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]

I saw your recipe on Highfalutin today and since it is snowing I gave it a try to add to our chicken noodle soup. The recipe is super!!! Now we can have noodles without all of the carbs. The soup and noodles turned out so good. I used parchment paper and a cookie sheet that decided it needed a new wonky shape when heated( mixture was really thick on on side) but I was able to salvage all of the mix after repeatedly reheating the thicker portions until they were set. No sogginess in the noodles and they held up well in the soup. Kudo’s to your creativity! Now to try them in other things as mentioned in the comments that I didn’t read before making the recipe, whoops!!
Look, the good doctor is right – he only forgot to stress “portion control” which is why many fanatical dieters are so kee-jerk reactive to any discussion – odds are you over ate like a hog before your keto diet, and are weak and insecure in your diet plans. Eat EVERYTHING in small amounts, and you will live long and prosper. The only thing to avoid are processed foods. Cook your meals from scratch using quality ingredients.

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] 

Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
Sometimes a hot cereal hits the spot, but with around 28 grams per serving, regular oatmeal may overshoot your carb goals. However, sugar-free instant oatmeal has around 19 grams per packet, if you don’t mind the artificial sweeteners, and instant Cream of Wheat has 20 grams per packet, which is about ¾ cup prepared. Two other brands, Sensato and ProtiDIET, are sucralose-sweetened hot cereals. Sensato hot cereal comes in apple cinnamon, strawberrilicious and vanilla almond, with 12, 11 and 10 grams of carbs per ½ cup, respectively. ProtiDIET oatmeals have 6 carb grams per packet and come in cinnamon spice, apple cinnamon and maple brown sugar flavors.

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.
With all of the new low-carb food products hitting the marking lately, you may be wondering if it is really worth it to make your own keto-friendly baked goods. Unfortunately, many “keto-friendly” products have been found to contain more net carbs and a bigger impact on insulin secretion than indicated by the packaging. For this reason, one ready-made “keto cookie” can kick you out of ketosis, even if the label says “only with four net carbs.”
Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.

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.
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]

From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
BREAKFAST BARS: You can't beat them for convenience, but choose carefully—many bars have only a gram or two of fiber, and most are loaded with added sugars, such as high-fructose corn syrup. Read the labels and look only for those that have no added sugars and at least 6 grams of fiber. Atkins® bars are a great source of fiber and are available in an array of flavors, so your taste buds can be pleasantly surprised every day of the week.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].

The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat [12]. Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.

Fiber is an important part of a healthy lifestyle because it helps you feel full sooner and longer and minimizes the impact of carbs on your blood-sugar and insulin levels, making weight management easier. A high-fiber diet also reduces your risks for a host of ailments, including heart disease1, digestive disorders2, diabetes3 and certain cancers4. Of course, if regularity is your problem, fiber is your friend. All that's pretty impressive for something you don't even digest.


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.
Hi Lee, A blender might also work, if it’s powerful enough to chop up nuts. You’ll still want to use a pulse-stop-pulse method, and may need to stir between pulses. Otherwise, you can also try chopping up the nuts and seeds before mixing with the other ingredients. If you go that route, the resulting granola texture will be a little different compared to a food processor. I used a food processor partly because it makes both prep time and cleanup a lot faster, but also because that way you get a mix of larger chopped nuts and finer powder. I hope one of the other methods works out for you!

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 am post menopause and I did lose about 40 lbs. Then I stalled and stalled. I was too hot all the time and was having sleep issues. I added more carbs and was better. I attempted keto/ low carb again in January. Two weeks in I had the same symptoms. It is not uncommon. It works well for some but not for me and a few of the other women at my gym. I liked what I was eating and I stuck to it through the stall but no. With the guidance of my trainer I have modified it, lost weight and feel great. Sleep helps!
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.  

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. 
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.

These are great additions to the low carb pantry. No need to give up wonderful baked goods and live low carb. I use them all the time. I have also tried many of Carolyn’s recipes that use nut flours and coconut flour. They are awesome! You can easily take them to parties where people are expecting flour-baked goods and fool them. Thank you Carolyn for your many contributions to the low carb lifestyle!
If you prefer hot to cold cereal, Sensato makes a High Fiber Hot Cereal that comes in five flavors: plain, apple cinnamon, butter pecan, “strawberrilicious,” and vanilla almond. The cereal is sweetened with artificial sweetener, so there are no calories from sugar. Each serving has about 12 grams of carbs, ten of which are fiber. The cereal is a mix of wheat bran, flax seed meal, and soy protein isolate.
I’m afraid there won’t be a straight substitution ratio because they behave a little differently. Not as different as coconut flour vs almond flour, but flaxseed nonetheless will have a different protein/fat/water ratio so will act in cakes and baking in a unique way. Saying that I love experimenting. I would begin by using a lower amount of the flaxseed to whichever recipe you decide to try, then mix and see what the result is. It may be that you need some extra liquid, an extra egg or a little more flaxseed. Sorry, that’s probably not the easy answer, but in the long run, if you get to really know how these new flours world – bam – you’re away!

I have spent weeks reading and learning about the Keto diet plan, downloading random recipes that my husband might even try, and have been overwhelmed with all the information. I was pleased to find your system and how organized everything seems to be. The only question I have is will I be able to “temporarily suspend” my subscription if I find there are more recipes than I have time to prepare. I want to only do about 3 per week and repeat them as leftovers, since I have very little time after working a 12-hour shift, to do much cooking. Once I “catch up,” I would reinstate my subscription. Is that an option? Looking forward to trying out your program.
While these sources have lower carbs, they typically have higher fat contents. For example, most nuts are calorically dense with fat, though most of it is good fats such as monounsaturated and polyunsaturated varieties. If someone is trying to reduce his fat intake as well as his carbohydrate intake, then it may be a good idea to look into low-carb flour varieties that also are low-fat, such as soy flour.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]

A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]


"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.


Crazy right though? I just can’t even believe it for myself until I see this picture of my mid section! I’m truly in shock how it was just 2.4 pounds I lost in 6 weeks and just a half percent in body fat. But clearly the keto diet produces results. I feel better. I look leaner and more toned and I’m just motivated to continue on even though I’m not one of those people who have lost a crazy amount of weight in a short time. I’m in it for the health benefits I mentioned above, but also I’m feeling pretty darn good in my size 6 pair of jeans!
If you're in search of carb-free noodles that perfectly mimic the taste and texture of regular spaghetti -- a true miracle -- keep looking. Like pasta, shirataki noodles are mostly neutral in flavor and can absorb the tastes you cook with. But, shirataki has a slimier consistency and you won't be able to choose the hardness of your pasta -- al dente or otherwise -- because the noodles are already "cooked."
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