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]

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].


One of the easiest traps to fall into when starting a ketogenic diet is the assumption that all fats are healthy. It is not uncommon to see new adherents loading up their plates with industrially harvested bacon, exclaiming, “I’m keto, so it’s healthy!” In reality, because ketosis repositions ketones as your primary fuel source, ensuring you consume healthy fats becomes even more important on the ketogenic diet.
To make cocoa puff balls (takes a LOT more time, but they’re REALLY fun): pinch a little thumbnail sized amount of dough and roll between your hands to form a ball. Place on the baking sheet. Bake for 8 minutes, then take baking sheet from oven and carefully move the balls around so they cook on the other side. Place bake in the oven and cook another 5 minutes. Allow to cool and enjoy!
AMAZING! I just made this bread and I can’t believe how perfect it is! My fiance and I are doing low carb. Not quite keto but trying to stay close to that range of carb intake! Honestly I’ve just been saying I’m avoiding bread, potatoes, and pasta. Either way this bread rocks. The only substitutions I made to the recipe was plain seltzer water in place of the still water. Wanted to give the dough some extra lift. I also put some pumpkin and sunflower seeds on top to increase the heartiness. This bread came out rocking our socks off. Can’t wait to make some grilled cheese Sammie’s with it!
A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
Must say, however, that the shape of choice (for most pasta-like results) are the cavatelli. Both because the ridges help the sauce to stick better, and for the resulting texture and mouthfeel. Though you’ll need to procure a (9 bucks!) cavatelli & gnocchi board. Cavatelli are very similar to gnocchi in shape (which you can make too!), though slightly thinner and with more of a bite. 
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?

The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]
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.
After trying literally DOZENS of Keto bread recipes, I have FINALLY found something I can use as a burger bun! Other recipes were great for biscuits or rolls and such, but didn’t work for a burger bun – and SO EASILY! I added a tiny bit of garlic powder and topped them with TJ Everything Bagel spice, baked them in a muffin top pan and they are AWESOME! Finally – after all this time having to have my cheeseburger without a bun – last night I had a burger AND a bun! Woohoo!!! Next time I will try adding some yeast, just for the flavor. THANK YOU SO MUCH for the GREAT recipe!!!
Hi Beth, I do use the one that is linked from the recipe card and it doesn’t turn purple for me. But, I have heard some people say they did end up with purple bread – just not sure if they used the same brand or not. Either way it’s a visual thing and still totally fine to eat. Sorry to hear about the mix-up with the orange flavor, hope it was still edible for you and you’ll try again with the plain kind!
You can substitute half of the spelt flour for half of the flour called for in your recipe. This will help to keep the texture of bread when baking spelt bread. For total carbohydrates, it comes in at almost 27, with a net carbohydrate count of just under 22. The GI is getting up into the midrange, so this bread will start to raise blood sugars more at 55-67 than the previous four choices on our list. 

Instead of making your own cereal, you can always have a low-carb alternative. Try out chia seed pudding, flax granola sprinkled into coconut or almond milk, salted caramel pork rind cereal, or just mix together toasted nuts that are crushed and crispy. It’s quite easy to find a crunchy alternative to cereal (or just a low-carb replacement in general) so keep on the lookout and experiment for yourself to see which you like best.


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]

I personally think it has a mild taste (I understand what you mean about almonds can sometimes have a strong taste). Why not make a small recipe first to see if you like it. With all low carb flours (like coconut flour also) if you are sensitive to their subtle taste, you can help the recipe by adding more flavour such as vanilla for a sweet recipe, or cheese and spices if it is a savoury recipe.
The Keto diet is high in fat, moderate in protein and extremely low in carbs. It’s a highly effective diet as it takes into account accurate tracking of your meals, to find the right body balance, followed by charting your goals! I’m a big fan of the low-carb diet. Not only has it been shown to be more effective than a low-fat diet, but it bestows many additional health benefits over a typical diet.
Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
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]
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!!!!
Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.

I’m afraid I don’t. I have never used peanut flour and would hate to guess a conversion for you. And as you may know, almond flour and coconut flour are completely different beasts so are used completely differently to one another. If you are about to throw it away anyway, maybe try experimenting with it, you have nothing to lose (other than some eggs and butter perhaps).


Maya, Thank You so much for this recipe. I made it as written with your suggestion of 2-3 Tbsp of psyllium husks and I am in heaven! Thank you so much! Being keto has been an amazing thing for me and my health but was truly starting to miss certain foods. This was so good and my family loved it too! Definitely a keeper for me. Thank you again! A quick question- if I halved the coconut oil, would that throw the texture off too much?
Health's contributing nutrition editor Cynthia Sass, RD, MPH, suggests looking for cereals that are made with nuts, seeds, coconut, a little bit of fruit, natural sweetener (think honey or agave syrup) instead of added sugar, and spices for flavor. Although many of these cereals may be gluten- or grain-free, you can also look for flaked whole grain varieties.
×