My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
I remember years ago loving the Monterey Chicken at Chili’s Restaurant Grill & Bar. Then, they took it off the menu, and it has been just a distant memory ever since. Since starting Keto, I have thought about making a keto friendly version. In fact, I did post a very lazy crockpot version of the recipe that is keto friendly/low carb, which is delicious, but I missed the skillet version like Chili’s Restaurant.
Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.
Maintaining a state of ketosis is as simple as following the same dietary parameters that got the body into that state in the first place. If you limit carbohydrates and sugars in your diet, your body will opt to burn the healthy fats you consume for energy. However, when cutting carbs from your diet it is very important to focus on limiting net carbs, which is simply the number of grams of total carbohydrates in a portion of food minus the grams of fiber. Constipation is a very common issue for new adherents to the ketogenic diet, and it is caused by foregoing fiber in an attempt to limit total carbohydrates. So to prevent constipation from derailing your ketogenic diet, simply make sure you consume adequate levels of fiber!

Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18] 

Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA. 1998;280:140–146. doi: 10.1001/jama.280.2.140. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
In general, people on ketogenic diets tend to consume a lot of foods high in monounsaturated and saturated fats such as olive oil, butter (often butter from grass-fed cows is recommended), avocado, and cheeses. The high oleic types of safflower and sunflower oils (but not the regular forms of these oils) are also good choices, as they are high in monounsaturated fats and low in polyunsaturated fats.
Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.
In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
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!
For those who prefer to weigh ingredients rather than volume measure everything, here are my weights: using Honeyville almond flour, 2 cups is 6.5 ounces; and NOW brand psyllium husk you need 1 ounce. (I have the husks so I ground some to a fine powder in my coffee/spice grinder and measured 1/4 cup of the powder, which weighed 1 ounce or 31 grams. In future, I will just weigh 31 grams of husks into the grinder and know I have the right amount.) A quarter cup of coconut oil, like other fats, weighs 2 ounces.
I really love this bread the taste and texture, but I just can’t get the bread to rise. It always falls in the middle even before it is finished baking and continues to fall while cooling. The slice of bread looks like a sway back horse. It will rise and look wonderful and then start falling in the middle while baking. I’ve added a tablespoon of Baking Soda, increase the water to 1.5 cups, tried glass and metal loaf pans, baking at a higher temperature but nothing works. Can anyone help me with this falling in the middle problem?

Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.
On the other hand, the types of foods you’ll avoid eating on the keto, low-carb food plan are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of “empty calories”). 

Participants were recruited from the Durham Veterans Affairs Medical Center (VAMC) outpatient clinics. Inclusion criteria were age 35–75 years; body mass index (BMI) >25 kg/m2; and fasting serum glucose >125 mg/dL or hemoglobin A1c >6.5% without medications, or treatment with oral hypoglycemic agents (OHA) and/or insulin. Exclusion criteria were evidence of renal insufficiency, liver disease, or unstable cardiovascular disease by history, physical examination, and laboratory tests. All participants provided written informed consent approved by the institutional review board. No monetary incentives were provided.
I actually clicked on the story just to see if they included anything about it’s use in managing chronic migraine. I have chronic migraine, basically intractable. Nothing has helped. I’ve tried medications, meditations, and everything in between including a bunch of dietary changes. Keto is my next consideration. I’m happy to hear it helped you! Thanks for sharing
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
I don’t make pancakes often and never waffles, but I have definitely used it for the crepes A LOT. The key to the crepes is that the liquid is super thin–like cake mix, not like brownie mix. The xantham gum is really not a huge amount for the full recipe. It is under 1 TBSP per cup of other dry ingredients. Let me know if you like it better with the wheat gluten. Thanks for writing!
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!
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]
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf.
Congratulations on your keto success! i started keto on September 2, 2017 after reaching my highest weight ever of 192. As of this morning, I’ve lost 50 pounds, weighing 142. I’ve struggled with weight my entire life, & never thought I would be this size or weigh this little. I have never felt better! My hormones are stabilized (I’m 60, so I have the perimenopausal thing going on); my acid reflux is almost completely gone; my arthritis symptoms are gone; I’m sleeping MUCH better; and my skin isn’t dry! I started keto for weight loss, but now I know the weight loss is a perk. I’m never “hangry” and have been able to incorporate 24 – 48 hour fasting into my weekly regime with no difficulty. I do intermittent fasting every day, eating all my food in 8 – 12 hours daily. My “food obsession” is gone; yet, I love eating more than I ever did pre-keto! I eat only when I’m hungry (not by a clock) and stop when I’m satisfied. I agree that a lot of docs still are not on board with keto. A great book to understand keto from a medical perspective is Jimmy Moore’s Keto Clarity. I think the reason some people don’t do well on keto is they have a difficult time embracing the idea of eating “this much fat”. Happily, I’m an “all or nothing” person, so when I started keto, I jumped in – and found that the fat fills me up faster & keeps me full longer so I don’t have cravings. When I do want something sweet, I make a keto treat – but it’s not every day or even every week. Most of the time, I’m super happy on my bacon, sour cream, cream cheese,and fattier meats! I am keto for life – there is no reason to go back to eating any other way!
Use our premium meal planner tool (free trial) to access tons of weekly meal plans, complete with shopping lists. You can adapt the plans to your liking, skipping any meal, choosing how many people you’re cooking for, and the shopping lists adapt. You can even start a new plan from scratch (of from pre-existing ones), tailor them completely and save them.
If you're a fan of health food already, you'll appreciate that a good portion of low-carb pastas are made using gluten-free ingredients. Gluten is a substance found in wheat and similar grains that some individuals do not tolerate well. In fact, those who suffer from celiac disease are completely allergic to it. If you find that your body doesn't agree with foods like bread and cereal, there's a good chance you'll feel better after switching to a gluten-free diet. There are lots of low-carb pasta varieties available that have a noodle-like texture thanks to beans, not wheat.
This recipe is FABULOUS! I just made it and used a muffin pan. I got 12 smaller muffins out of the batch. I baked them until they were dark golden and pulled away from the pan. After sitting on a cooling rack they got wonderfully hardened to a nice little crunch then the inside is so moist and tender. I’m a crunchy texture person so this is perfect for me!
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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. 
Hi Kathy, Almond flour doesn’t rise very much, but if they didn’t at all, it might be that you need newer baking powder. Falling apart is also likely due to the baking time I had in the original recipe, and I’ve updated it for a better result. Check the post for new tips! Cookies sound like an interesting idea, too, though I think the batter might be too liquid to form them.
I too have been following you for a long time, trying your recipes and loving most of them. I am 4 days into the keto diet. I have not looked at the scale yet, but I kinda feel like my clothes fit a bit better. I am not in ketosis though…I was glad to hear that it took you a bit longer to get there so I don’t feel like I am doing it wrong. I am 62 and 5 foot 2 and I just can’t seem to keep my protein low enough. Too much meat I am guessing. I am trying to stay at 1330 calories, 105 grams of fat, 20 carbs, and 76 protein. I am very interested in learning what you eat in your typical meals for the day. I use the free version of My fitness pal.
2. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566 
I’ll be the first to admit it, I’m kind of obsessed with Big Mac sauce. What can I say? That special sauce is magical! These easy Low Carb Big Mac Bites were inspired by the Low Carb Big Mac Bowl I made recently. You know Melinda and I love bite size appetizers and who doesn’t like food-on-a-stick at a party? Say hello to these awesome mini bunless burgers served with a creamy, tangy special sauce :). 
These tasty mini burgers are perfect for parties because they can feed your low carb AND carb-loving guests and no one will even miss that bread. Make them for tailgating parties, game day parties, summer picnics, or just a fun weeknight dinner for the family. Once you dip those little burger bites in that special sauce you’re going to be going back for seconds!
Ground psyllium husk powder is 100% pulverized psyllium husk shells and is used to give a bread-like texture to what you’re baking. Due to its high fiber content it’s often sold as a laxative which can be good to know if you have a sensitive digestive system. When adding it to a liquid it turns into a gel-like substance. It works a bit like gluten in traditional baking, and makes it possible to handle the dough when rolling or shaping it.
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.
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]
Maintaining a healthy weight has never been easy for me. I’ve struggled with sugar addiction and weight gain since I was a teen. You can read about my whole journey here and see Before pics as well. But since I’ve been low carb over the last 4 years I’ve been able to easily maintain my weight. Now with keto, I’m hoping to change my body even more. I may not lose “pounds” but just seeing these results shows the scale number is just one measurement and to me the body fat number is more important.
Interested in trying a fad diet? There are plenty to choose from, and low-carb pasta can be incorporated into most. The Atkins, ketogenic, and paleo diets — to name just a few — all prescribe a low-carb lifestyle to support health and fitness. On these diets, instead of consuming carbs for energy, you will eat protein, healthy fats, fruits, and veggies. Each of the aforementioned programs allows for a small portion of carbs each day, so you can chow down on low-carb pasta without falling off plan.
Granola can be used as a breakfast dish or as a source of energy to snack on during the day, especially if you take part in sports and need a bit of a boost. This low carb version makes a lovely crunchy breakfast cereal but it also a great topping for yogurt or ketogenic ice cream. This granola can be stored in an airtight container for up to two weeks.
So today I was sitting here getting some work done and occasionally looking out the window. The roses on the trellis are pretty actively in bloom and the trees are loaded with bright green leaves. The colors are bright against a glowery gray sky, though and it looks chilly. It’s not in the least – I think the high today is going to be 81F – BUT it LOOKS that way.

If you’re counting your carbs, it’s important to check the labels of the foods you eat. You should look for the term “total carbohydrate,” which includes starches, sugars, and fiber. This can help you balance the number of carbs you eat during each meal. Spreading your carbs evenly throughout the day helps ensure your body has a steady supply of energy to power you during the day.
This keto granola can be made in big batches and stored for use during the week, but it takes just a couple of minutes to throw it together so can be made fresh each morning. This makes a perfect energy-rich start to the day if you are no-sugar, and the slow release of energy will boost your system till lunch. Serve with nut milk of your choice – almond milk or coconut milk work well here.
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]
Almond flour works well as a wheat flour substitute. Because it is so dense and crumbly, you'll need an extra egg to give baked goods rise and structure. Lower the oven temperature by 25 degrees Fahrenheit and allow food to cool completely before serving. A 1/4-cup serving of almond flour has 6 grams of carbohydrates and 3 grams of fiber. At only 5 grams of carbohydrates per 1/4 cup, hazelnut flour is another low-carbohydrate option. It is a good source of vitamin E and healthy fats. Replace up to 30 percent of wheat with hazelnut flour in baked goods such as pie crust and cookies.

The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]
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