The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]

I guess the closest would be almond flour/ground almonds but there is not a direct substitution because wheat flour behave totally differently because it has gluten. Great question to ask and I am so glad you are starting low carb. Begin by baking an established low carb recipe first. All the hard recipe development has been done for you. Enjoy, and welcome.


I began my low carb diet (around 50 net per day) almost 3 months ago. I have only lost 2 lbs. I need to lose at least 30. I am 62 years old and in good health. Everything I have read leads me to believe that I am doing everything correctly. I even make my own Keto bagels! What do you think could be the issue? I tried going down to less than 20 carbs but I just cannot do it. Thanks for any help you can provide.
There are many recipes here that use coconut flour OR almond flour. Some I even have instructions to use both (from the post above, you can see they are not easily interchangeable). Is he tolerant of almond flour? I have many recipes which use that. Some recipes that use a small quantity of almond flour/meal, you can actually use some seed flours such as sunflower or pumpkin. I managed to make Fat Head pizza once using ground sunflower seeds when I ran out of almond flour.
1 cup of almond milk (or milk of choice); 1/3 cup quinoa flakes (purchased at http://www.nuts.com); sweetener of choice; pinch of salt; toppings of choice (usually nuts or berries or banana). Heat the milk in medium saucepan. When it comes to a slight boil, drop in the flakes and salt. Remove from heat, stir and let the cereal cook for about 3 mins. Give it a final stir after 3 mins. It will be thicker and creamier and ready to serve.
In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
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.
Hi Lee, A blender might also work, if it’s powerful enough to chop up nuts. You’ll still want to use a pulse-stop-pulse method, and may need to stir between pulses. Otherwise, you can also try chopping up the nuts and seeds before mixing with the other ingredients. If you go that route, the resulting granola texture will be a little different compared to a food processor. I used a food processor partly because it makes both prep time and cleanup a lot faster, but also because that way you get a mix of larger chopped nuts and finer powder. I hope one of the other methods works out for you!
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.
Nutritional ketosis has been proposed as a mechanism through which hunger may be suppressed. A recent meta-analysis investigated the impact of diet on appetite and shed some light on this possible phenomenon (11). The meta-analysis included 12 studies which investigated the effect of either a very low energy diet (VLED: defined as <800 calories per day) or ketogenic low-carbohydrate diet (KLCD: defined as CHO consumption of <10% of energy or <50 g/day, but ad libitum consumption of total energy, protein and fat). Interventions ranged from 4 – 12 weeks and weight loss was from 5.0 to 12.5 kg. In all studies nutritional ketosis was confirmed in VLED and KLCD via circulating levels of β-hydroxybutyrate. Interestingly, both groups reported decreases in appetite. The results of this meta-analysis are noteworthy in two regards. The VLED groups were clearly and significantly hypocaloric, suggesting a state in which hunger should be increased, not decreased. Similarly, the KLCD groups experienced simultaneous reductions in weight and appetite, while eating an ad libitum diet. The results of this meta-analysis provide support for the theory that nutritional ketosis may exert an appetite suppressing effect.
Not in the mood for cake? Brownies definitely come second on that list of delicious treats that we want once we turn to a ketogenic diet. You can easily make keto brownies that you can fully enjoy without having to fight against the craving to have more. Besides using almond flour and other mixtures of flours, you can make them out of avocado as well.
By incorporating the foods we offer into your diet, we find many people are able to stick to their diet longer because it provides greater variety, they are able to have foods that they wouldn't be able to make at home (even with serious chef inspired dedication), and in many cases the cost of the item is significantly cheaper than if you were to attempt to create it at home. We've heard some horror stories about spending big bucks on bread machines, ingredients, hours of lost time, and only winding up with a poor tasting loaf.
Thanks for posting about the psyllium Sarah,, I tried psyllium flakes 10g and they turned out great. Not even very fragile. It just gets thick so the batter doesn’t self-level, I had to do my best, and the thick spots required 1 extra minute in the oven. Used immediately in a skillet lasagne- just ground beef, jar of pasta sauce, mozz cheese and cream cheese. Definitely wouldn’t have been much of a lasagne without the “pasta”! So these noodles are my hero 🙂 

Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.
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!!

Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.

I bought a package and boiled the whole thing. I split it up to make two different meals with. The first one was simple jarred sauce and parmesan and the second was the noodles, sauteed zucchini and tomato, ricotta cheese, and parmesan. Both were DELICIOUS. With the tomato sauce dish, I really couldn't even tell the noodles were any different. Maybe they're slightly more fragile, but it's no worse than whole wheat ... full review

Elisabeth Almekinder, a certified CDE and expert in Diabetes Self-Management Education Program, grew up in a small town in the piedmont of NC. During her time at St. Andrews Presbyterian College, she developed a love of writing and obtained a BA in English. After obtaining her nursing degree, her first job out of school was on the vascular surgery floor, where she saw many people with diabetes lose their limbs. She worked as an RN for 22 years in public health in South Carolina. In her spare time away from educating people about diabetes, she continues her passion by writing about diabetes.
I guess the closest would be almond flour/ground almonds but there is not a direct substitution because wheat flour behave totally differently because it has gluten. Great question to ask and I am so glad you are starting low carb. Begin by baking an established low carb recipe first. All the hard recipe development has been done for you. Enjoy, and welcome.
CEREALS: Oatmeal is the quintessential hot cereal, and along with that tummy-warming satisfaction, you'll get a nice dose of fiber. A quarter of a cup of “old-fashioned" rolled oats (uncooked) boasts 4.1 grams of fiber and, along with an added source of protein such as nuts or an egg, will give you the staying power to get you to lunchtime. If you don't have the five minutes to make oatmeal, though, there are a number of ready-to-eat cereals that are high in fiber. To find the best ones, seek out whole-grain cereals with at least 4 grams of fiber per serving and no added sugars.
Next, the noodles are tasteless, so they make a great vessel for your pasta sauces. These are 6g net carbs per serving, but the servings are huge! We generally aren’t big fans of the concept of eating less of something to make it seem lower in carbs. But, we have found that when cooked, even half of the recommended serving is pretty sizable for these noodles.
I needed a break from breakfast chia pudding, and I found this lovely recipe. I’ve been craving sugary cereals since I started Keto. I made this the night before and had it the next morning. This was everything I wanted and more, and also super simple to make. Mine weren’t as crunchy as I’d hoped (were still soft and cookie-like next day), but were still amazing! Probably because I stored them in the fridge overnight. Either way, delicious and nutritious and took me back to Cinnamon Toast Crunch, so 10/10!!
Protein can turn into carbohydrates via a metabolic process called gluconeogenesis (making new carbs) and will do in people at varying degrees. Protein turning into carbohydrates means you’re not in ketosis. However, this is generally an overblown statement that only happens at the extreme cases when you are drinking a lot of liquid protein shakes. 

To make squares: Place dough on a piece of parchment paper, with a second piece of parchment on top. Using a rolling pin, roll the dough into a thin and even layer about 1/4-1/8” thick. Remove the top piece of parchment paper. Using a pizza cutter, cut into small squares (about 1”). Bake in the oven for 5 minutes, then take baking sheet from oven and carefully break up the squares (so they’re no longer connected). Bake for another 7 minutes. Allow to cool and enjoy!
So imagine my delight, as an adult, every time I get to pour a bowl of keto friendly cereal comprised completely of paleo granola clusters that I feel good about! I’m willing to bet that your inner child is going to be just as excited about this homemade sugar-free granola when you try it, too. Paleo cereal can now be a part of your morning routine and I highly recommend a sprinkle of it on keto oatmeal too!
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][31][32] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.[9][33]
Maintaining a state of ketosis is as simple as following the same dietary parameters that got the body into that state in the first place. If you limit carbohydrates and sugars in your diet, your body will opt to burn the healthy fats you consume for energy. However, when cutting carbs from your diet it is very important to focus on limiting net carbs, which is simply the number of grams of total carbohydrates in a portion of food minus the grams of fiber. Constipation is a very common issue for new adherents to the ketogenic diet, and it is caused by foregoing fiber in an attempt to limit total carbohydrates. So to prevent constipation from derailing your ketogenic diet, simply make sure you consume adequate levels of fiber!
Ketogenic and low-carb diets aren’t as new as most people think. The ketogenic diet was developed in the early 1900’s to help control pediatric seizure cases who were not responding to medical treatment. Low-carb diets gained a lot of attention due to the Atkins nutrition plan which emerged in the 1970’s and remains a fairly popular program today. When it comes to keto vs low-carb, they are actually pretty different and can have drastically different effects on the human body.
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