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]
We can help. We’ve put together a list of the top 10 healthiest and lowest carbohydrate options for diabetes. Whether you are on an American Diabetes Association (ADA) Diet or a Ketogenic diet, you can enjoy them with diabetes guilt free. If you are on a ketogenic diet, we hope that you are being followed by your doctor and nutritionist for needed lab work.
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

Spaghetti covered in marinara sauce. Classic macaroni salad. Creamy chicken Alfredo. Minestrone soup. It’s hard to imagine a food more versatile than pasta; this beloved pantry staple is delicious in a seemingly endless variety of ways. Whether you like it cold, hot, as the centerpiece of the recipe, or playing a supporting role to chicken or another meat, it’s almost certain that you eat dishes containing pasta at least a few times each month – or even weekly, if you’re a hardcore pasta lover. At BestReviews, we like delicious food as well. That’s why we decided to bring you this buying guide to all things pasta. If you’re ready to get cooking, check out our five recommendations in the matrix above. If you’d like to learn more about pasta in general, including the difference between all those different shapes and flours, read on.

Also, I wanted to let you know what a fabulous addition your recipes were to our Christmas. I made the orange spritz cookies which were well received by those with diabetes, my gluten free friends, and everyone! I made them Christmas Eve. Christmas morning, I made your apple coffee cake and it was fab along with eggs, sausage and fruit. Thank you so much!
Erythitol gives me painful tummy cramps; Swerve or Pyure and generic brands all cause this. 1 tsp liquid stevia or liquid Splenda is equivalent to 1 C erythitol, so 1/4-1/2 tsp is enough for this recipe. However adding a liquid sweetener offsets the solid to liquid ratio. I usually add sifted egg protein powder in the amount of the powered sweetener. A glaze can be made with coconut milk, liquid sweetener, and thickened with xanthan gum. A lemon extract or raspberry extract are perfect for flavoring the glaze.
Thank you so much for sharing this recipe. I made it last night for the first time & it turned out perfect – just like your picture above! I used the big bowl of my Kitchen Aid food processor to grind the almonds & psyllium husks really finely, then I beat the eggs & coconut oil in the smaller bowl for a few minutes until it looked bubbly, then just added all the ingredients together in the big bowl & continued to process for a few minutes. I sprinkled sesame seeds on the top before putting it in the oven & after 55 minutes, it was perfectly cooked, had a good rise & our house smelt divine! The texture was also just right – soft & fluffy in the middle, golden & crunchy on the outside. I might add some other small seeds to the mix next time. Thank you so much – this is one of the nicest & easiest gf bread recipes I’ve come across!!! Keep up the great work xx
While CHO is almost universally regarded as necessary for both health and athletic performance, many studies have called into question the absolute necessity of dietary CHO. As early as 1930 there was evidence demonstrating the efficacy of long-term CHO restriction (14). In an audacious attempt to demonstrate proof-of-concept, arctic explorers Dr. Viljalmur Stefansson and K. Anderson, agreed to participate in a study that involved one year of eating a diet that consisted solely of “meat.” The diet, which consisted of beef, pork, lamb, and chicken, also included significant portions of animal fat, as well as organ meat. This dietary regimen yielded a macronutrient distribution of approximately 81% fat, 18% protein and 1% CHO, over the course of 375 days. The subjects experienced a modest reduction in weight, which occurred during the first week; there were no restrictions on food portions, subjects ate to satisfy appetite. Interestingly, the researchers noted no vitamin deficiencies, no significant change in mental alertness or physical impairment, or any other deficit attributed to eating a high fat, all-meat diet.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
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're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin.


There are many recipes here that use coconut flour OR almond flour. Some I even have instructions to use both (from the post above, you can see they are not easily interchangeable). Is he tolerant of almond flour? I have many recipes which use that. Some recipes that use a small quantity of almond flour/meal, you can actually use some seed flours such as sunflower or pumpkin. I managed to make Fat Head pizza once using ground sunflower seeds when I ran out of almond flour.
If you are wondering what the heck a daikon radish is, don’t worry, I was in the same boat this time last year. My first experience with daikon radish was in my CSA box. I actually got a purple daikon radish and had absolutely no idea what to do with it. So I pulled out all my cookbooks and found a recipe in my Inspiralize Everything cookbook (affiliate link).
Of the 28 participants enrolled in the study, 21 completed the 16 weeks of follow-up. Reasons for discontinuing the study included unable to adhere to study meetings and unable to adhere to the diet; no participant reported discontinuing as a result of adverse effects associated with the intervention. All but one of the 21 participants were men; 62% (n = 13) were Caucasian, 38% (n = 8) were African-American (Table ​(Table1).1). The mean age was 56.0 ± 7.9 years.
Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly.
Hi!! I have been following you since I started Keto…. Dec 26, 2017. I have lost 41 lbs since then and in the last 3 weeks I can not seem to get the scale to move nor are the inches changing… I am 58 yrs old and lightly active (I work in retail and am on my feet all day.. 10 hrs per day… operating register, stocking soda, candy… putting grocery truck away) I have been running my macros at 16 carbs (I do not do net) fat 97gm and protein is 78gms which is for my calorie intake of 1258 5/70/25…. I am at a total loss as to what steps I need to take…but for the most part I generally only get in 700-900 calories per day… I am just not hungry. Days off are nightmares…. it seems all I want to do is eat… I have NO “bad” foods in my house… I mostly eat veggies on my days off… asparagus, broccoli, zucchini, cabbage, radishes cooked in an oil of some sort olive, avocado, sesame……. I dearly love tomatoes but eat them sparingly.

Being healthy is all about getting the right nutrients and vitamins from your food so always include variety in your diet. Have plenty of meat (or fish), dairy and veggies on a daily basis based on this low carb food list. Use coconut oil and olive oil when you cook and in your salads (respectively) and have a handful of nuts or berries from time to time.

Hi Jan, Sorry they didn’t work for you. It’s hard to say what happened without being in the kitchen with you. Did you use exactly the same ingredients and amounts? Also, if they were not cooked, then they probably needed to be in the oven for longer. If they were clumpy, it’s also possible that the almond flour wasn’t fine blanched (it needs to be) or the batter wasn’t mixed well enough. Hope this helps.
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!
Carbohydrate: Most of what determines how ketogenic a diet is will depend on how much carbohydrate is eaten, as well the individual's metabolism and activity level. A diet of less than 50 or 60 grams of net (effective) carbohydrate per day is generally ketogenic. Some sources say to consume no more than 20 grams of carbohydrates per day, while others cite up to 50 grams, and many recommend no more than 5 percent of calories from carbs. However, athletes and people with healthy metabolisms may be able to eat 100 or more grams of net carbohydrate in a day and maintain a desired level of ketosis. At the same time, an older sedentary person with Type 2 diabetes may have to eat less than 30 net grams to achieve the same level.
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.
Measuring blood ketones is the most reliable method. There is a home blood test you can use, but the strips can be very expensive. An alternative is to measure ketones in the urine with a dipstick test, which is much more accessible and inexpensive. However, this method is much less reliable and as time goes on and the body adapts to ketosis, it becomes even less reliable.
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
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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.
Katie, Almond flour is probably the easiest keto-friendly flour for a new cook to work with. It’s very versatile and can be used in recipes for cookies, muffins, breads, scones, cakes, etc. (Of course the ratio of almond flour to other ingredients changes based on what you’re making.) But with that being said, because almond flour doesn’t have gluten, it can be difficult to simulate the soft crumb of regular baked goods unless you combine almond flour with another keto-friendly flour and/or a binding agent. This is why a lot of our recipes call for more than one type of flour. I hope this helps! If you’re looking for a certain recipe in particular please let us know and we’ll try to point you in the right direction!
Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly.
Made from dried and defatted coconut flesh, coconut flour has a high fiber content, with 8 grams of carbs and 5 grams of fiber in two tablespoons. To use the flour, replace up to 20 percent of the regular flour in a recipe with coconut flour and add an equal amount of liquid. For example, if a bread recipe calls for five cups of all-purpose flour, use 4 cups of the all purpose flour and one cup of coconut flour plus one cup of water. You can also use the flour alone for breading.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
Hi Sandy, You might be able to deep fry them (haven’t tried), but you’d still have to bake them first. The batter is too thin to just straight deep fry, it wouldn’t hold together. You can make them into a different shape if you don’t have a donut pan; some people have used muffin tins. Otherwise the cheap but great donut pan I use is linked in the post above if you want to get one.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
Overweight individuals with metabolic syndrome, insulin resistance, and type 2 diabetes are likely to see improvements in the clinical markers of disease risk with a well-formulated very-low-carbohydrate diet. Glucose control improves due to less glucose introduction and improved insulin sensitivity. In addition to reducing weight, especially truncal obesity and insulin resistance, low-carb diets also may help improve blood pressure, blood glucose regulation, triglycerides, and HDL cholesterol levels. However, LDL cholesterol may increase on this diet.
Just made these, without a silpat (I used parchment) and with a wonky cookie sheet (I desperately need a new one, and will have one before I make these again) but they were great! I really wanted chicken noodle soup, as I woke up this morning with a sore throat.. These are awesome!! Very little taste, not eggy at all, and my chicken soup really hit the spot! Thanks!
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.

So glad to hear that I’m not the only one that’s not dropping pounds/inches like gangbusters…I’ve been “pretty” low carb/keto, lift twice a week and cardio 3 other days and nothing…nothing happens. I’d like to lose 10-15 pounds and just can’t seem to get anywhere…55…post menopausal. I’d say that my carbs are generally around 30 per day or less and I do IF. Love to hear your thoughts.
^ 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. 

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.

As a clinician, I have recommended the ketogenic diet both as a clinical intervention for patients suffering from a wide variety of ailments as well as a general suggestion for people looking to optimize their cognitive health. And while the diet is relatively easy to follow, there are a number of common misconceptions and lots of outright misinformation that one must be aware of. If you’re looking to incorporate a ketogenic diet into your lifestyle or just wanting to learn more, I’ve compiled a few tips for you here.


You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)
Hey there! Tried these today and they are awesome. I did change a couple of things…I used Fairlife Milk instead of Almond milk and used real sugar instead of a sweetener. The crazy thing is…I ran the ingredients through my recipe calculator and with my ingredients there is 11.6 carbs per donut (and I got 8 instead of 6) and with your ingredients, there were just over 13 carbs. This confused me. Whatever the carb count, they are great!

Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.


Hello, I can’t have any actual sugars in my diet. So when your label at the end says 1 sugar etc is that for the “fake” sweeteners in each recipe? Or real sugars? I can have ones like Splenda, truvia, etc. It’s only so specific for me because it’s to keep all sugar away and control my seizures. These desserts sound amazing and seem to fit my diet till the sugar part on the label.


Most people are used to how white flour works, but when they try to bake or cook with low-carb flour, they most likely will notice some differences. Depending on the source of the flour — and how many carbs, fat and protein calories it has — the flour may well react differently. For example, flour with high protein may clump easier; the flour also may brown or burn quicker than regular flour. This means cooks and bakers may have to experiment with the flour to learn how it works.

It’s a habit to enjoy a brie cheese for desert instead of a piece of chocolate cake but each are favored deserts in France. I’m personally more satisfied after a 350 calorie sized wedge of brie than the same number of calories of cake.. which will give me sugar crash and .. really I’d like two slices of cake(I’ve got a sweet tooth that once I get going it wants to keep being fed)
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