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 creamy, cheesy alternative to typical mac and cheese, it’s not a stretch to think this version is preferable to using elbow pasta, no matter what your relationship with carbs may be. Boil cauliflower, whisk up a cheese sauce, and throw it all in the oven. For a fancier twist, use your favorite non-cheddar cheeses or a combo (mozzarella and pepper jack, anyone?)
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
These are amazing! I only had almond meal instead of almond flour and didn’t have a donut pan so I used a muffin pan. I was surprised at how light and fluffy they were, and the taste! Oh my!! I was so wrapped I made another batch today but just left them plain with no coating and they were divine. I also froze some yesterday and thawed one and they freeze excellent. Thank you Maya!
All cold cereals are going to have some carbs in them. The key is to avoid simple carbohydrates, such as those found in processed grains like corn flakes or any old-school cereal made with refined white flour and a ton of sugar. The health organization Diabetes UK recommends choosing a cereal based on whole wheat, oats or bran. In addition to eating whole grain cereals, you also need to avoid excess added sugar such as high fructose corn syrup. The Center for Young Women's Health suggests that you choose a cereal that contains fewer than 8 grams of sugar per serving. Dried fruit counts as added sugar, so pay attention to the ingredient list. You can always purchase unsweetened cereal and add fresh fruit as a sweetener, because the vitamins, minerals and antioxidant benefits of fresh fruit outweigh the natural sugars.

Most people are used to how white flour works, but when they try to bake or cook with low-carb flour, they most likely will notice some differences. Depending on the source of the flour — and how many carbs, fat and protein calories it has — the flour may well react differently. For example, flour with high protein may clump easier; the flour also may brown or burn quicker than regular flour. This means cooks and bakers may have to experiment with the flour to learn how it works.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
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.
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!

In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
Hi Louise, I haven’t tried that product so can’t say for sure if it’s a good choice, but it sounds like it is if the recipe worked for you – which is great! Feel free to add herbs, spices, or garlic powder if you want some flavor to the bread. I kept it plain to be used for many different applications. The number of slices will depend on how thick you cut them and the size of your pan. 

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.
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.
Diet is the most important lifestyle factor for weight loss. In order to effect significant loss of weight it is necessary to create a consistent caloric deficit. This has the rather obvious side effect of leaving individuals feeling hungry and as though they are in a constant state of deprivation. Dieting is based upon this basic concept, which is the most likely reason why dieting is very likely to fail in the long-term. The ketogenic diet, while controversial and a highly polarizing subject, has demonstrated promise as an alternative dietary strategy for weight management. The KD may hold an advantage over traditional calorie-restricted diets, in that nutritional ketosis may enhance appetite control, and subsequently improve dietary adherence and long-term success. Nevertheless, the KD should be approached with caution, as there are both short- and long-term potential negative side effects. More research into this unique dietary strategy is warranted to fully investigate all potentially positive and negative aspects.

A computer program such as KetoCalculator may be used to help generate recipes.[47] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil, or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas, and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower, and green beans are all equivalent. Fresh, canned, or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[37]
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]
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
Important Disclaimer: The information contained on Bodyketosis is intended for informational and educational purposes only. Any statements made on this website have not been evaluated by the FDA and any information or products discussed are not intended to diagnose, cure, treat or prevent any disease or illness. Please consult a healthcare practitioner before making changes to your diet or taking supplements that may interfere with medications.
Yes, some ideas on meal plans and very easy recipes would be very helpful. I’m 67, very overweight, diabetes, high blood pressure. My big love are all the carbs. This way of life seems impossible to me, all that fat just doesn’t sound appealing. I can’t see how to eat that much fat a day. Years ago, I did try Dr. Atkins diet but I had a very hard time with the very limited carbs. But now, I need to something drastic but haven’t a clue how to start.
Every meal should include a heaping portion of low-carb veggies, like leafy greens, broccoli, and cauliflower, which provide the essential nutrients for optimal health. Vegetables that should be limited due to their higher carbohydrate content include all root vegetables: potatoes, carrots, and parsnips fall into this category, unfortunately. Fruits should be consumed with caution, as well, because they contain high amounts of sugar (read: carbohydrates).
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.
With just 4g of carbs, this pasta, made from hearts of palm, is a plant-based pasta substitute you may not have heard about before. Palmini is low in calories, high in fiber, gluten free, and looks more like traditional pasta than some other alternatives. It can be purchased canned or in pouches. While you can eat it straight from the package, it also cooks up well—keeping its pasta-like consistency.
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.
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.
Thank you so much for sharing this recipe. I made it last night for the first time & it turned out perfect – just like your picture above! I used the big bowl of my Kitchen Aid food processor to grind the almonds & psyllium husks really finely, then I beat the eggs & coconut oil in the smaller bowl for a few minutes until it looked bubbly, then just added all the ingredients together in the big bowl & continued to process for a few minutes. I sprinkled sesame seeds on the top before putting it in the oven & after 55 minutes, it was perfectly cooked, had a good rise & our house smelt divine! The texture was also just right – soft & fluffy in the middle, golden & crunchy on the outside. I might add some other small seeds to the mix next time. Thank you so much – this is one of the nicest & easiest gf bread recipes I’ve come across!!! Keep up the great work xx
Then on the nutrition label, it reads, Low carb. Also the nutrition label does not list as a category, the carb count. All nutrition labels that read “Low Carb” would have a line item for the carbs, even if its <1g. Although, I personally have never seen a label that reads Low Carb as part of the nutrition label it's self, maybe in the ad area though.
Regular flour is made from wheat and grains, both of which have high amounts of carbohydrates. To make a similar flour with fewer carbohydrates, different sources — sources considered low-carb — are used. These sources typically include nuts such as almonds and walnuts, seeds such as flax seed, and legumes such as peanuts and soy. Wheat also can be used as low-carb flour, but only if the wheat section containing the protein is used and nothing else.
Dr. Stephen Phinney, who has been doing research on ketogenic diets since the 1980s, has observed that people don't do as well when they are consuming a lot of these oils (mayonnaise and salad dressings are a common source). This could be because omega-6 fats can be inflammatory, especially in large amounts, or some other factor. In his studies, people didn't feel as well or perform as well athletically.

Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.


Thanks for your quick reply. Yes, BP is fresh. My batter wasn’t runny either. In fact I was going to add some more liquid but decided to leave as it was. The only other thing it could have been is that I live at 5100′ elevation and it was cold and snowing the day I made them. I am going to make them again and see what happens. I am not giving up! 🙂

There’s nothing like pouring a bowl of low carb cereal with almond milk for an easy morning breakfast. These low carb granola and low carb muesli recipes are made from nuts and seeds resulting in a nourishing sugar free, gluten free, and grain free breakfast option. Because they are very nutritionally dense, enjoy a small portion. Enjoy a spoonful on full fat Greek yogurt or ice cream.


Almond Meal is made slightly different than almond flour. Instead of blanching the almonds to remove the skins, the skins on the almonds are kept on. It’s a little bit coarser than almond flour and still bakes the same. For baked goods, I like to use a super fine ground almond flour but I will equally use almond meal as it seems to perform just as well in most recipes, at a reduced cost.
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!!
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.
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.
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
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.
The KD stands in stark contrast to current macronutrient recommendations for both health promotion, as well as enhancement of athletic performance (7,21). The KD is characterized by a macronutrient distribution ratio consisting of approximately 70 – 80% fat, 10 – 20% protein and <5% carbohydrate (CHO), with daily CHO intake limited to ≤50 grams. Two of the most prominent and vocal researchers of the KD, Jeff Volek, PhD and Stephen Phinney, MD, PhD, in their book The Art and Science of Low Carbohydrate Performance, recommend protein consumption of 0.6 – 1.0 grams per lb of lean body mass, a figure which almost perfectly matches the commonly recommended protein intake for athletes (i.e., 1.2 – 2.0 g/kg bodyweight) (21,26). With CHO intake radically restricted and protein within the commonly recommended range, fat becomes the primary macronutrient target for manipulation.

It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]
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.
I made this. It’s excellent! I had to sub with xanthan gum (estimating the conversion from psyllium husk powder – i used 2 tsp of xanthan gum) and it’s still great. I made Alaskan monte cristos with it that were fantastic. (Low carb french toast dredge and griddled the bread, then griddled again with ham and swiss like making grilled cheese then a bit of sugar free raspberry jelly on the side.) Next I substituted coconut flour (1/2 a cup) for the almond flour and made it again because I liked the original recipe so much. I added 1/4 cup extra warm water and 2 tbsp melted butter to the dough. I was a little off on the conversion for bread but ended up with an excellent pound cake. So… I whipped up some low carb cream cheese icing to put on it the topped that off with non-sweetened coconut shavings. OH MY GOODNESS!!! To have coconut cake again! It was excellent! I estimated the cake ended up being about 100 calories for a 1/2 inch slice and about 2.5 net carbs. Anyway, thanks for the recipe and I enjoyed playing with it some.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
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.
Carbs in fruits and veggies do count, but you don’t add up the carbs and sugar. Sugar is already included in the carbs – it’s just listed separately on labels because some people want to see a breakdown of how much of the carbs are sugars (versus other, complex carbs). If it says 2g carbs and 2g sugar, it means there is 2g total carbs and all of them are sugar (in this case).
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.
While there are many different types of pasta today, the classic cooked, unenriched traditional pasta is about 30 grams of carbohydrates per 100 grams. That’s your entire daily carbohydrate intake on the ketogenic diet, if you’re lucky. After that comes a minuscule 0.9 grams of fat, about 6 grams of protein and minimal micronutrients. Even whole wheat pasta, advertised as a health food, contains 37 grams of total carbohydrates[*].
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