The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
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. 

It sounds like the bread needed to bake for longer. Sinking is the first tell-tale sign that it was not finished baking. Even when it passes the toothpick test, the top should get very crusty before removing from the oven. I’ve found that even with the same oven and correct calibration, the exact baking time can vary a bit. Unfortunately, it will not work the same way if you take the bread out, let it cool, cut it, and return it to the oven afterward.
To help you get acquainted with making keto-friendly baked goods, we decided to put this article together with all the info you’ll need to get started. Below you will find the many low carb flour options you can use on keto, how to utilize them correctly, and some of our favorite low-carb flour recipes. After reading through this guide, you will have the information you need to make the keto-friendly version of the high-carb food that you’ve been craving.

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].
It's not the easiest plan to follow, but the theory of ketosis as a possible prevention against disease is gaining attention from cancer specialists. Tumor immunologist Dr. Patrick Hwu, one of the leading cancer specialists in the U.S., has followed the keto diet for four years, although he prefers to call it the fat-burning metabolism diet, or fat-burning diet. More research is needed to prove its benefits, but Hwu, the head of cancer medicine at MD Anderson in Houston, believes in it after seeing improvements in his own health.

^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
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.

Just made these. They were absolutely delicious. I used coconut sugar and I will definitely be making them again. Thank you so much for sharing this recipe , this was the first time I ever made donuts in my life. I actually just lost 45 lb and these were perfect because they weren’t too sweet which I really enjoyed but they tasted fantastic and the recipe was super simple

Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
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]
This may be a silly question, but what brand of Psyllium Husk Powder do you use? I’m looking for one that does not turn the bread purplish. When I clicked on the link next to Psylluim Husk in your recipe, it took me to Amazon. When I read the questions and answers about the product, some people said that it did turn their bread purplish. I have never purchased this product before and made the mistake of buying the orange flavor one. My bread smelled and tasted a bit on the citrus side! LOL

Almond flour is available in supermarkets and grocery stores, but you can find it for the lowest price when you buy it in bulk online. Make sure you purchase the finest blanched almond flour that has no darker specks of skin. The finer the grind of the almond flour, the finer the consistency of your baked goods and the easier it will be for your food to rise.


Donuts were never a food we had around the house growing up. Even though my parents were far from low carb, they did eat real food and didn’t buy much that was processed. I’m not going to lie, though. I would have happily eaten donuts elsewhere whenever given the chance. It’s too bad that a keto low carb donuts recipe like this one wasn’t an option back then!
"Avoid inflammatory oils like safflower, sunflower, corn, or soybean oils and opt for whole food cereal or granolas with limited ingredients, which tend to be made from nuts, seeds and occasionally whole oats or puffed rice," says Kelly LeVeque, RD, a celebrity nutritionist who works with Jennifer Garner and Jessica Alba, and author of Body Love. One of her faves: This grain-free granola from Thrive Market, which has a blissfully short ingredient list but tons of flavor.
From the study itself: “Mortality increased when carbohydrates were exchanged for animal-derived fat or protein and mortality decreased when the substitutions were plant-based … Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.” 

Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
Melanie, curious to know what the quality of the foods you are eating? Organic? Grass fed Beef/butter? What oils are the using for fats? And do you think you are getting enough dark leafy greens, which give you the nutrient density needed to detox well? toxins stored in fat cells can cause issues with weight lose. looking into these topics and some light tweaks may help you with your goals! Best of luck!
I tried the original recipe and was impressed. I tweaked the recipe to create a slightly sweet, nuttier profile. Instead of 2 cups almond flour, I used 1 cup almond flour with 1 cup almond meal. Instead of 1/4 coconut oil, I used 1/4 cup unsalted butter. I reduced the psyllium husk powder to 3 level tablespoons. I also added 2 tablespoons regular molasses stirred into the warm water. The molasses has 32 grams of sugar total, but when you divided by 16 slices it only adds 2 grams of carbs per slice. Thanks for a great bread. I look forward to more great recipes!
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]
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13] 

These donuts were moist and tasty! But mine did not rise on the one side- they were flat like a bagel.. I was kinda depressed 🙁 What did I do wrong? I used new everything- I even bought the pan you suggested. When you say fill up the donut pan 3/4 to the top- is that almost to the top of the donut pan? Maybe I didn’t put enough in each of them? Thank you for any suggestions you may have.
Merra G, Miranda R, Barrucco S, Gualtieri P, Mazza M, Moriconi E, Marchetti M, Chang TF, De Lorenzo A, Di Renzo L. Very-low-calorie ketogenic diet with aminoacid supplement versus very low restricted-calorie diet for preserving muscle mass during weight loss: a pilot double-blind study. Eur Rev Med Pharmacol Sci. 2016 Jul;20(12):2613-21. [PubMed: 27383313]

Thank you, Wenda! Yes, the nutrition info is based on 6 donuts. If you keep the ingredients the same but make more (smaller) donuts out of them, the macronutrients per donut would be lower. If you just multiply the ingredients by 4 to make 24 donuts that are the same size as mine (increase the # of servings on the recipe card to 24), then the nutrition info per donut would stay the same.

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.
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]
I personally think it has a mild taste (I understand what you mean about almonds can sometimes have a strong taste). Why not make a small recipe first to see if you like it. With all low carb flours (like coconut flour also) if you are sensitive to their subtle taste, you can help the recipe by adding more flavour such as vanilla for a sweet recipe, or cheese and spices if it is a savoury recipe.

Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
The ketogenic diet has recently become very popular, and many food companies want to cash in by putting a “ketogenic” or “low carb” label on a new product. Be very cautious of special “keto” or “low-carb” products, such as pastas, chocolate bars, energy bars, protein powders, snack foods, cakes, cookies and other “low carb” or “ketogenic” treats. Read all labels carefully for natural low carb ingredients. The fewer ingredients the better.
Low Carb (VLC): This is about as low carb of a mixture that you will get in low carb baking (except for straight up flax or oat fiber). You could get approximately the same carb count with almond flour alone, but I don’t like feeding us huge handfuls of nuts over and over again every time we eat any baked good. (I know the low carb high fat people say it doesn’t matter, but it feels like it matters!) I also like the “dilution factor” of using multiple non-grain flours in a mix.
Hi Celia, It sounds like you are looking at something else. Did you sign up for the email list using the form? The PDF does not contain any comments or pictures at all, so it sounds like you were looking at some other file. If you signed up to get the free PDF, please feel free to respond to the email you received and I’d be happy to help you locate the right file. I promise the food list does have net carb counts for every food and there are no pictures – it’s a single printable page.
It is a carbohydrate for sure (the way it acts). It is why breads are fluffier when it is added. The carb count is included in the mix for the addition of the gluten (if you decide to add it). For those who do not want gluten or can’t have it (or do not want the twelve carbs per mix (approximately 1 carb per cup of the mix from the gluten), you can definitely do the xantham gum and/or omit it. Does that help? I’d love to know more of your thoughts! Thanks!
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18]
With all the options, most of you ought to be able to mix and match your way to 8 to 10 grams of fiber at breakfast without much hassle at all. That's oatmeal with flaxseeds and almonds, a vegetable frittata with some berries on the side or whole-grain toast with natural peanut butter. And just so you know we're flexible: There's no rule against having any of these fiber-rich goodies for lunch!
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.
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.
Finally! A granola that I don’t HAVE to put any kind of a sweetener in! I’ve been keto for almost 2 years and have really missed a good bowl of granola/cereal for breakfast. Your recipe is perfect. I made it ahead of time and keep it in an airtight container. It’s so nice to be able to grab the container, pour some in a bowl and enjoy, and for me, I find that the nuts give a good flavor without the sweetener. I’m always looking for recipes that I don’t HAVE to use a sweetener in because almost all of the ones used in LCHF recipes cause war in my bowels, sigh. This recipe is perfect. THANK YOU so much for getting online for the rest of us. 🙂
Walnut flour can be used for all low-carbohydrate baking needs and it can be swapped out for other grains in your diet. You can make pancakes, breads, muffins, cakes, you name it! Walnut flour is delicious, so give it a try. There are many brands, but we’ve linked you to one of the best-sellers or top choices on Amazon above. The brand listed is fine ground in California, USA.
Brenda, here is the link to the article. From what I have been reading the diarrhea is not uncommon. I had been using KCT oil in my coffee and smoothies, that compounded the problem. I have tried several of the suggestions this article suggested and it has been a great help. My wife and I were wondering what fat sources are you using. We have been trying to get more fat into our diets. We do use butter, sour cream, full fat dairy products, and changed our hamburger meat back to 85-15, most of the time. Super love your articles, they show you care. That is what is missing in today’s world.
I’ve tried a ”ton” of low carbs foods...so trust me when I tell you how good this stuff is. If your low carb or keto...Sola products are sanity in a bag with a taste authenticity comparitative to their high carb counterparts. You won’t be disappointed so go ahead and order extra. I like to put it in my yogurt, cottage cheese, protein shakes, sugar free pudding, etc. It’s the jam with almond milk by itself too.
H. Guldbrand, B. Dizdar, B. Bunjaku, T. Lindström, M. Bachrach-Lindström, M. Fredrikson, C. J. Östgren, F. H. Nystrom, “In Type 2 Diabetes, Randomisation to Advice to Follow a Low-carbohydrate Diet Transiently Improves Glycaemic Control Compared with Advice to Follow a Low-fat Diet Producing a Similar Weight Loss,” Diabetologia (2012) 55: 2118. http://link.springer.com/article/10.1007/s00125-012-2567-4.
Epilepsy is one of the most common neurological disorders after stroke,[7] and affects around 50 million people worldwide.[8] It is diagnosed in a person having recurrent, unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients achieve control of their epilepsy with the first drug they use, whereas around 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation, and the ketogenic diet.[7]
Coconut flour is made from dehydrated coconut meat after most its fat has been extracted to produce coconut oil.  Each 1/4 cup of coconut flour contains 60 calories, 2.5 g of fat, 6 g of protein, 19 g of carbohydrates, 12 g of fiber, and 7 g of net carbs. Due to its high fiber content, this low-carb flour is perfect for anyone who needs a digestive health boost.
I was on the ketogenic diet for 6 months to support my husband, who is on it permanently for epilepsy. The diet totally messed with my hormones, which my doctor and my husband’s nutritionist sadly confirmed was a possibility. I am continuing to eat low-carb, but the ketogenic thing unfortunately seemed to work against me as a 49-year old pre-menopausal woman.
×