The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
Good morning! My first loaf of bread is in the oven. I have a couple questions though, I used unblanched almond flour is that okay? Also I used ground flax seed instead of psyllium husk as I was not able to find any. Do you need to use coconut oil or would vegetable or olive oil work? Then, I have a question about your almond flour biscuits, would that work as a biscuit topping for chicken pot pie?
Walnut flour can be used for all low-carbohydrate baking needs and it can be swapped out for other grains in your diet. You can make pancakes, breads, muffins, cakes, you name it! Walnut flour is delicious, so give it a try. There are many brands, but we’ve linked you to one of the best-sellers or top choices on Amazon above. The brand listed is fine ground in California, USA.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
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]
Ketogenesis results in the production of ketone bodies, a product of fatty acid catabolism performed primarily by the liver, in the absence of adequate CHO availability. Three primary ketone bodies are produced; acetone, acetoacetate and β-hydroxybutyrate. Even though trace amounts of ketones are always present in the blood, it is only during periods of inadequate CHO availability that significant ketone production will occur. This accumulation of ketone bodies in the blood is commonly referred to as ketosis.
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.

I recently started using Carbquik and overall, I'm pleased with it. I'm on a low-carb diet, and my dining options have really opened up! So far, I've made cheese biscuits, pizza dough, and pancakes. The pizza dough isn't great, but if you use the right kind of pizza pan and roll it thin enough, it's certainly acceptable and it beats not being able to have pizza at all.


Donna the problem about using that much xantham gum in a recipe for gluten free is the problem. Usually when using xantham gum in a flour mix the general rule is 1 tsp per cup of flour or starch in the mix. so for this recipe there should only be 4 tsp of xantham gum not the 1/4 cup ( 4 Tbls) you call for. It should give you a less gelatinous texture and a much better taste. Another possibility to use instead of the xantham would be to use Psyllium husk powder. Hope this helps someone who might be finding it hard ro bake with the gluten free mix as written, try lowering the xantham gum to the levels I suggested.
Arguably the most challenging period of transitioning to a ketogenic diet is the first few days as your body adjusts to the dramatic decrease in carbohydrate intake and your metabolism begins its shift to fat as its primary fuel source. It is not uncommon during this period to experience a lack of energy, irritability, ravenous hunger, and brain fog, symptoms commonly referred to as the “low-carb flu.” These uncomfortable symptoms arise because a ketogenic diet eliminates the spikes in blood sugar that follow carb-heavy meals, keeping insulin levels low (because it is no longer needed in response to said blood sugar spikes) and triggering the kidneys to excrete high levels of electrolytes—think sodium, potassium, and magnesium. Additionally, many people transition to a ketogenic diet from a standard, modern diet, which was likely rich in processed foods packed with sodium, so electrolyte levels drop simply because you aren’t getting enough sodium to replace that which you previously took in from processed foods. In the end, if you do not replace these excreted and/or missing electrolytes in your new ketogenic diet, it can ultimately lead to a drop in blood pressure and bring about the symptoms of “low-carb flu.”
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.
Muesli has been a popular cereal worldwide for decades and it was the first experience of healthy eating for a lot of us. So low carb versions like this one are a great addition to your keto diet and give you all the goodness you need to get through the morning. You can play around with the ingredients to make it your own by adding some fruit or using different nuts.
I know I know, you’re reading the directions and you’re annoyed that you have to cut each and every ¾ inch square out and transfer it to a pan because WHO HAS TIME FOR THAT. But I am here to tell you that YOU HAVE TIME FOR IT because the end result is cereal that fancy-person-you made yourself, which is going to make you feel very elite and accomplished because WHO DOES THAT?
Join our community of “losers” today and subscribe free to IBIH newsletters to get notified when I post new keto recipes and updated keto diet menu plans! Also head over to the IBIH Facebook page where the cool kids hang out – and you’ll get access to my daily Amazon freebies, health and fitness tips, and other fun content I only post on Facebook! Finally, be sure to register for our new IBIH Community Forum where you can get daily support for the 5 Day Keto Soup Diet, 5 Day Keto Egg Fast Diet, Weekly Keto Diet Menu Plans, or just gab with fellow IBIH fans who are following a low carb or gluten free lifestyle!
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
I ditto that. I’m starting the keto diet, but am struggling to get my macros right. I usuaslly end up with too much protien and not enough fat. A daily “menu” to try to copy would be great! I”m 59, almost 60 and have about 20 to get off. My birthday is October and would like to have this gone by then! Thank you for all you do. I love reading your posts!!
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!
So let’s talk about vital wheat gluten. Yes, it is wheat, and yes in high amounts it has carbs – although not as many as flour. In this tiny amount it adds no carbs to the recipe yet helps the noodles to not only hold together but also to have that tender chewy texture we all love. This should NOT be served to anyone with a gluten intolerance or allergy but it’s just fine for low carb lifestyles.
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.
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[19] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[31] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[18] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[51] Other formula products include KetoVolve[52] and Ketonia.[53] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[53]
I think these are unbelievable! This is actually the first time I've written a review on Amazon, but I feel like I have to with these. I am trying to do a low carb/low cal diet to lose about 30 pounds, and have a huge weakness for pasta. I have tried Shirataki noodles, spaghetti squash, skipping the pasta altogether and just making veggies with sauce, and this is BY FAR the best way to quench my craving for pasta.
At 60 minutes, the bread showed as done with a toothpick. Removed it from the oven and it sank down the center. I waited 15 minutes. Cut a piece off and it was wet, like not done in the center. I baked it 15 more min and it stayed the same. Is it supposed to be wet/moist like, maybe it’s oily from the coconut oil? If it’s supposed to be completely dry but moist, not wet, then something went wrong.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
Then on the nutrition label, it reads, Low carb. Also the nutrition label does not list as a category, the carb count. All nutrition labels that read “Low Carb” would have a line item for the carbs, even if its <1g. Although, I personally have never seen a label that reads Low Carb as part of the nutrition label it's self, maybe in the ad area though.
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]

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.
However, replacing high carb flours like all-purpose flour, wheat flour, corn flour, and rice flour with low-carb flour is not as simple as just using one for the other. Due to the difference in composition between high-carb and low-carb flours, you will need to use different amounts of low-carb flour together with other essential ingredients that you don’t typically find in traditional baking recipes like psyllium husk, xanthan gum, and protein powder.
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
Maintaining a healthy weight has never been easy for me. I’ve struggled with sugar addiction and weight gain since I was a teen. You can read about my whole journey here and see Before pics as well. But since I’ve been low carb over the last 4 years I’ve been able to easily maintain my weight. Now with keto, I’m hoping to change my body even more. I may not lose “pounds” but just seeing these results shows the scale number is just one measurement and to me the body fat number is more important.
LOVE keto! I started January 23rd and have lost 17 lbs!! One more lb and I will have lost 10% of my body weight. I am so excited about these results and feel great! I wish I had taken before pics, but people are noticing. I was “winging” keto for most of this time, not truly counting macros. Just yesterday I downloaded carb manager and boy was it eye opening! I feel I am now better equipped to make this work. Most importantly, I’m excited to see what my A1C is next month. By my lab values, I am a diabetic. It runs rampant in my family. I do not want to have to go on medication…hoping to get things under control with diet and exercise. I am so thankful for all the wonderful resources online that are helping me do this and for a network of encouragement as we all try to be a healthier version of us!
I doubled the recipe. Accidentally added 3tsps baking powder. Also added 1/4 cup ground flax, 1/4 cup sesame seeds, 1/2 cup slivered almonds. I then mixed it for 3 minutes in my stand mixer. I baked the bread for 60 min and then added 10 and then another 10more. I used a thermometer and let it get to 200 degrees internal temperature.. That’s what I use for regular bread and seems accurate for your recipe. I’ll try to send a picture. It looks like bakery bread and tastes delicious. My family who are Leary of myGF and grain Free experiments love this bread!!!!

VEGETABLES: Before you think that veggies are an unconventional breakfast choice, remember the omelet. Add half a cup of cooked spinach (3.5 grams of fiber) and two cups of mushrooms, which cook down to half a cup, (add 2.4 grams) and you'll have a fiber bonanza. Add a half cup of black beans (7.5 grams) to your eggs by whipping up huevos rancheros or a breakfast burrito wrapped in a low-carb tortilla (9 grams). Don't forget the salsa; it doesn't have appreciable fiber content, but it does make things taste better.
Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly.

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!
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.
OMG! This is delicious! I’m trying to reduce carbs because it seems to be causing systemic inflammation. I finally got to try this, I am wowed. I used the Ghee instead of coconut oil, used a silicone loaf pan and baked it for 60 mins. It came out crusty,good texture. Yummy with Pepper jack cheese. Next time, I plan to make a double recipe for a larger loaf. Thank you sooooo much.
OMG! This is delicious! I’m trying to reduce carbs because it seems to be causing systemic inflammation. I finally got to try this, I am wowed. I used the Ghee instead of coconut oil, used a silicone loaf pan and baked it for 60 mins. It came out crusty,good texture. Yummy with Pepper jack cheese. Next time, I plan to make a double recipe for a larger loaf. Thank you sooooo much.

What's a foodie to do when you adore pasta, but you're trying to cut back on carbs or switch to a diet with a lower glycemic index? Simple. Try some of the low-carbohydrate pastas we found. Not only do they contain fewer carbs and calories that the regular stuff, but many have added protein and fiber, and are available in vegan options, too. When users buy our independently chosen editorial picks, we may earn commissions to support our work. Skip to the best low carb pasta on Amazon.

What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
Hi Joellen, It doesn’t rise as much as a wheat bread but does a little. The almond flour being frozen might have made it worse, I’m not sure – I don’t store mine there since I go through it a lot. I’m glad you like the texture. If you want a taller loaf, you can multiply the recipe by 1.5 or even double it, but would need to increase the cook time and probably cover it to prevent browning the top too much before the middle is done.
My daughter loves cereal, but I rarely let her have it because it jacks her blood sugar like crazy, and is rarely filling enough. This is low carb enough that if she likes it, I can fill her up with other stuff, too, while letting her have the cereal she so badly wants. I was just admonished by the nutritionist at her endocrine clinic for letting her often have a nutritionally vacant breakfast (toaster waffles; we get so busy in the morning! I need to be better at pre-prep).
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
You can definitely do keto without eggs. For a while I just did bulletproof coffee for breakfast which is super filling. But I have my 2 minute english muffin you might like. And my Crock pot granola is fantastic too with unsweetened almond milk. I love all veggies but I did have to cut way back in order to not go over my 20 net carbs. I just make sure to enjoy different veggies each day so I don’t feel like I’m missing out.
From the study itself: “Mortality increased when carbohydrates were exchanged for animal-derived fat or protein and mortality decreased when the substitutions were plant-based … Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.”
Carbohydrates are your body's favorite fuel source; it breaks them down into glucose. Without a steady intake of carbohydrates, your body turns to using protein for fuel. But if you also are limiting how much protein you eat, your body is forced to burn stored fat as its primary source of fuel. That can result in weight loss, and ketones are a byproduct of burning fat.
I don’t make pancakes often and never waffles, but I have definitely used it for the crepes A LOT. The key to the crepes is that the liquid is super thin–like cake mix, not like brownie mix. The xantham gum is really not a huge amount for the full recipe. It is under 1 TBSP per cup of other dry ingredients. Let me know if you like it better with the wheat gluten. Thanks for writing!
At 64 I had over 125 lbs to lose. I started a Keto Diet 7 months ago and have lost 75lbs. I have a number of autominnune issues and my health was so bad I was almost bedridden. I now do a water workout twice a week and yoga. I can see a low carb diet being my way of life after I get down to my goal weight. I feel so much better and I agree I am never hungry. I recommend the Bullet Proof Coffee for Kate. Coffee with cream, coconut butter and butter, blend. Adds fat to your diet and keeps you full.
I really love this bread the taste and texture, but I just can’t get the bread to rise. It always falls in the middle even before it is finished baking and continues to fall while cooling. The slice of bread looks like a sway back horse. It will rise and look wonderful and then start falling in the middle while baking. I’ve added a tablespoon of Baking Soda, increase the water to 1.5 cups, tried glass and metal loaf pans, baking at a higher temperature but nothing works. Can anyone help me with this falling in the middle problem?

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.
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).
I’ve searching and searching for a keto bread that is not too eggy or have no cheese. I just mad this bread and oh! It’s soooo good! It’s got the wholesome texture but nice and firm. No eggy taste! Thank you so much Maya for sharing this recipe. Finally, I can make my Brit husband happy. We’ve been on a keto for 3 moths and he lost 20 lbs but since he is from England, bread is so important to him. I will surprise him when ge gets home. I’m so happy!
Wow!! I was so happy to see last night that I had all of the ingredients except the flax seeds, so I threw all these ingredients together and am enjoying them this morning on my homemade Gree yogurt…delish!! This is really giving me my cereal satisfaction. I did substitute some ground flax for the flax seeds and it seems to have worked beautifully. Other than that I followed the recipe exactly and couldn’t be happier with the results! Thank you thank you for posting this!
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]
I think I might have been in ketosis sooner but after 1 month I took my blood test at night and I was surely in and I had felt all the good effects of it too, like no hunger between meals etc. It wasn’t difficult to reduce the carbs to 20 net because you’re replacing it with good healthy fat which is so filling. I think my body likes to hold on to the fat as stubbornly as yours and I agree stress doesn’t help, but I have always been a slow loser. I’d suggest taking measurements and body fat and pictures so you can see the difference. If you really think you’re not progressing you may have to reduce calories too.
While there are many different types of pasta today, the classic cooked, unenriched traditional pasta is about 30 grams of carbohydrates per 100 grams. That’s your entire daily carbohydrate intake on the ketogenic diet, if you’re lucky. After that comes a minuscule 0.9 grams of fat, about 6 grams of protein and minimal micronutrients. Even whole wheat pasta, advertised as a health food, contains 37 grams of total carbohydrates[*].
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].
Taken together, these results demonstrate a positive effect of LCD/KD on body composition. While KD may not be superior to other dietary strategies aimed at weight reduction, the evidence does suggest that it may be equally effective. Nevertheless, the International Society of Sports Nutritionists, in their Position Stand on the effects of diets on body composition, suggest the KD holds little benefit over higher CHO diets, with one notable exception; KD may enhance appetite control (1).
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