by saying how much easier it is to use. No clumping, no harsh after taste, and I love the whole grain flavor! The pancakes are awesome, and its good to be able to have them again! You feel satisfied on a very small amount of anything made with this product, and remain comfortably full, which helps you avoid 'picking' in between meals. Highly recommend! 

Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[56]

Ketogenic and low-carb diets aren’t as new as most people think. The ketogenic diet was developed in the early 1900’s to help control pediatric seizure cases who were not responding to medical treatment. Low-carb diets gained a lot of attention due to the Atkins nutrition plan which emerged in the 1970’s and remains a fairly popular program today. When it comes to keto vs low-carb, they are actually pretty different and can have drastically different effects on the human body.
You can grind almost any nut to obtain a flour-like consistency and use it to reduce the carb content of your recipes. Walnut meal, for example, can be used in many recipes that call for almond flour. Other nut flours that you can experiment with are hazelnut meal, pecan meal, macadamia nut meal, and pistachio meal. Each one will provide your baked goods with a unique flavor, so choose wisely.

A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).


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.
Hi! My donuts are in the oven right now, but they are spreading too much & not rising. Almost running off the donut pan. I only filled them 3/4 full as you show in the video. I doubled the recipe using the above calculator. I know I followed it exactly. Any idea of what I did wrong? The batter tasted yummy and so did the finished product, the donuts just weren’t as pretty as yours.
The Keto diet is high in fat, moderate in protein and extremely low in carbs. It’s a highly effective diet as it takes into account accurate tracking of your meals, to find the right body balance, followed by charting your goals! I’m a big fan of the low-carb diet. Not only has it been shown to be more effective than a low-fat diet, but it bestows many additional health benefits over a typical diet.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
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. 🙂
Hi Carleen, I wouldn’t recommend unblanched almond flour. It might be ok but the texture will be much worse than using finely ground blanched. I haven’t tried the recipe with flax but I expect that it will work better with psyllium, which provides that chewy bread texture and flax doesn’t do that. If you don’t want to use coconut oil, I’d recommend butter or ghee over vegetable oils. The almond flour biscuits should work fine as toppings.
I just made these and followed the advice of another comment. I added a scoop of vanilla whey protein and a scoop of sour cream. I did not have a donut pan so used my regular sized muffin tins. I buttered the tins very generously. I filled half full and it made 10. I shortened the baking time to 13 minutes which was perfect. I made a glaze of heavy whipping cream and powdered swerve for half and the cinnamon sugar combination for the other half. They are fabulous!

"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.

Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.
Granola can be used as a breakfast dish or as a source of energy to snack on during the day, especially if you take part in sports and need a bit of a boost. This low carb version makes a lovely crunchy breakfast cereal but it also a great topping for yogurt or ketogenic ice cream. This granola can be stored in an airtight container for up to two weeks.
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.

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]


As with cold cereals, your best bet for a low-carb breakfast cereal comes in the form of whole grains. Oatmeal is an excellent choice because it is high in fiber and contains a substance called beta-glucan, which slows down the digestive process. That means you will stay full throughout the morning. Bran cereals can also be eaten hot, and whole grains such as quinoa or grits can be flavored to be either savory or sweet. Quinoa goes especially well with walnuts and raisins, dates or dried figs. It is is also scrumptious when flavored with a little bit of coriander and served with a poached egg on top. Grits are also a natural partner for eggs, but they are also delicious with pecans and fresh blueberries. Drizzle a bit of honey, agave or real maple syrup on top for sweetness. This will increase the carb count a bit, but the nutritional benefits of starting your day with a hearty, hot breakfast are more than worth the few extra carbs.

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]


Hi Megan, My batter is pretty sticky, too, which is fine. You can add a little more almond milk if it’s very thick. Other than that, if they are dry they were probably in the oven too long. Try reducing the baking time a bit next time. The last step of dipping in butter for the cinnamon coating should also help with dryness. I hope you’ll try them again!
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

After the 1st time I started making these i started making it as a cake using a small casserole dish cutting into 8 pieces, without the sugar/cinnamon topping. I tried monk fruit sugar and love it (new at Costco in Seattle) I also used 2% milk (all I had on-hand). I’ve made several batches and theres been some on the counter for 2 weeks now. My husband and I love having a treat we can grab on the go.
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

Of course it does not match the price of mass produced cereals on the market, I’m not surprised. It’s about on par with other specialty Keto items in my opinion. It has 15 servings per bag and will last you two weeks if you eat one serving a day. To me it is well worth the price because if I were to have it as a snack every day that’s only $5 a week for something I enjoy eating!
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).
So today I was sitting here getting some work done and occasionally looking out the window. The roses on the trellis are pretty actively in bloom and the trees are loaded with bright green leaves. The colors are bright against a glowery gray sky, though and it looks chilly. It’s not in the least – I think the high today is going to be 81F – BUT it LOOKS that way.
Hi Amelia, I’m glad you liked the bread! Sorry it turned out expensive for you. I usually use this almond flour from Amazon, which is a lot cheaper than the one you mentioned ($8.49 per pound right now), but I don’t know if it’s available on Amazon UK. Vitacost also often has good prices, especially if you look for a coupon code online, but not sure about their shipping prices to the UK. Let us know if one of those turns out to be a better deal, or if you find some other place that’s better.

I made this bread several times now using ground flaxseed in place of the psyllium powder and it came out perfect every time. I decided to try it as a sweet bread and added 1/2 cup raisins, 1 Tbsp. cinnamon, 1/4 cup erythritol and 2 Tbsp. Splenda. After it was done I iced it with 1/2 cup powdered sugar mixed with enough milk (about 1 Tbsp. to keep it thick but a little runny. Now I have a healthy, delicious, loaf of cinnamon raisin bread. Thanks for the great recipe!
Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.
At $12.99 for 12 ounces it can get expensive. It’s times like these when I long for Germany, where a big bag of walnuts flour is 1.60 Euro. Benefits are great bang for the buck. There’s lots of protein in nut flours, amino acids, omega-3s and vitamins. There’s plant fiber and healthy fat. It helps you control your blood sugar, and keeps you full until the next meal. These are just a few of the benefits of nut flours in general.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
First time we were able to have ‘bread’, on Passover, as I was able to find the kosher for Passover version of all the ingredients. Costco had Kosher for Passover (KFP) Almond flour & Himalayan sea salt. Original Metamucil (KFP all year) for the phylum husks (although I could have gotten the husks on line). Passover Gefen baking powder was in my local kosher food store, La Bonne coconut oil is KFP, though other brands may be as well. This was such a hit recipe!!
Despite “cereal” being often associated with “carbs,” these days there are plenty of low carb cereals available. Remember that milk has naturally occurring sugars, which are carbs, so be sparing in how much milk you put on your cereal if you want to cut even more carbs. You can also opt for hot cereals – plain oatmeal is actually one of the best whole grain, low carb choices out there – if you do not like plain cereal and milk. The five brands above provide particularly good options in their low carb counts along with high fiber and protein. Head to your nearest supermarket today to find some great low carb cereals!
Hi Patti, It’s up to you if you want to go by weight or by volume. I include both for convenience. Some people don’t want to weigh all their food, though weighing is definitely more accurate. The volumes listed are based on how a food is normally served, so for iceberg lettuce it would be chopped, not minced. It sounds like you’re weighing anyway, so in this case just use the weights instead (they are shown in grams in parentheses next to the volumes). Hope this helps!
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you’re still falling within an acceptable range of your daily goal.

I made this bread several times now using ground flaxseed in place of the psyllium powder and it came out perfect every time. I decided to try it as a sweet bread and added 1/2 cup raisins, 1 Tbsp. cinnamon, 1/4 cup erythritol and 2 Tbsp. Splenda. After it was done I iced it with 1/2 cup powdered sugar mixed with enough milk (about 1 Tbsp. to keep it thick but a little runny. Now I have a healthy, delicious, loaf of cinnamon raisin bread. Thanks for the great recipe!

Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
Hi Andrea, There is no added sugar in the recipe. The sweetener is natural, not fake, but it is not sugar and does not contribute any sugar. The 1g on the label comes from almond flour, which has no added sugar but almonds themselves have a tiny amount of sugars. For this recipe, make sure the chocolate you get is 100% cacao without any sugar added. Hope this helps.
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.
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].
Hi Sandy, You might be able to deep fry them (haven’t tried), but you’d still have to bake them first. The batter is too thin to just straight deep fry, it wouldn’t hold together. You can make them into a different shape if you don’t have a donut pan; some people have used muffin tins. Otherwise the cheap but great donut pan I use is linked in the post above if you want to get one.

I made this today and the flavor is outstanding! My only thing about it I’m not completely thrilled with is the lack of clumps of nuts and seeds. I put some pecan pieces in hoping they would form some clumps with the nuts, but it didn’t really help. I’m wondering if a thicker liquid would make a difference. Perhaps Sukrin gold syrup instead of coconut oil and sweetener? Could maybe add some maple flavoring to it. You might not be able to find Sukrin in the UK, but it is accessible through Amazon. Would maybe some of your followers from the US have an opinion about this?
After the 1st time I started making these i started making it as a cake using a small casserole dish cutting into 8 pieces, without the sugar/cinnamon topping. I tried monk fruit sugar and love it (new at Costco in Seattle) I also used 2% milk (all I had on-hand). I’ve made several batches and theres been some on the counter for 2 weeks now. My husband and I love having a treat we can grab on the go.

I am post menopause and I did lose about 40 lbs. Then I stalled and stalled. I was too hot all the time and was having sleep issues. I added more carbs and was better. I attempted keto/ low carb again in January. Two weeks in I had the same symptoms. It is not uncommon. It works well for some but not for me and a few of the other women at my gym. I liked what I was eating and I stuck to it through the stall but no. With the guidance of my trainer I have modified it, lost weight and feel great. Sleep helps!

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