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]
By the way, I love how simple this recipe is! I love that it uses whole eggs instead of separated since I’m really bad at separating the yolks from the whites, and if you use more whites than yolks then you have to find another use for the yolks and it’s a pain in the neck. I went keto on summer last year and when I decided to start baking my own bread and went looking for almond flour bread recipes, I chose this one for its simplicity
I thought that eating this amount of protein would leave me a withered and emaciated little boy, but this is a belief I held for years of being beating over the head with jugs of protein powder and bro-science. It turns out, you (or, at least I) don’t need as much protein as once thought. However, eating very FEW grams of protein is not smart either. 

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 was on the ketogenic diet for 6 months to support my husband, who is on it permanently for epilepsy. The diet totally messed with my hormones, which my doctor and my husband’s nutritionist sadly confirmed was a possibility. I am continuing to eat low-carb, but the ketogenic thing unfortunately seemed to work against me as a 49-year old pre-menopausal woman.
Reading through the comments I had to chuckle at the number of times the same question/suggestion was asked and answered – that being said, the answer is “a protein” so I have a bag of LivFit Plant protein in my pantry – it’s a protein so do you think that might work? If not, I know where I can get the whey gluten from already but would rather keep on the track we are 🙂
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.

Made in mini muffin pans, will have to oil them better next time so they come out easier. Taste great, although sadly more like a muffin than donut (the shape doesn’t help, lol). I may try to thicken it up to deep fry next time. Was out of cinnamon so I used pumpkin spice. Not so strict on low-carb and wanted the kiddos to like them, so offered cinnamon/sugar, powdered sugar, and toasted coconut for coating. I recommend the coconut! Browned in a dry skillet makes it nice and crunchy… just how to make it stick was the only drawback.

Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >


This is the best! I’m really bad at baking but I have made this twice and both times it was perfect. I’ve shared it with all my gluten intolerant friends, thank you. Oh, I reduced the psyllium husk to an eighth and replaced the other eighth with gluten free flour. It made it less gritty. Yummy! Today I’m going to add some spices and sultanas for a sweet treat. Hope it works!
Since going low-carb a few years ago, I simply let go of breakfast cereals as they were always a slippery slope for me. No big deal, I found other lovely foods to enjoy. With that said, I kept seeing this recipe in my line of (scrolling) vision and I thought, okay .. time to partake as the reviews were too good to ignore. So I went about my merry way and followed everything exactly and then realized when I already had the mixture patted into a pan, I forgot the sweetener LOL. Screw it, baked it anyway and topped with the sweetener/cinnamon mixture (I used xylitol) and honestly, this was perfect. If I had used the sweetener in the mixture, it may have been too sweet for me. At the same time, I am reading the comments about the importance of the proper sweetener IN the mixture but I despise Swerve (too heavy cooling reaction for me) and wouldn’t have used it anyway but I found a roundabout fix that did work for me. About 1/2 and 1/2 chunky texture to crumbs but those crumbs can be sprinkled on yoghurt or even as pie crust, as suggested above. I’ll definitely put this in the ‘keeper’ folder (along with the Zucchini Tart that is simply divine!). Thanks, Carolyn!!
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.
Thank you so much for all of this great info! My husband started a Keto plan two weeks ago so I have been researching going Keto for a few weeks now. I figured I’d use him as a guinea pig to test buying food, preparing and cooking meals to see how easy or hard it would be to hit his macros for the day. I decided to start it this week (today is my fourth day) so now I am doubling up on the recipes so there’s enough for the both of us. I am still constantly looking for more recipes and trying to get more comfortable with changing up food so we are not eating the same things everyday. I can’t wait to try the meatloaf since it’s one of my favorite dishes! Thank you again for all the work you put in to sharing this info with others!

If you’re someone who loves to bake, you may think that starting a low carb diet means your favorite pastime is now off-limits. You can’t have flour and you can’t have sugar, so you can’t possibly make muffins and cakes and cookies, right? Well sure, if you want to define baking in those narrow, high carb terms, then I suppose you might be right. But if you’re ready to explore a whole new world of healthy low carb ingredients, stay with me.
Louise holds a Bachelors and Masters in Natural Sciences from Cambridge University (UK). She attended Columbia University for her JD and practiced law at Debevoise & Plimpton before co-founding Louise's Foods, Paleo Living Magazine, Nourishing Brands, & CoBionic. Louise has considerable research experience but enjoys creating products and articles that help move people just a little bit closer toward a healthy life they love. You can find her on Facebook or LinkedIn.
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]
I made these donuts super skeptically but holy crap am I impressed. They taste like the little mini donuts you get from the carnival. I baked them until I thought they were dark brown enough but I ate a donut as soon as the timer went off and it crumbled quite a bit. Luckily I had the oven on and could just pop them back in. I would recommend these to everyone!!!

Ketosis means that your body is in a state where it doesn't have enough glucose available to use as energy, so it switches into a state where molecules called ketones are generated during fat metabolism. Ketones can be used for energy. A special property of ketones is that they can be used instead of glucose for most of the energy needed in the brain, where fatty acids can't be used. Also, some tissues of the body prefer using ketones, in that they will use them when available (for example, the heart muscle will use one ketone in particular for fuel when possible).
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.
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.

Emmy-award nominated screenwriter Brynne Chandler is a single mother of three who divides her time between professional research and varied cooking, fitness and home & gardening enterprises. A running enthusiast who regularly participates in San Francisco's Bay to Breakers run, Chandler works as an independent caterer, preparing healthy, nutritious meals for Phoenix area residents. Her work has appeared in The Houston Chronicle and San Francisco Chronicle, among other places. She is hard at work on her first cookbook which combines simple, fresh recipes with science-based herbal medicine.

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.
I will say, though, that if you can bite the bullet and buy the products and make it one time, you will have the products for refills of the mix over and over since it uses small amounts of various things and since it is a bulk mix (makes a lot). (Then I recommend buying the products one at a time each month or however often you order or go to stores carrying the products, so that it will not feel overwhelming to continue making the mix cost-wise.)
Thanks so much for sharing your results. You look so good, and you have inspired me to try a more structured version of the Keto Diet. I lost some weight recently on HCG 2.0, which puts you into ketosis (keto flu and all!). I have tried to maintain my weight loss with a version of the Keto Diet, but I know that I am probably still eating too many carbs and not enough fat. I am 47, and I contine to have issues with keeping the weight off despite a healthy diet and exercise. I am sure it is hormone-related.

Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
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!
The keto diet focuses on eating foods that are low in carbohydrates and high in fat. It is very similar to the Atkins diet, but doesn’t not allow for as much protein. By eating a diet low in carbs and high in fat you are able to put your body into a metabolic state called ketosis. To properly follow the keto diet, you need to educate yourself on which foods are keto diet friendly and plan on making meals at home. It’s almost impossible to eat out at restaurants on the keto diet because they use sugar and starches in almost everything. Meal prep while on the keto diet is a must, so make sure to check on all of my keto diet meal plan ideas to get you inspired.
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!
Hello there. Thanks for sharing this recipe. I am sooo excited to try it. In fact, I have just ordered some almond flour. I have a question regarding eggs. The recipe calls for four. Can I use two instead, and substitute with flax eggs for the other two? I have a lot of flax in my cupboard and I am looking for creative ways to use it up. Also, it is nice to be able to utilise ingredients already in my cupboard. I am trying to get out of the habit of buying new ingredients for everything new recipe I want to try. Anyway, looking forward to your response. Thank you.
Overweight individuals with metabolic syndrome, insulin resistance, and type 2 diabetes are likely to see improvements in the clinical markers of disease risk with a well-formulated very-low-carbohydrate diet. Glucose control improves due to less glucose introduction and improved insulin sensitivity. In addition to reducing weight, especially truncal obesity and insulin resistance, low-carb diets also may help improve blood pressure, blood glucose regulation, triglycerides, and HDL cholesterol levels. However, LDL cholesterol may increase on this diet.
I had pasta last night, and I feel guilty that I cheated. This recipe is that good. I followed your directions exactly, including simmering the noodles in some sauce for a few minutes. What size pan did you use? It was hard for me to estimate and I ended up throwing away some egg mixture. Putting pan sizes in all your wonderful recipes would be helpful. Keep up the good work. You are my low-carb, go-to guru.
Amongst all the sugar-filled cereals on our supermarket shelves, there are the occasional good one. But I always get sick of them so quickly, and I find they’re usually quite bland. But, thankfully there are some easy, low carb breakfast options that don’t involve cereal! Have a look at the list below and hopefully you’ll get inspired to try a few for yourself.
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.

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.

Hits the spot! I love traditional cereal and this definitely satisfied my tastebuds!! I will say I did realize how important it is to not over pulse, and to create a thin layer when placing in the oven. For the first few minutes I had a thick, maybe 3/4 inch layer, and I ended up thinning it out after reading reviews. I think in total I baked mine for 25-28 minutes. It was a little soft after coming out of the oven, but like you said it hardens after it cools. I added cinnamon, and wish I added more (I love a strong cinnamon flavor).

I am thankful for you and for Maria Emmerich as well. Your biscotti recipe and a few others make my low carb life possible and enjoyable. Maria E’s bread with psyllium recipe is another that keeps me happy and healthy. Thank you both. My life is revolutionized in these past 2 years and I couldn’t have sustained low carb eating without you. Your almond tea cake recipe was my first venture into almond flour and erythritol, etc—low carb cooking and eating would just be too drab and boring for me without your recipes.
My 1st attempt & it was delish w/unsweetened organic coconut milk.Had no hazelnuts & only half the amount of almonds so I substituted extra pecans. Used unground flax & also added additional 2 tbs ground flax for more fiber. Added 1 tbs vanilla. Used a combo of sweeteners: Eryth, Xylitol & Stevia. Next time will grind ingredients separately to get a more chunky result.
Several studies have investigated the potential of LCD or KD on weight loss. For example, Brinkworth et al. (2) compared one year of low-fat (LF) vs. LCD diet in adults with abdominal obesity. Subjects were randomly assigned and diets were isocaloric, with moderate energy restriction. Both groups realized significant weight loss, however, there was no significant difference between groups, suggesting that a LCD was equally effective as a LF diet.

Digestible carbs are also sometimes called “net carbs” but be very careful of this term on labels of low-carb products, processed foods, protein bars and energy/chocolate bars. Manufacturers often use “net carbs” as a way to disguise sugar alcohols that may slow weight loss and impact blood sugar. In fact, try to avoid any processed product that list “net carbs” on a label. Learn more about keto sweeteners


Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided. 
×