A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
Like any other fad diet, you can lose weight and see some positive results in the short term, but what effect does a low-carbohydrate ketogenic diet have on your long-term health? Recent research published by The Lancet studied the eating patterns of more than 15,400 adults in the U.S. and another 432,000 people around the world. Researchers found that restricted carbohydrate levels replaced or supplemented by animal-based protein and fat sources could lead to a higher risk of premature death.

Oatmeal is something we all miss when it starts to get cold outside, but it is filled with carbs. You can easily make your own oatmeal by following one of the many recipes online. Or, if you’d like a different twist on oatmeal, give our Cinnamon Roll Oatmeal a try. Using what you might think are strange ingredients (cue cauliflower), you get an absolutely delicious faux oatmeal.
I have been eating keto for few months and looked up so many bread recipes but yours looked the most doable and convincing. I must say this is the first time I baked bread.. ever and it turned out PERFECT!! I love you for sharing this recipe. I was a little apprehensive though because it looked rather thick so maybe a good point to indicate for new bakers like me. 🙂 Also, can I box and store in fridge (not freezer) for few days? Again thanks! I’ll be sure to try another one of your recipes soon when I am not feeling so lazy.
If you are trying to get the kids to eat healthier and not rely on sugary cereals you might find this keto one will win them over. It has a great texture from the nuts and seeds and has a sweet warming flavor from the cinnamon and sweetener. This cereal is great with your choice of milk or can be made a bit more filling by adding in some fresh berries.
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.
I’ve searching and searching for a keto bread that is not too eggy or have no cheese. I just mad this bread and oh! It’s soooo good! It’s got the wholesome texture but nice and firm. No eggy taste! Thank you so much Maya for sharing this recipe. Finally, I can make my Brit husband happy. We’ve been on a keto for 3 moths and he lost 20 lbs but since he is from England, bread is so important to him. I will surprise him when ge gets home. I’m so happy!
Hi!! I have been following you since I started Keto…. Dec 26, 2017. I have lost 41 lbs since then and in the last 3 weeks I can not seem to get the scale to move nor are the inches changing… I am 58 yrs old and lightly active (I work in retail and am on my feet all day.. 10 hrs per day… operating register, stocking soda, candy… putting grocery truck away) I have been running my macros at 16 carbs (I do not do net) fat 97gm and protein is 78gms which is for my calorie intake of 1258 5/70/25…. I am at a total loss as to what steps I need to take…but for the most part I generally only get in 700-900 calories per day… I am just not hungry. Days off are nightmares…. it seems all I want to do is eat… I have NO “bad” foods in my house… I mostly eat veggies on my days off… asparagus, broccoli, zucchini, cabbage, radishes cooked in an oil of some sort olive, avocado, sesame……. I dearly love tomatoes but eat them sparingly.
I made these tonight for supper (just finished eating) and they were fantastic! I simmered them in a mixture of chicken broth, soy sauce, hot sauce, garlic, and ginger, then added some leftover cooked veggies and chicken for an eastern-inspired chicken noodle soup. I didn’t find the noodles eggy, but it wouldn’t bother me if they were because I love me some eggs. I didn’t change a thing in the recipe (yes, I actually DID use the vital wheat gluten! 😀 ). I know I’ll be making these on a regular basis now – I think I’ll be riffing on the classic tuna noodle casserole later this week. Thanks so much for a wonderful recipe!
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
I really like this stuff. I've been following the THM plan for around a month now and it's working great. I have recently started using a lot of the THM recipees and this is one of the ingredients that are used quite often. It makes it a lot easier just to use their blends but, you can use other things as a substitute. It really does work great in baking and tastes good too. I will definitely purchase it again.
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.
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]

ADA dieters can use it to cut the amount of carbohydrates from grains in their diet and to allow for other carbohydrate containing foods in the diet based on their recommended amounts. Walnut flour also contains healthy fats, fiber to help slow down the break down of other carbohydrates eaten with a meal and it’s got a great nut-buttery taste. The oils in the walnuts give it added flavor.
Toasted coconut flakes make the perfect alternative to corn flakes in cereals like this one, letting you still enjoy the crunch but without the added issues that traditional cereals can cause. Just be careful to watch the flakes as they toast so they don’t burn. Serve this cereal with your favorite milk and a few berries and you have a tasty and filling breakfast cereal to keep you going all morning.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]

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. 

This is REALLY good. My OH also thought that this was ‘proper’ bread LOL! Why do people think that anything not made with wheat is not ‘proper’? I guess they don’t have a gluten intolerance. This really is the best low carb GF bread I’ve tasted in a LONG while. It will become a staple in this household that’s for sure. Will definitely still use the 90 second rolls as well for convenience!
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
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.
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.

I really like this stuff. I've been following the THM plan for around a month now and it's working great. I have recently started using a lot of the THM recipees and this is one of the ingredients that are used quite often. It makes it a lot easier just to use their blends but, you can use other things as a substitute. It really does work great in baking and tastes good too. I will definitely purchase it again.

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.
In the absence of CHO, however, the body must shift to fat as the primary energy source. In this case, the body catabolizes stored triglycerides, which exist in abundance in even the leanest individual. In effect, the KD provokes a physiological stimulus, i.e., CHO restriction, that mimics starvation. Due to the limited ability to store or produce CHO during periods of starvation, the body thus switches to ketogenesis, the production of ketone bodies as a primary fuel source (3).
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.
There is nothing inherently difficult about following a ketogenic diet. We have many patients who do this very easily over many years. The metabolic benefits significantly outway any perceived challenges from limiting particular food types. Uptake would be far more widespread if nutrition professionals left their predujical opinions of SFA’s behind. Finally, given the expertise in Ketogenic Diets at Harvard, Dr David Ludwig, for one springs to mind, I am surprised the author did not avail themselves of the local expertise.
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!

A classy twist on the average turkey burger, this nutritious recipe comes together quickly—the mushrooms roast in the oven for 12 minutes while the turkey cooks on the stovetop—looks complicated (read: serve when you have friends coming over), and tastes delicious. Packed with protein, thanks to turkey, plenty of potassium courtesy of the mushrooms, and crazy tasty. What more do you need?
This is REALLY good. My OH also thought that this was ‘proper’ bread LOL! Why do people think that anything not made with wheat is not ‘proper’? I guess they don’t have a gluten intolerance. This really is the best low carb GF bread I’ve tasted in a LONG while. It will become a staple in this household that’s for sure. Will definitely still use the 90 second rolls as well for convenience!
The central aim of the ketogenic diet is to push the body into a state of ketosis, where metabolism shifts from burning carbohydrates as the primary energy source to fat, or “ketone bodies.” These ketones are a special type of fat that serve as cellular “superfuel.” In order to achieve ketosis, one must consume a diet high in healthy fats and dramatically lower in sugar and carbohydrates. This allows blood sugar to drop to the point that glucose is significantly less available to the body to burn as a source of fuel. In the absence of glucose, the body shifts its focus to ketones for energy production. Ketosis not only burns fat—which supports weight loss and BMI reduction if in a calorie deficit—it also transitions the body’s energy source to what clearly turns out to be a better fuel. In fact, energy derived from burning fat is associated with a remarkable reduction in the amount of damaging free radicals in the body, in comparison to burning sugar.

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.


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.
Yes, nuts can be seen as antiinflammatory when eaten whole and in small amounts, the problem with much of low-carb baking is the huge quantity of almonds you can easily consume in just one slice of cake/pie/cookie. 1 cup almond flour = 90 almonds, and I don’t think many would sit and consume 90 almonds, but it’s easy to overeat almond baking so I am developing recipes with either almond flour or coconut flour to mix things up. This is a great article explaining why we can enjoy nuts, but be cautious of which type and how much. Nuts have become readily accessible too often and eaten it too larger quantities. Nibbling on a few isn’t going to be a problem and probably beneficial.

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!

The American Heart Association recommends eating six to eight servings of grains every day, which is a lot of carbohydrates. But whole grains also contain a lot of fiber, which is the basis for the recommendation. Fiber is bulky and slow to digest, so you feel full longer after a high-fiber meal. Fiber also aids in healthy elimination, which can keep you feeling – and looking – less bloated and sluggish. People who eat a high-fiber diet are at a lower risk for heart disease, strokes and certain types of cancers because fiber helps you avoid the insulin spikes that occur when you eat starchy carbs. Fiber also helps control your cholesterol levels.
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!
However, replacing high carb flours like all-purpose flour, wheat flour, corn flour, and rice flour with low-carb flour is not as simple as just using one for the other. Due to the difference in composition between high-carb and low-carb flours, you will need to use different amounts of low-carb flour together with other essential ingredients that you don’t typically find in traditional baking recipes like psyllium husk, xanthan gum, and protein powder.
I made this bread several times now using ground flaxseed in place of the psyllium powder and it came out perfect every time. I decided to try it as a sweet bread and added 1/2 cup raisins, 1 Tbsp. cinnamon, 1/4 cup erythritol and 2 Tbsp. Splenda. After it was done I iced it with 1/2 cup powdered sugar mixed with enough milk (about 1 Tbsp. to keep it thick but a little runny. Now I have a healthy, delicious, loaf of cinnamon raisin bread. Thanks for the great recipe!
Rod, With a ketogenic lifestyle, the point is to stay within your macros, so if you’re not gluten-intolerant and the flour fits into your macros, you should be fine. Have you calculated what your macros should be? We have a post talking about which macro calculators we like best, if you’re interested: https://theketoqueens.com/macro-calculator-review/ Additionally, a doctor can help you figure out the macros that will work best for your health and fitness goals. Best of luck and welcome to the keto family!
Thank you, thank you. I appreciate ALL the work that has gone into this information. I am starting TODAY and so grateful for this coming out in time to really help me. and I am excited to see anything else you will have in the future. I am sure you will be credited for helping so many of us get healthier. My doctor agreed I could go on a Keto diet for 3 months, so I am hoping for some help with my diabetes. He states I don’t need it since I seem to have it under control…but, I feel strongly in at least trying it and see if I can improve my A1c. THANKS AGAIN!
Brown rice flour should be stone ground in order to preserve the natural whole grain of the rice. It’s got carbohydrates, though. You knew rice would have carbohydrates, and even with brown rice in flour form, it carb city. Total carbohydrates in this flour are up to about 60.5, with net carbohydrates a little lower at 57. The GI index isn’t bad at the lower midlevel at 62. It’s going to raise some blood sugars, though.
The American Heart Association recommends eating six to eight servings of grains every day, which is a lot of carbohydrates. But whole grains also contain a lot of fiber, which is the basis for the recommendation. Fiber is bulky and slow to digest, so you feel full longer after a high-fiber meal. Fiber also aids in healthy elimination, which can keep you feeling – and looking – less bloated and sluggish. People who eat a high-fiber diet are at a lower risk for heart disease, strokes and certain types of cancers because fiber helps you avoid the insulin spikes that occur when you eat starchy carbs. Fiber also helps control your cholesterol levels.

Fiber and fatty acids combine in ground flaxseed with ALA and other proteins. Flaxseed promotes healthy cholesterol levels, and its fiber will help to keep your digestive tract running smoothly. The ALA and other proteins promote heart health by increasing the muscle energy of the heart. Smooth hair, clear skin and healthy nails are some other side benefits of flaxseed.
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).
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.

The ketosis produced by fasting or limiting carbohydrate intake does not have negative effects for most people once the body has adapted to that state. The ketosis caused by diet has been referred to as dietary ketosis, physiological ketosis, benign dietary ketosis (Atkins), and, most recently, nutritional ketosis (Phinney and Volek), in an attempt to clear up possible confusion with diabetic ketoacidosis.


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!
Made from dried and defatted coconut flesh, coconut flour has a high fiber content, with 8 grams of carbs and 5 grams of fiber in two tablespoons. To use the flour, replace up to 20 percent of the regular flour in a recipe with coconut flour and add an equal amount of liquid. For example, if a bread recipe calls for five cups of all-purpose flour, use 4 cups of the all purpose flour and one cup of coconut flour plus one cup of water. You can also use the flour alone for breading.
First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
I made this today and the flavor is outstanding! My only thing about it I’m not completely thrilled with is the lack of clumps of nuts and seeds. I put some pecan pieces in hoping they would form some clumps with the nuts, but it didn’t really help. I’m wondering if a thicker liquid would make a difference. Perhaps Sukrin gold syrup instead of coconut oil and sweetener? Could maybe add some maple flavoring to it. You might not be able to find Sukrin in the UK, but it is accessible through Amazon. Would maybe some of your followers from the US have an opinion about this?

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.
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!!
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After the 1st time I started making these i started making it as a cake using a small casserole dish cutting into 8 pieces, without the sugar/cinnamon topping. I tried monk fruit sugar and love it (new at Costco in Seattle) I also used 2% milk (all I had on-hand). I’ve made several batches and theres been some on the counter for 2 weeks now. My husband and I love having a treat we can grab on the go.
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!!!! 

Melissa, First of all, welcome to the keto family! Unfortunately, we don’t use Carbquick so we can’t give advice on that. Regarding psyllium husk powder and oat fiber, they are typically used in very small amounts in conjunction with another keto-friendly flour because they can create very dense and/or rubbery baked goods when used alone. We hope this helps!
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].
Gluten Free (GF): This can definitely be gluten-free if you do not add the gluten and you are sure your oat fiber is completely gluten free. Again, just like the Family-Friendly and the THM E mix options given above, if you are not after low carb but simply after healthier and gluten-free baking options, you may omit the lower carb flours (oat fiber, golden flax, etc.) and use part oat flour or part gluten-free flour. (Bob’s Red Mill Gluten-Free Flour is the lowest carb gluten-free flour I have found—by many carbs in some cases!) Also, you can do the option of making it as is and using half Basic Low Carb Flour Mix and half gluten-free flour for a healthier alternative to just gluten-free flour (which is often made with corn starch, rice flour, and other “white” flours).
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
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