While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.

I have several health challenges and the latest was the need to be on a gluten free diet. At first I thought it wouldn’t be too bad as I had seen many products in the store to help me. Then…I started tasting them. Can I say cardboard might have more flavor and texture?!? Oh my, what an adventure…lol! Then I found you and your amazing recipes! It is very apparent the time, dedication and love you put into making each recipe taste perfect.

Please note that I am not a medical or nutritional professional. I am simply recounting and sharing my own experiences on this blog. Nothing I express here should be taken as medical advice and you should consult with your doctor before starting any diet or exercise program. I provide nutritional information for my recipes simply as a courtesy to my readers. It is calculated using MacGourmet software and I remove erythritol from the final carb count and net carb count, as it does not affect my own blood glucose levels. I do my best to be as accurate as possible but you should independently calculate nutritional information on your own before relying on them. I expressly disclaim any and all liability of any kind with respect to any act or omission wholly or in part in reliance on anything contained in this website.


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.
Supporting these results, Naude et al. (15) found a similar outcome in obese adults with and without type 2 diabetes. This meta-analysis of 19 randomized, controlled trials compared dietary interventions using standard CHO recommendation (i.e., 45 – 65%), low-carbohydrate/high protein (LCHP) and low-carbohydrate/high fat (this group, although not specifically stated, met the criteria for KD). Results demonstrated significant weight loss among all groups in the short-term (3 – 6 months) and long-term (1 – 2 years), with no significant difference among dietary interventions. The authors concluded that weight loss interventions using CHO restriction are equally effective as isocaloric diets of standard CHO recommendation.
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Hi Bill, Sorry to hear that. I haven’t experienced that before. Usually, if bread falls during baking it’s too much baking powder, but if it falls after baking it’s just not baked long enough. So you could try both less baking powder and increasing the baking time. Finally, this recipe uses baking powder, not baking soda, so if you used baking soda that could be the issue as well.
Hi Kathy, I would persevere with coconut flour. Many people say it doesn’t work like regular flour, and while that may be true, I have learned to work with it. I ensure I use enough eggs, enough sweetener and flavours or enough salt and spices to overpower the subtle coconut flour taste. I have a whole new category in my recipe finder just for coconut flour recipes. Wy not give may flourless berry sponge a try to begin with, I love it and my kids make it all the time, even as cupcakes too.

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Another amazing recipe!! I made these this morning and they came out great. I baked for 28 minutes. Mine didn’t rise very much, I used brand new baking powder but I must have measured something incorrectly. I used your knife method when taking out of the pan and then turned my pans upside down and tapped them and the donuts fell right out. I also bought the pans you suggested. They were a huge hit. Thank you!!
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.
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.
3. Dreamfields Low-Carb Pasta: Now this pasta really comes down to the individual. The company says they’ve created this whole-wheat pasta in a way that won’t impact your blood sugar significantly, “Its blend of fiber and plant proteins helps create a pasta that offers many healthy benefits while still having the same great taste of traditional pasta.” You see, the low-carb spaghetti box says there are 41 grams of carbs and 5 grams of fiber, which leaves you with a whopping 36 grams of carbs–not low at all–but again, the company says these carbs shouldn’t impact you like normal carbs. But many people have found they still have to take insulin for all of those 36 grams of carbs, but that the carbs do raise their blood sugar slower than a normal serving of 36 grams of carbs. Others say they don’t see a spike in their blood sugar and the pasta is indeed low-impact. You will have to experiment and decide for yourself!
Hi Shandelle, Sorry to hear that it didn’t rise for you! I don’t live at high altitude so can’t test in those conditions. I’ve read that high altitude baking usually requires reducing baking powder slightly and increasing oven temperature by 15-25 degrees. If your bread rose at first but then fell flat, this could help. If it never rose in the first place, you could try more baking powder and whisking the batter more to introduce more air. I’m so glad that you like the recipes overall though!
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Low Carb (VLC): This is about as low carb of a mixture that you will get in low carb baking (except for straight up flax or oat fiber). You could get approximately the same carb count with almond flour alone, but I don’t like feeding us huge handfuls of nuts over and over again every time we eat any baked good. (I know the low carb high fat people say it doesn’t matter, but it feels like it matters!) I also like the “dilution factor” of using multiple non-grain flours in a mix.
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!!
2. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566 

The information you share, including that which might otherwise be Protected Health Information, to this site is by design open to the public and is not a private, secure service. You should think carefully before disclosing any personal information in any public forum. What you have written may be seen, disclosed to, or collected by third parties and may be used by others in ways we are unable to control or predict, including to contact you or otherwise be used for unauthorized or unlawful purposes. As with any public forum on any site, this information may also appear in third-party search engines like Google, MSN, Yahoo, etc. Your use of this site is governed by Harvard University and its affiliates Terms of Use located at www.health.harvard.edu/privacy-policy and may be amended from time to time.


Hi Vivian – I am 60 yo and researching Keto and would love more information from you since we are same age. What is TDEE? What fat sources do you use and how much daily? What are some meals you make regularly and what does a day of food look like? What is the easiest/best way to count carbs getting started? If you and Brenda are ok with you giving me your email I would love to learn more from you! I just need some help getting started. Brenda – thank you for all your information and recipes!
I have made your beautiful bread a number of times, however today I scored the top to help it rise. Unfortunately it rose too quickly and it has a huge hole in right through the middle of it 🙁 might be good for toad in the hole tomorrow morning but not much else 🙂 do you know how I can prevent the hole next time? I was so excited about the heigh of this attempt but may have to stop the scoring in the future. Thx
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.
I am very new to this diet, but I must say I am so impressed. No snack cravings were the first surprise! I am already gluten intolerant so was bummed out to learn of all the flours that are way too high carbs especially rice flours! But already I have tried many recipes even found one made with almond flour taste just like the cheddar biscuits at red lobster! Heading out, I saw you mentioned oat fiber.. what can you use this in?
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

Proponents of the ketogenic diet say the problem with a high-carbohydrate diet is that it induces high insulin levels and keeps the body burning sugar and carbs instead of fat. In contrast, on a low-carb diet, the body learns to burn fat preferentially. When this happens, acids known as ketones are released from fat into the body, while insulin levels go down. Ketosis can occur after several days on a low-carb diet.


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.
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.
I was quite high in protein and ate a moderate amount of fat.  It was just right since I was maintaining my weight, but not low enough to firm, tone and see the muscle I wanted to achieve. I’ve been seeing a trainer twice a week for the last year for full body workouts, but just wasn’t satisfied with how my body was responding. I recently decided a keto diet might be best to really achieve the tone and muscle I was looking for.
Interested in trying a fad diet? There are plenty to choose from, and low-carb pasta can be incorporated into most. The Atkins, ketogenic, and paleo diets — to name just a few — all prescribe a low-carb lifestyle to support health and fitness. On these diets, instead of consuming carbs for energy, you will eat protein, healthy fats, fruits, and veggies. Each of the aforementioned programs allows for a small portion of carbs each day, so you can chow down on low-carb pasta without falling off plan.
Being healthy is all about getting the right nutrients and vitamins from your food so always include variety in your diet. Have plenty of meat (or fish), dairy and veggies on a daily basis based on this low carb food list. Use coconut oil and olive oil when you cook and in your salads (respectively) and have a handful of nuts or berries from time to time.
In relation to overall caloric intake, carbohydrates comprise around 55% of the typical American diet, ranging from 200 to 350 g/day. The vast potential of refined carbohydrates to cause harmful effects were relatively neglected until recently. A greater intake of sugar-laden food is associated with a 44% increased prevalence of metabolic syndrome and obesity and a 26% increase in the risk of developing diabetes mellitus. In a 2012 study of all cardiometabolic deaths (heart disease, stroke, and type 2 diabetes) in the United States, an estimated 45.4% were associated with suboptimal intakes of 10 dietary factors. The largest estimated mortality was associated with high sodium intake (9.5%), followed by low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%), low intake of omega-3 fats (7.8%), low intake of vegetables 7.6%), low intake of fruits (7.5%), and high intake of artificially sweetened beverages (7.4%). The lowest estimated mortality was associated with low polyunsaturated fats (2.3%) and unprocessed red meats (0.4%). In addition to this direct harm, excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains,  fruits, and vegetables.
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]
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While these sources have lower carbs, they typically have higher fat contents. For example, most nuts are calorically dense with fat, though most of it is good fats such as monounsaturated and polyunsaturated varieties. If someone is trying to reduce his fat intake as well as his carbohydrate intake, then it may be a good idea to look into low-carb flour varieties that also are low-fat, such as soy flour.
Are you missing your lattes and frappes? Time for a quick keto coffee fix! Ketoproof coffee is a fantastic mix of coconut oil and butter in your coffee instead of the generic cream or milk. You might think that it sounds disgusting at first, but if you think about what butter is made out of – it’s pretty much just hardened cream. Once you melt it down and mix it all up using an immersion blender, you get a delicious latte-like froth on the top of your morning coffee.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
Eat this for breakfast or for added energy before a work out.  Made in America in small batches, the fermentation process opens up the nutrients to be readily absorbed and introduces gut prebiotics to keep your gastrointestinal system running smoothly. Try this fermented option for thirty days. The makers state that you will experience improved digestion and increased energy levels.
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.
I love this Easy Low Carb Bread Recipe – Almond Flour Bread! I made it this morning for the first time and it turned out great – taste really good. I didn’t have the Psyllium husk powder so I used Golden Flaxseed Meal and I doubled the recipe for a thicker loaf. My question is – does this need to be refrigerated and if not how long does it keep if not refrigerated.
Hi Vivian – I am 60 yo and researching Keto and would love more information from you since we are same age. What is TDEE? What fat sources do you use and how much daily? What are some meals you make regularly and what does a day of food look like? What is the easiest/best way to count carbs getting started? If you and Brenda are ok with you giving me your email I would love to learn more from you! I just need some help getting started. Brenda – thank you for all your information and recipes!
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