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]

Hi Denise, Sorry, no. Baking powder reacts once it hits wet ingredients, and loses efficacy if not baked right away after that. However, you can mix all the dry ingredients the night before (through step 2) and do the rest in the morning. Or, you can just bake the bread the night before and eat it in the morning. You can also toast or reheat it if you want warm bread in the morning.

Urine ketone data were missing in a median of 4 participants (range 0–8) at any given visit. The proportion of participants with a urine ketone reading greater than trace was 1 of 17 participants at baseline, 5 of 17 participants at week 2, and similar frequencies at subsequent visits until week 14 when 2 of 18 participants had readings greater than trace and week 16 when 2 of 21 participants had readings greater than trace. During the study, only 27 of 151 urine ketone measurements were greater than trace, with one participant accounting for all 7 occurrences of the highest urine ketone reading (large160).

Coconut flour is a low carbohydrate alternative to regular flour. A quarter cup serving contains 16 grams of carbohydrates, 10 grams of fiber, 4 grams of fat and 4 grams of protein for a total of 120 calories.  While it’s a bit higher in carbs compared to other low carb substitutes for flour, it makes up for it in texture. Its light appearance and consistency make it more absorbent than any other flours.
The biggest difference is in the fat!! Your fat should be around 70-75% of your daily food intake! When I first heard that, I was like, “Are you kidding, No Way, I will surely gain weight!” I was truly wrong and misguided. I think we’ve all been too accustomed to hearing for years and years that fat makes you fat! That is the farthest thing from the truth. Let’s not blame the butter for what the bread did. Sugar and Carbs are the culprit to gaining weight among other health related issues.

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]


A final common issue on a ketogenic diet is that instead of increasing fat intake, people increase their protein intake. A ketogenic diet is NOT a high-protein diet. In fact, too much protein will prevent you from entering a state of ketosis. This is because excess amino acids in the blood stream can be converted into sugar via a process called gluconeogenesis.
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 >

Because pasta. One of the things most peeps understandably miss the most when going keto, or grain free for that matter (🙋🏿!!). Because let’s face it, not much beats a bowl of pasta. And while this low carb version is a little different (think fried pasta/gnocchi), fairly certain you’ll be surprised by the al dente-like results and wonderful pairing with traditional Italian sauces.

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.

Keto low carb: less than 20 grams of carbs per day. This level will be ketogenic for most people — if protein intake remains moderate. In our keto recipes, less than 4 per cent of its total energy is coming from carbs, and the rest will come from protein and fat. In keto recipes we also keep the protein level moderate, as excess protein can be converted to glucose in your body. See note* below.
Well from what I’ve learned and of course there is conflicting info, no one is really an expert and every person is different, but I lose the bullet proof coffee but I’d rather “eat” my fat amount later in the day I guess. Like in the form of a sweet fat bomb or something. I’ve read that too much fat for where I’m at with just like 5 pounds to lose, I may not see the scale move because my body will only be burning the fat I’m eating. I’m still experimenting to see what works best for me. Right now I’m slowly losing and seeing results. I guess if the I stop seeing any results I will have to change things up. I will be sure to post about it.

A wandering writer who spends as much time on the road as in front of a laptop screen, Brett can either be found hacking away furiously at the keyboard or, perhaps, enjoying a whiskey and coke on some exotic beach, sometimes both simultaneously, usually with a four-legged companion by his side. He has been a professional chef, a dog trainer, and a travel correspondent for a well-known Southeast Asian guidebook. He also holds a business degree and has spent more time than he cares to admit in boring office jobs. He has an odd obsession for playing with the latest gadgets and working on motorcycles and old Jeeps. His expertise, honed over years of experience, is in the areas of computers, electronics, travel gear, pet products, and kitchen, office and automotive equipment.


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.

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.
Urine ketone data were missing in a median of 4 participants (range 0–8) at any given visit. The proportion of participants with a urine ketone reading greater than trace was 1 of 17 participants at baseline, 5 of 17 participants at week 2, and similar frequencies at subsequent visits until week 14 when 2 of 18 participants had readings greater than trace and week 16 when 2 of 21 participants had readings greater than trace. During the study, only 27 of 151 urine ketone measurements were greater than trace, with one participant accounting for all 7 occurrences of the highest urine ketone reading (large160).
When it comes to low carb breakfasts, it's easy to go the route of bacon and eggs. We all do it and it works great. It's filling, delicious and basically no carbs. But, some of us can get bored of that and want to change it up and that's where low carb cereals come into play. Now, I've tried many low carb cereals from Amazon and there are a few options, but they just aren't low carb enough. We wanted to change that, because as I've mentioned, cereal is my ultimate food. We even have a couple others recipes that utilize more than just the standard bacon and eggs. Give our Keto Oatmeal and Keto Macro Cakes a try!
Where does nutrition info come from? Nutrition facts are provided as a courtesy, sourced from the USDA Food Database. You can find individual ingredient carb counts we use in the Low Carb & Keto Food List. Carb count excludes sugar alcohols. Net carb count excludes both fiber and sugar alcohols, because these do not affect blood sugar in most people. We try to be accurate, but feel free to make your own calculations.

Trim Healthy Mama-Friendly (THM) (www.trimhealthymama.com): This is an S baking mix as it is written due to the heavy almond flour amount. However, it could easily be made into a Fuel Pull or an E mix by reducing the amount of almond flour. For the FP, you would reduce the amount of almond flour and replace it with oat fiber. For the E mix, you would reduce the amount of almond flour and replace it with oat flour or sprouted wheat flour. Easy peasy! Also, like the suggestions above for the Family-Friendly folks, you could make it as it is listed and then use half and half—half Basic Low Carb Flour Mix and half oat fiber for FP OR half Basic Low Carb Flour Mix and half oat flour or sprouted wheat for E mix. (I do not do much FP or E baking, but I would make this mix as is and then combine it with Sprouted Flour Mix anytime you want to make an E baked good. Easy peasy!)

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!
NOTICE: The information contained or presented on this website is for educational purposes only. Information on this site is NOT intended to serve as a substitute for diagnosis, treatment, or advice from a qualified, licensed medical professional. The facts presented are offered as information only - not medical advice - and in no way should anyone infer that we or anyone appearing in any content on this website are practicing medicine. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professional. Seek the advice of a medical professional for proper application of ANY material on this site to your specific situation.
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
I have only been on a Keto diet for a couple of weeks, but I have found some great recipes on your site and have loved them all! Today I made these donuts and then frosted them with your Low Carb Keto Cream cheese frosting. I followed both recipes exactly as written and had great results. Thanks so much! I thought I would never be able to give up sweets, but now I do not have to and I am so relieved.

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.


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).
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]
The improvement in glycemic control occurred while medications for diabetes were discontinued or reduced in most participants (Table ​(Table5).5). During the study, hypertension and hyperlipidemia medication doses were not increased from baseline nor were new agents added, except in 3 individuals. No serious adverse effects related to the diet occurred. One participant had a hypoglycemic episode requiring assistance from emergency services after he skipped a meal but the episode was aborted without need for transportation to the emergency room or hospitalization.
Finally! A granola that I don’t HAVE to put any kind of a sweetener in! I’ve been keto for almost 2 years and have really missed a good bowl of granola/cereal for breakfast. Your recipe is perfect. I made it ahead of time and keep it in an airtight container. It’s so nice to be able to grab the container, pour some in a bowl and enjoy, and for me, I find that the nuts give a good flavor without the sweetener. I’m always looking for recipes that I don’t HAVE to use a sweetener in because almost all of the ones used in LCHF recipes cause war in my bowels, sigh. This recipe is perfect. THANK YOU so much for getting online for the rest of us. 🙂

I have spent weeks reading and learning about the Keto diet plan, downloading random recipes that my husband might even try, and have been overwhelmed with all the information. I was pleased to find your system and how organized everything seems to be. The only question I have is will I be able to “temporarily suspend” my subscription if I find there are more recipes than I have time to prepare. I want to only do about 3 per week and repeat them as leftovers, since I have very little time after working a 12-hour shift, to do much cooking. Once I “catch up,” I would reinstate my subscription. Is that an option? Looking forward to trying out your program.


Hi Paula, Sorry that you were disappointed. The color likely has to do with the brand of psyllium husk powder; some of them turn purple when baking, though this is not harmful. The brand I use is linked on the recipe card and does not turn purple (as shown in the pictures). Regarding taste and texture, I’d love to help troubleshoot, if you can describe what issue you are seeing.

Hi Cathy, are you adapting these recipes yourself or are they already developed using coconut flour? From experience, it takes a lot of attempts to get it right (but fun too, it brings out the scientist in me). Coconut flour requires a high number of eggs for volume, thickening, protein, binding, and structure. I would be worried if there was too much avocado in there as that is just adding a soft ingredient that gives no structure. The sweet potato would add volume but unless there is enough eggs and coconut flour in the recipe, again it won’t add to the solidity of the final recipe. Psyllium I add purely to get a better crumb texture. It swells and thickens and helps bind all the other ingredients together nicely. Scones – they won’t have risen because of the lack of gluten (yay), but I quite like heavy scones as a personal choice. I started baking using recipes that had already been developed using these low-carb flours, and start by adjusting the flavours only not the ratios of the bulk ingredients. You will soon get the hang of them. Start with my flourless berry sponge, I use these ratios all-the-time! Yum.
New to low carb eating, My first attempt actually turned out really well. Baked 70mins. came out a little under, no color change from psyllium, lots of little air pockets ,but still firm and a little dense. Held up well to firm butter and refrigerated almond butter. Cant wait to have toast or a sandwich. Thanks for doing all the hard trial & error work and keep the recipes coming.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.

Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
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).
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.
41 pounds is wonderful! How much more do you feel you need to lose? I honestly think you’re not eating enough with just 700-900 calories and then you’re body is craving and hunger when you are actually home. I would suggest trying to be more at 1000 -1100 on each day consistently and give it at least a month. I’ve not quite figured out the plateau area yet for myself and since writing this post my weight hasn’t budged and it’s been 3 weeks so I am working on changing some things and will update if I have success with it. Also I forgot to mention Intermittent Fasting? Have you tried that? Dr.Eric Berg on youtube has a lot of info on that if you’re interested. Good luck!
In fact, once all our our reserved glucose/glycogen runs out after several days on a low-carb, keto diet, our bodies create compounds called ketone bodies (or ketones) from our own stored body fat, as well as from fats in our diet. In addition, researchers have discovered that ketones contain main benefits, such as fat loss, suppressing our appetites, boosting mental clarity and lowering the risk for a number of chronic diseases.
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.
I bought this as an alternative to the Medi-Fast Oatmeals. This one has similar caloric, protein, fat, and carb content, with lots of vitamins, without the price tag you get with MediFast. I liked the taste of it and will buy it again as a result. The nutritional content is better than any of the Quaker Oats products involving Oatmeal, and for someone who is constantly battling obesity, having a thick bowl of oatmeal is a welcome addition to my diet.

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.
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 reading all the above comments about the gluten verse other ingredients. As a pastry chef, the information that has been missing here is that not only is gluten a protein, it is also the “elastic” that holds the pasta together. 80% of the proteins in flour are called glutenin and gladin. When combined with liquid, they form the elastic substance called gluten.
On the other hand, the types of foods you’ll avoid eating on the keto, low-carb food plan are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of “empty calories”).
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