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]
Hello there. Thanks for sharing this recipe. I am sooo excited to try it. In fact, I have just ordered some almond flour. I have a question regarding eggs. The recipe calls for four. Can I use two instead, and substitute with flax eggs for the other two? I have a lot of flax in my cupboard and I am looking for creative ways to use it up. Also, it is nice to be able to utilise ingredients already in my cupboard. I am trying to get out of the habit of buying new ingredients for everything new recipe I want to try. Anyway, looking forward to your response. Thank you.
While low-carb simply describes a vague behavior pattern that is subject to each person, ketosis is an objective and measurable fat-burning state of the human body. It is when the body’s metabolism switches gears to burn fat for energy instead of sugar. It is this metabolic state in which people experience the full benefits of a ketogenic lifestyle.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
This is the best! I’m really bad at baking but I have made this twice and both times it was perfect. I’ve shared it with all my gluten intolerant friends, thank you. Oh, I reduced the psyllium husk to an eighth and replaced the other eighth with gluten free flour. It made it less gritty. Yummy! Today I’m going to add some spices and sultanas for a sweet treat. Hope it works!

Protein can turn into carbohydrates via a metabolic process called gluconeogenesis (making new carbs) and will do in people at varying degrees. Protein turning into carbohydrates means you’re not in ketosis. However, this is generally an overblown statement that only happens at the extreme cases when you are drinking a lot of liquid protein shakes. 
Thanks for posting about the psyllium Sarah,, I tried psyllium flakes 10g and they turned out great. Not even very fragile. It just gets thick so the batter doesn’t self-level, I had to do my best, and the thick spots required 1 extra minute in the oven. Used immediately in a skillet lasagne- just ground beef, jar of pasta sauce, mozz cheese and cream cheese. Definitely wouldn’t have been much of a lasagne without the “pasta”! So these noodles are my hero 🙂

First time we were able to have ‘bread’, on Passover, as I was able to find the kosher for Passover version of all the ingredients. Costco had Kosher for Passover (KFP) Almond flour & Himalayan sea salt. Original Metamucil (KFP all year) for the phylum husks (although I could have gotten the husks on line). Passover Gefen baking powder was in my local kosher food store, La Bonne coconut oil is KFP, though other brands may be as well. This was such a hit recipe!!


I had pasta last night, and I feel guilty that I cheated. This recipe is that good. I followed your directions exactly, including simmering the noodles in some sauce for a few minutes. What size pan did you use? It was hard for me to estimate and I ended up throwing away some egg mixture. Putting pan sizes in all your wonderful recipes would be helpful. Keep up the good work. You are my low-carb, go-to guru.
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.
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]
Participants returned every other week for 16 weeks for further diet counseling and medication adjustment. When a participant neared half the weight loss goal or experienced cravings, he or she was advised to increase carbohydrate intake by approximately 5 g per day each week as long as weight loss continued. Participants could choose 5 g carbohydrate portions from one of the following foods each week: salad vegetables, low-carbohydrate vegetables, hard or soft cheese, nuts, or low-carbohydrate snacks. Diabetes medication adjustment was based on twice daily glucometer readings and hypoglycemic episodes, while diuretic and other anti-hypertensive medication adjustments were based on orthostatic symptoms, blood pressure, and lower extremity edema.

In the absence of CHO, however, the body must shift to fat as the primary energy source. In this case, the body catabolizes stored triglycerides, which exist in abundance in even the leanest individual. In effect, the KD provokes a physiological stimulus, i.e., CHO restriction, that mimics starvation. Due to the limited ability to store or produce CHO during periods of starvation, the body thus switches to ketogenesis, the production of ketone bodies as a primary fuel source (3).
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook [11] detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
Health's contributing nutrition editor Cynthia Sass, RD, MPH, suggests looking for cereals that are made with nuts, seeds, coconut, a little bit of fruit, natural sweetener (think honey or agave syrup) instead of added sugar, and spices for flavor. Although many of these cereals may be gluten- or grain-free, you can also look for flaked whole grain varieties.
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