Still, whole wheat flour comes in about midway on our list of flours based on carbohydrate content, so it’s got a little less than 45 carbohydrates per half cup, and comes in mid-range for GI at 69, You may find that you want to sneak whole wheat flour into your recipes, by adding a little at a time and working up to where you have mostly whole-wheat bread.


One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
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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.


Carbohydrates are used to make glycogen, which is required for muscle function. The difference between this and common meal plans is the amount of carb intake is limited to enough for the glycogen production of a normal person. Not every carbohydrate is created equal. Sugar alcohols don’t affect most people’s blood sugar levels. Nor does most fiber. A keto eater is interested in net carbs, figured by total carbohydrate minus fiber minus sugar alcohols.
You can substitute half of the spelt flour for half of the flour called for in your recipe. This will help to keep the texture of bread when baking spelt bread. For total carbohydrates, it comes in at almost 27, with a net carbohydrate count of just under 22. The GI is getting up into the midrange, so this bread will start to raise blood sugars more at 55-67 than the previous four choices on our list.
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
I had to make a few changes though. First, what makes a donut taste like a donut is nutmeg. I added a few gratings and cut the cinnamon down to about half. Second, I live in South Korea and almond milk almost always contains sugar and is very expensive. I used heavy cream and then added a splash of water when the batter was very thick. Third, I don’t have erythritol, but I do have a stevia and erythritol blend so I used that.

Thanks so much for sharing your results. You look so good, and you have inspired me to try a more structured version of the Keto Diet. I lost some weight recently on HCG 2.0, which puts you into ketosis (keto flu and all!). I have tried to maintain my weight loss with a version of the Keto Diet, but I know that I am probably still eating too many carbs and not enough fat. I am 47, and I contine to have issues with keeping the weight off despite a healthy diet and exercise. I am sure it is hormone-related.


I have never made waffles with this mix as we don’t make waffles. However, I would think it would be similar to pancakes, which I have made. Did you use 1/4 cup of Xantham gum? More than this seems to make a pastier batter. When making pancakes, I found that I needed to batter to be way thicker than most pancake batters. I also found that I needed more eggs. As for what else this mix can be used for, I have recipes at the blog for cookies, cupcakes, biscuits, and crepes using this mix. I have dozens of recipes in various stages of testing that use this mix. Some of my favorites are quick breads and muffins and cookies. Cake type recipes (muffins, small loaves of bread, cupcakes, cake, etc.) really turn out well with this mix. Let me know how some other dishes turn out for you! Thanks!
1. Black Bean Pasta from ExploreAsian, Gluten-Free: This pasta is a favorite of mine because it’s gluten-free, it cooks really fast (in about 5 to 7 minutes) and it holds together. Oh wait, did I mention the only ingredients are black beans and water? Very clean and very healthy! After subtracting the 12 grams of dietary fiber from the total carbohydrates, you’re left with 5 grams of very low-impact carbohydrates! Feel free to have two servings at that count!
Hi! I tried this the other day and it baked up strangely. I baked it for about 63 minutes and it was nice and crusty on top. It was still a bit gummy inside so I may need to bake it longer. However, when I flipped the loaf over it was extremely concave. The only thing I did differently is use canola oil instead of coconut oil. Any suggestions? Thanks much
Soba noodles: In many Japanese dishes, fiber-rich soba noodles are the star player. While they’re similar in texture to traditional long noodles, their nutty flavor makes them a great fit for savory and slightly sweeter dishes. At 24g of carbs per cup, they’re a higher-carb option than veggies, but still lower in carbs than a cup of regular spaghetti which has around 43g of carbs.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
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.
Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.

What a great post. I thought i would add about the selection of food you eat on keto and that everyone is different. Some food gives you energy and some doesnt, this varies person to person. I started and quit keto 3 times before i managed to find my balance. The first few times it made be poorly, from the shock of diet change. However, you can wean yourself into the diet which i did the last time when i had the most success.
Hi Liz, Low carb bread doesn’t rise as well as one made with wheat flour, but it shouldn’t be quite that short. Some factors that might contribute include the age of your baking powder and how well the batter is mixed – the mixing process helps create air bubbles. Also, did you use baking soda or baking powder? They are not the same. Baking soda needs something to interact with, in this recipe I use baking powder. More baking powder *might* help, but is risky because using too much can cause it to fall even more flat.
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 >
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]

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).

If you want something that feels a little more indulgent, you can recreate gnocchi with just two ingredients: egg yolk and shredded mozzarella. In fact, as the Primitive Palate discovered when creating the recipe, while it’s a little more time consuming (you’ll need about a half hour from start to finish) making gnocchi this way is considerably easier than the traditional method.
One of the central questions new adherents to the ketogenic diet must answer is whether or not they want to incorporate meat into their new diet. It is entirely possible to consume adequate levels of healthy fats whether you approach the diet as an omnivore or a vegetarian, so this decision is largely a personal one. However, if you choose to incorporate meat into your version of the ketogenic diet, it is crucial to ensure it is grass-fed, organic, and free of antibiotics. Furthermore, it is important to focus primarily on above-ground leafy vegetables, with meat serving as a side dish. An example of the perfect plate for a keto omnivore would be a sizeable portion of colorful, above-ground leafy vegetables covered with a healthy fat like olive oil, paired with a 3-5 oz serving of high-quality meat.
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[*].
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]
This was very good general. I would love to see a menu plan of what you actually ate between low crab(like a sample day) and Keto. I also found it encouraging that it took you moths to be keto adapted even though you were already doing low carb. Is this because you found it hard to cut out the carbs? I have been trying to do Keto for weight loss and clear mind and focus since the end of December. I did well the first week, then had a bad day and got back to it.. I have a good week and then a bad day and that’s been my cycle for 3 months. SO I have lost some weight 12lbs, but I really need to lose more. Nothing else worked for me to lose weight, My body really likes to hold onto its fat, most likely due to that it doesn’t process stress well and I have a high stress lifestyle. Any suggestions would be much appreciated. Thank you, I love your blog.
Because I don’t think it does work as well. If you use it that way and you like it great but I can’t recommend it because I didn’t like the texture the times that I tried it in this recipe. Each recipe is tested several times… usually by several people… and this one everyone who tried it liked the original better than the xanthan gum. SO… now you know why I keep saying there’s no substitute. 🙂
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
As a newbie to Keto, and after perusing many Keto websites, I find yours to be the most satisfying in many ways. Your recipes are down to earth desirable substitutes for the things we hate most to switch from in a regular diet. And I was thrilled to see your breakdown of the carb friendly items in these easy to use tables. It is very difficult at first to dial in the macro percentages needed daily, because one might focus on a low carb item, to add for the day, only to find out that the protein blows your schedule. So tables are a very concise and effective snapshot of what one might add in any meal segment. I would love to see similar tables reflecting the protein in different food groups and also one reflecting sugars. With those three printed out and in front of me, it would be a lot easier to navigate the landscape. Thanks for the time and effort you put into this.
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Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.

The primary outcome, hemoglobin A1c, decreased from 7.5 ± 1.4% at baseline to 6.3 ± 1.0% at week 16 (p < 0.001), a 1.2% absolute decrease and a 16% relative decrease (Table ​(Table4).4). All but two participants (n = 19 or 90%) had a decrease in hemoglobin A1c (Figure ​(Figure1).1). The absolute decrease in hemoglobin A1c was at least 1.0% in 11 (52%) participants. The relative decrease in hemoglobin A1c from baseline was greater than 10% in 14 (67%) participants, and greater than 20% in 6 (29%) participants. In regression analyses, the change in hemoglobin A1c was not predicted by the change in body weight, waist circumference, or percent body fat at 16 weeks (all p > 0.05).
Sunflower seed meal and pumpkin seed meal are ideal options for those who are allergic to any of the nut flours we mentioned above. These seed flours are high in vitamins and minerals such as vitamin E, copper, thiamine, selenium, and phosphorus, and relatively low in net carbs (less than five net carbs in every 1-ounce serving), making them a healthy keto-friendly option.

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In trying to decrease carbs I have tried a few recipes for baked goods but they’re a bit “off”. One was a brownie recipe using coconut flour, avocados & sweet potatoes. It tasted pretty good but the texture was almost custard like. Would have allowing it to rest & thicken before baking have helped? I wondered about using psyllium husk to thicken or make it more dense. Maybe 3 instead of 4 eggs?? The other recipe was a traditional scone recipe that I adjusted. I used half wheat flour and almond flour. They tasted fantastic but were just a bit too moist and didnt rise as typical which I expected from the reading I did beforehand. Do you have advise on leavening agents? I found “use a little bit more” in a recipe where almond flour is substituted but there was no percentage or specifics on how much “a little bit more” meant… My brain is swirling in trouble-shooting overload!

The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
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.
I made these yesterday using straight from the fridge eggs and cream cheese, parchment paper sprayed with cooking spray (I folded up the sides of the paper to prevent leakage), and a mini-chopper. Even with these imperfect tools my noodles were perfect. I was able to just tilt the pan until the batter was covering the entire area, which made them fairly thin and a few on one side were over-done but still were fine in my faux chicken faux noodle soup. They cut easily and slid right off the paper. My kids had nothing bad to say either! I will make them thicker next time for eating in a sauce as they are fairly soft but did hold up in the soup and even by lunch today were still great. Thank you!

There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]
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JoAnna, We have 3 ways we typically thicken soups: 1) with a bit of cream cheese, 2) with heavy cream, or 3) with beef gelatin. Depending on which you use, it will change the flavor of the soup slightly, but cream cheese or heavy cream might be a really delicious flavor pairing with mushrooms! Xanthan gum will also work if you have it on hand (start with a little and work your way up), but we don’t use it (unfortunately it causes tummy troubles for a lot of people, us included!).
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.
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