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]
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.
Overall, to get a good nutrition calculation (1) weigh all dry ingredients instead of volumetric (go try and weigh a cup of pecans, pour it out, try again, etc; you will see you probably have around 10% variance, and that variance skyrockets when you start talking about smaller quantities like 1/4 cup due to how the nuts pack in); (2) add all the ingredients into your recipe calculator of choice (I use mynetdiary.com, but YMMV); (3) weigh the final result out to find a total weight of results; (4) divide that weight by the number of servings, to see what weight your servings should be. You could also get a volumetric measure of servings after that just for fun, but see above about volumetric measures of dry goods (especially chunky, variably sized dry goods like this).
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.

A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
These didn’t come out right but that was my fault. I didn’t have a large enough baking pan so that my silpat would lie flat which caused the batter to pool in the middle and it took a long time to cook (11 minutes) and I had to keep pulling it out of the oven, cutting off the cooked part, etc. Having said that, they were pretty good even though some of them were kind of thick. I made beef and noodles and simmered the noodles in the crockpot on low for about 20 minutes. I ordered a new pan and will try this recipe again because I think it will be good if made correctly. Also, I doubled the recipe 2 oz of cream cheese, 4 eggs, and 1/2 tsp of vital wheat gluten. Thanks so much for posting..
I really appreciate this article. I have done low Carb for the most part for over 15 years and was able to keep my weight down. Now that I have gone through menopause is just keeps getting harder. I try doing keto but tend to fall off the wagon a lot and go back to low Carb or Weight Watchers. Simple ideas would be great. I think some keto bloggers make it seem that you have to create difficult recipes. Thanks for all you do.
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 swap out the Erythritol and 100% cacao for 2 squares of 90% cacao (I’ve been using a Lindt candy bar; they were on sale). I use just a bit over 1/8 tsp. of baking powder. I add a touch of pink Himalayan sea salt. I microwave it for 42 seconds (1100 watts), Set a Tbsp. of peanut butter on top, make my coffee (gives the peanut butter time to soften/melt), dump the measuring spoon out and spread it around a bit. Absolutely perfect. (note: this is a VERY DARK CHOCOLATE TASTING CAKE, if you don’t usually eat dark chocolate, you will want to stick with the original recipe!)
Hey there! Tried these today and they are awesome. I did change a couple of things…I used Fairlife Milk instead of Almond milk and used real sugar instead of a sweetener. The crazy thing is…I ran the ingredients through my recipe calculator and with my ingredients there is 11.6 carbs per donut (and I got 8 instead of 6) and with your ingredients, there were just over 13 carbs. This confused me. Whatever the carb count, they are great!

Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
Meat – Unprocessed meats are low carb and keto-friendly, and organic and grass-fed meat might be even healthier. But remember that keto is a high-fat diet, not high protein, so you don’t need huge amounts of meat. Excess protein (more than your body needs) is converted to glucose, making it harder to get into ketosis. A normal amount of meat is enough.

Most recently, Wilson et al. (27) investigated the effect of a 10-week KD on strength, body composition, blood lipids and hormonal response in resistance trained males, while following a periodized resistance training program. The investigation included a 2-week dietary adaptation period, and a control group, which followed a more traditional macronutrient ratio consisting of 55% CHO, 25% fat and 20% protein (WD). The 10-week dietary intervention was followed by a 1-week CHO re-introduction for the KD group. Average caloric consumption across the 11-week intervention was similar between groups. Blood lipids remained constant and were not significantly different between groups. The KD group did, however, elicit a significant increase in blood triglycerides during week 11, with the re-introduction of CHO. Total testosterone was significantly increased in the KD group, compared to WD, however, free testosterone was not significantly different between groups. While both groups saw increases in lean body mass, the KD group realized gains significantly greater than the WD group. Similarly, the KD group experienced significantly greater decreases in fat mass during the 10-week CHO restriction period. There were no significant differences in measures of strength or power between groups. From this, the authors concluded that the KD favorably impacted body composition, with no negative impact on blood lipids or muscular strength and power.

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!
This post may contain affiliate links to products we believe in, which means that even though it doesn’t cost you anything extra, The Keto Queens will receive a small amount of money from the sale of these items. Also, please know that nutritional information is provided as a courtesy calculated from the nutrition plugin API and we cannot guarantee its accuracy.
The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
With the help of keto-friendly ingredients, you can easily make yourself some delicious, fluffy pancakes. There are, in fact, several ways to make fantastic keto pancakes, but our favorite is the Faux “Buckwheat” Pancakes made with almond flour and flaxseed meal. Try them for yourself if you want low-carb pancakes that taste just like the real thing.
This is the second recipe for a cinnamon toast cereal I’ve tried and failed at miserably! I want to know details when baking, it is a science after all. How did you spread this on the sheet pan, how thick, was it rolled? Too much missing I formation! I’m finding a lot of keto or low carb recipes are like this, very discouraging and extremely disappointing from this community. Details PLEASE!

It's not the easiest plan to follow, but the theory of ketosis as a possible prevention against disease is gaining attention from cancer specialists. Tumor immunologist Dr. Patrick Hwu, one of the leading cancer specialists in the U.S., has followed the keto diet for four years, although he prefers to call it the fat-burning metabolism diet, or fat-burning diet. More research is needed to prove its benefits, but Hwu, the head of cancer medicine at MD Anderson in Houston, believes in it after seeing improvements in his own health.
Made these donuts this morning, and they are delicious. The simplest and one of the best low carb donut recipes that I have tried. I did add a scoop of whey protein powder for structure, and that worked great. I used Swerve in the donuts and a small amount of Truvia (which contains a little sugar–but okay in this tiny amount per donut) for the topping. I got 8 donuts out of the recipe, but I think I actually could’ve gotten 10. I have two 6-cavity nonstick Wilton donut pans like the ones pictured in your link. Great recipe, Maya. Thanks!

Shirataki Noodles: There are people who like this pasta, but I don’t know many of them. You probably should try it yourself just in case you’re one of those few who likes them. With essentially zero calories, carbs, fat, or protein (in other words: void of nutrition whatsoever), these “noodles” are made with yam flour (konnyaku) and water. There are a variety of brands and you can find them just about everywhere these days. In your grocery store, you’ll probably find them within the produce section. Even stranger is that they are packaged in a bag full of water. What’s the downside to a pasta that has basically zero carbs? They smell gross. They taste gross. The texture is gross. Ick. You’re encouraged to rinse them thoroughly in an effort to rid them of their funky taste and smell, but I found that no amount of rinsing was good enough. If you’re someone who does like these noodles, please let us know how you managed to make them edible!
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.
Cutting back on protein is one of the largest challenges to the diet. Because high levels of protein in the diet can turn into glucose in a process called gluconeogenesis, the keto theory says too much protein in the diet can mean too much glucose, whisking you out of ketosis. That’s why bacon, which has a ton of fat but not a lot of protein is a preferred food over chicken breast, which is high in protein with very little fat.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
^ Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg, saccharin and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1).[17] The eggnog may also be cooked to make a custard, or frozen to make ice cream.[37]
Low Carb (VLC): This is about as low carb of a mixture that you will get in low carb baking (except for straight up flax or oat fiber). You could get approximately the same carb count with almond flour alone, but I don’t like feeding us huge handfuls of nuts over and over again every time we eat any baked good. (I know the low carb high fat people say it doesn’t matter, but it feels like it matters!) I also like the “dilution factor” of using multiple non-grain flours in a mix.
Crazy right though? I just can’t even believe it for myself until I see this picture of my mid section! I’m truly in shock how it was just 2.4 pounds I lost in 6 weeks and just a half percent in body fat. But clearly the keto diet produces results. I feel better. I look leaner and more toned and I’m just motivated to continue on even though I’m not one of those people who have lost a crazy amount of weight in a short time. I’m in it for the health benefits I mentioned above, but also I’m feeling pretty darn good in my size 6 pair of jeans!
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]
While there have not been large studies that show the relationship between the ketogenic diet and cancer, we will be publishing a case study about that topic. The author failed to comment that pediatric patients with epilepsy are on the diet for usually about 2 years with no harmful effects. Before the false studies about heart disease and fat, the low carb diet was a respected way to lose weight. Studies into our metabolism show we can use both fat and carbohydrate as fuel. So stepping away from our high carb diet- I am sorry to say that we eat more carbs since the 70s with most of it processed and we now use high fructose corn syrup to sweeten products and we have a wide spread childhood obesity problem. If cholesterol is a concern try plant sterols and stenals to block cholesterol from the receptors in the body. So much more can be said about a keto diet than this article states

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 🙂

Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[35] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[36] However, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria, and other rare genetic disorders of fat metabolism.[9] Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[37]
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).
Regrettably I was one of those who couldn’t get the recipe to work. My baking sheets weren’t perfectly flat so it was a real mess, the batter separated on the silpat and I couldn’t get the thing to set. This morning I had an idea and it worked perfectly- I cooked the batter in a non-stick frying pan with a kiss of EVOO like a crepe! Worked like a charm. Made your alfredo sauce with some chopped spinach, simmered the noodles in the sauce a few minutes and served it with a crispy pork roast. What a treat! Thank you so much, I’ll use this recipe again and again.
I really appreciate this article. I have done low Carb for the most part for over 15 years and was able to keep my weight down. Now that I have gone through menopause is just keeps getting harder. I try doing keto but tend to fall off the wagon a lot and go back to low Carb or Weight Watchers. Simple ideas would be great. I think some keto bloggers make it seem that you have to create difficult recipes. Thanks for all you do.
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.
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
This book is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, a link is provided to the Creative Commons license, and any changes made are indicated.
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.
×