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]
To make squares: Place dough on a piece of parchment paper, with a second piece of parchment on top. Using a rolling pin, roll the dough into a thin and even layer about 1/4-1/8” thick. Remove the top piece of parchment paper. Using a pizza cutter, cut into small squares (about 1”). Bake in the oven for 5 minutes, then take baking sheet from oven and carefully break up the squares (so they’re no longer connected). Bake for another 7 minutes. Allow to cool and enjoy!
I was wondering if you have created some flour mixes to replace all purpose. Like a keto flour mix of sorts. I am also wondering, if with any other gluten free flour mix, the amounts of binder like xantham gum, guar gum, or gelatin would apply following the same rules of a non-keto flour mix. I found this recipe but haven’t tried it: https://donnareish.com/low-carb-flour-mix/

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.
Organic Sesame Flour. Sesame seed flour is a great alternative to all-purpose flour. It tastes great in both sweet and savory recipes and is especially good for making keto bread. By using sesame flour with psyllium powder, you can make your favorite baked goods more light and fluffy. Keep in mind, however, that this flour is similar to coconut flour in that it has high absorption properties.
If you are trying to get the kids to eat healthier and not rely on sugary cereals you might find this keto one will win them over. It has a great texture from the nuts and seeds and has a sweet warming flavor from the cinnamon and sweetener. This cereal is great with your choice of milk or can be made a bit more filling by adding in some fresh berries. 

Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].

I do not use the VLC mix to make yeast breads. 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!

Hi Debbie, Whole milk yogurt (whether cow milk or goat milk) is a person choice for a keto diet. It does contain some lactose, which is a sugar, but some people evidence suggests that there may be less than the label implies due to the beneficial bacteria in the yogurt. Either way, if you include it, be sure to get the plain kind without any added sugar.
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
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.
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]
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
Carolyn Ketchum writes All Day I Dream About Food, a food blog that focuses primarily on low carb, gluten free recipes. She has a Masters in Physical Anthropology and Human Evolution from Arizona State University and has an extensive background in higher education administration. She currently lives in the Boston area with her husband and three children. You can check out her experiments with low carb baking at All Day I Dream About Food.
The purpose of this study was to evaluate the effects of a low-carbohydrate, ketogenic diet (LCKD) in overweight and obese patients with type 2 diabetes over 16 weeks. Specifically, we wanted to learn the diet's effects on glycemia and diabetes medication use in outpatients who prepared (or bought) their own meals. In a previous article, we reported the results observed in 7 individuals [10]; this report includes data from those 7 individuals along with data from additional participants enrolled subsequently.
Cereal is a tough one to give up when starting a low carb, grain-free or paleo diet. It’s easy to make, it’s tasty and it fills you up. For a little bit, anyway, before the subsequent blood sugar crash. But it turns out that you don’t have to give it up at all, as long as you are willing to make your own. And many of these low carb cereal recipes are almost as easy to make as grabbing the box from your cupboard and pouring cereal into your bowl. From granola to squares to hot cereals for a cold winter morning, we’ve got you covered.
I love hearts of palm, I am steering away from pasta and other carbs. Hello? Made for me. Bought two cans. Made one two hours after delivery (with shrimp and a pesto-fredo sauce) and it was awesome. Delish. Fantabulous. I did not plop it into boiling water so I didn't get a chance to try it "softened" more like pasta and I don't really feel the need to. It was it's own experience and one I will keep buying into. Please buy this so they can keep making it, maybe they can try other pasta types as well. I'm partial to pappardelle

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).
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.
Hi Carl. I had never heard of it and upon research, it appears that Smucker’s (the parent company) does not make it available for sale in the States. I looked at the ingredients and it lists: cracked wheat, cracked rye, cracked and whole flax seeds and rice. At 27g carbs and 5g fiber, it would me my whole days worth of carbs. However, some people who do low carb diets can eat 100 carbs a day and still lose/maintain weight. If this is you, it might be something you can have. Most people on a ketogenic diet avoid grains as they tend towards inflammation. Other’s would not eat this product because it would cause too much of an insulin spike for them. I hope I answered your question. -Kim

My 1st attempt & it was delish w/unsweetened organic coconut milk.Had no hazelnuts & only half the amount of almonds so I substituted extra pecans. Used unground flax & also added additional 2 tbs ground flax for more fiber. Added 1 tbs vanilla. Used a combo of sweeteners: Eryth, Xylitol & Stevia. Next time will grind ingredients separately to get a more chunky result.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
So let’s talk about vital wheat gluten. Yes, it is wheat, and yes in high amounts it has carbs – although not as many as flour. In this tiny amount it adds no carbs to the recipe yet helps the noodles to not only hold together but also to have that tender chewy texture we all love. This should NOT be served to anyone with a gluten intolerance or allergy but it’s just fine for low carb lifestyles.

Participants completed take-home food records (4 consecutive days, including a weekend) collected at baseline and at weeks 2, 8, and 16 during the study. Participants were given handouts with examples of how to complete the records. A registered dietician analyzed the food records using a nutrition software program (Food Processor SQL, ESHA Research, Inc., Salem, OR).
Reading through the comments I had to chuckle at the number of times the same question/suggestion was asked and answered – that being said, the answer is “a protein” so I have a bag of LivFit Plant protein in my pantry – it’s a protein so do you think that might work? If not, I know where I can get the whey gluten from already but would rather keep on the track we are 🙂
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).

To replace 1 egg, mix 1 tbsp ground flax meal with 3 tbsp of water and allow it to swell. This can be used to replace the eggs but it will not give to properties that eggs do. Eggs help bind the ingredients, eggs help the baking become light, fluffy and rise. Eggs help emulsify the mixture. This formula is used in many vegan recipes or those who are allergic to eggs. If a recipe is heavily based on eggs, this substitution will not work.


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! 🙂
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]
Rami co-founded Tasteaholics with Vicky at the start of 2015 to master the art of creating extremely delicious food while researching the truth behind nutrition, dieting and overall health. You can usually find him marketing, coding or coming up with the next crazy idea because he can’t sit still for too long. His favorite book is The 4-Hour Workweek and artist is Infected Mushroom.
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.
These low carb egg noodles have the texture of homemade egg noodles. Although they aren’t gluten free they have 0 carbs for a generous serving. They are easy to make with just three ingredients! Use them any way you’d use regular pasta; in soups, casseroles, and with any low carb pasta sauce. They are especially good with the easy Alfredo Sauce recipe right here on Lowcarb-ology.
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!
There is a transition period in ketosis while the body is adapting to using fats and ketones instead of glucose as its main fuel. There can be negative symptoms during this period (fatigue, weakness, light-headedness, headaches, mild irritability), but they usually can be eased fairly easily. Most of these symptoms are over by the first week of a ketogenic diet, though some may extend to two weeks.

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.


A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.

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.
I know I know, you’re reading the directions and you’re annoyed that you have to cut each and every ¾ inch square out and transfer it to a pan because WHO HAS TIME FOR THAT. But I am here to tell you that YOU HAVE TIME FOR IT because the end result is cereal that fancy-person-you made yourself, which is going to make you feel very elite and accomplished because WHO DOES THAT?
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
Rest assured, not everyone experiences this side effect of the ketogenic diet and, if you do, it will abate on its own; furthermore, there are some simple preventative steps you can take to lower your likelihood of “catching” this flu. As you adopt a ketogenic diet, make sure you replace electrolytes, eat enough fat to meet your total caloric needs, drink plenty of water, and exercise as you are able. It’s very important, however, to ensure that you aren’t relying on sugary sports drinks to replace electrolytes, as all that added sugar will prevent your metabolism from entering ketosis. Ultimately, electrolytes play a crucial role in our health and many Americans do not consume them at adequate levels, so it is very important to monitor your intake of these nutrients regardless of whether or not you are an adherent of the ketogenic diet.
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
Proponents of the ketogenic diet say the problem with a high-carbohydrate diet is that it induces high insulin levels and keeps the body burning sugar and carbs instead of fat. In contrast, on a low-carb diet, the body learns to burn fat preferentially. When this happens, acids known as ketones are released from fat into the body, while insulin levels go down. Ketosis can occur after several days on a low-carb diet.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
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 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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