^ 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.

The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
I began my low carb diet (around 50 net per day) almost 3 months ago. I have only lost 2 lbs. I need to lose at least 30. I am 62 years old and in good health. Everything I have read leads me to believe that I am doing everything correctly. I even make my own Keto bagels! What do you think could be the issue? I tried going down to less than 20 carbs but I just cannot do it. Thanks for any help you can provide.
Even if you don’t like the taste of coconut, you may still want to try baking with coconut flour, as the strong taste can actually be masked well with other strong flavors. I find that vanilla, chocolate, and cocoa powder are good additions to help mask the coconut taste for sweet recipes. For savory items, add a little garlic or onion powder. Enhance other flavors with herbs, spices and extracts, and I think you will find you can still enjoy the end result.
The only problem with using almond flour is that it is easy to overdo it. A cup of almond flour, for example,  consists of about 90 almonds — an amount that someone would rarely eat in one sitting. Although there are many health benefits that you can get from almonds, consuming high quantities of them will flood your body with inflammatory fats and phytates, which can worsen pre-existing health issues.
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.
FRUITS: Don't choose fruit juices—you're just paying someone to take the fiber out of your food. Instead, eat the fruit itself, and get 3.1 grams of fiber. You can get a serious fiber bang for your carb buck with berries (a half cup of raspberries adds 4 fiber grams, blackberries add 3.8 and blueberries or strawberries add 1.7) and kiwis (2.7 grams per fruit). Always accompany fruit with protein and/or fat such as nuts or cheese to slow any negative impact of the natural sugars on blood-sugar levels.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
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.
I’ve been doing keto on and off for a year. Before that, I explored eliminating “inflammatory” or “reactive” foods based on another eating program. I have Celiac and autoimmune issues and I think one of the reasons people stall with Keto is because they are eating too many typically “inflammatory” foods–foods that your body has a harder time digesting and as a result create systemic inflammation which, in turn, cause weight loss plateaus. For those trying to fight through a Keto Plateau, I would suggest eliminating ALL dairy (try subbing ghee for butter), artificial sweeteners (including stevia and erythritol) and all nuts for 5 days. I know it sounds close to impossible but all three of these Keto staples are some of the biggest culprits of inflammation in the body. I found this suggestion on another Keto website and tried it and dropped 6 lbs in 5 days. Another typically inflammatory food is Eggs. If you can’t eliminate all of these foods at once, try eliminating one at a time for a minimum of 5 days and see if there is any movement on the scale. For those who have stalled, chances are at least one of your Keto staples is holding you up. Good luck!
2. Raygan, F., Bahmani, F., Kouchaki, E., Aghadavod, E., Sharifi, S., Akbari, E., . . . Asemi, Z. (2016). Comparative effects of carbohydrate versus fat restriction on metabolic profiles, biomarkers of inflammation and oxidative stress in overweight patients with Type 2 diabetic and coronary heart disease: A randomized clinical trial. PMID: 28607566 
My keto diet recipes are creative, full of flavor, and always low carb. You will find lots lots of keto diet meal prep recipes that allow you to eat low net carb keto meals all week long. All of my keto diet recipes are designed with you guys in mind, in fact, many of them are special requests from you, and that’s the kind of recipes you will find on my site.
After the 1st time I started making these i started making it as a cake using a small casserole dish cutting into 8 pieces, without the sugar/cinnamon topping. I tried monk fruit sugar and love it (new at Costco in Seattle) I also used 2% milk (all I had on-hand). I’ve made several batches and theres been some on the counter for 2 weeks now. My husband and I love having a treat we can grab on the go.
Hi Pete, We used American cheese because that’s what is on a Big Mac and we were making Big Mac Bites. Also, it’s a misconception that American cheese is not real cheese, it all depends on what you buy. The individually wrapped cheese sliced labeled “cheese product” aren’t real cheese but you can purchase American cheese from the deli counter which is real cheese. If you want to double-check just ask to see the label before purchasing. Boar’s Head makes a great REAL American cheese.
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.”
After going low-carb, I was resigned to never eating a satisfactory brownie ever again. And then... I made these brownies. Holy smokes! I followed the directions on the back for the fudgy brownies and they were everything I wanted in a brownie (basically a low carb version of what I used to get from those Gihardelli high carb mixes from Costco) AND sugar free/low carb!
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.
Hi Liz, Low carb bread doesn’t rise as well as one made with wheat flour, but it shouldn’t be quite that short. Some factors that might contribute include the age of your baking powder and how well the batter is mixed – the mixing process helps create air bubbles. Also, did you use baking soda or baking powder? They are not the same. Baking soda needs something to interact with, in this recipe I use baking powder. More baking powder *might* help, but is risky because using too much can cause it to fall even more flat.

Hi Patti, It’s up to you if you want to go by weight or by volume. I include both for convenience. Some people don’t want to weigh all their food, though weighing is definitely more accurate. The volumes listed are based on how a food is normally served, so for iceberg lettuce it would be chopped, not minced. It sounds like you’re weighing anyway, so in this case just use the weights instead (they are shown in grams in parentheses next to the volumes). Hope this helps!
Nutritional ketosis has been proposed as a mechanism through which hunger may be suppressed. A recent meta-analysis investigated the impact of diet on appetite and shed some light on this possible phenomenon (11). The meta-analysis included 12 studies which investigated the effect of either a very low energy diet (VLED: defined as <800 calories per day) or ketogenic low-carbohydrate diet (KLCD: defined as CHO consumption of <10% of energy or <50 g/day, but ad libitum consumption of total energy, protein and fat). Interventions ranged from 4 – 12 weeks and weight loss was from 5.0 to 12.5 kg. In all studies nutritional ketosis was confirmed in VLED and KLCD via circulating levels of β-hydroxybutyrate. Interestingly, both groups reported decreases in appetite. The results of this meta-analysis are noteworthy in two regards. The VLED groups were clearly and significantly hypocaloric, suggesting a state in which hunger should be increased, not decreased. Similarly, the KLCD groups experienced simultaneous reductions in weight and appetite, while eating an ad libitum diet. The results of this meta-analysis provide support for the theory that nutritional ketosis may exert an appetite suppressing effect. 

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.
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]
Hi Vivian – I am 60 yo and researching Keto and would love more information from you since we are same age. What is TDEE? What fat sources do you use and how much daily? What are some meals you make regularly and what does a day of food look like? What is the easiest/best way to count carbs getting started? If you and Brenda are ok with you giving me your email I would love to learn more from you! I just need some help getting started. Brenda – thank you for all your information and recipes!
It can sometimes be difficult to find a cereal that actually fills you up till lunch, so a keto-compliant granola can be the answer. This one is deliciously crunchy and has a warming flavor from the cinnamon and tastes great with your favorite nut milk. Nuts can be a great source of goodness and energy, so this can also be eaten as a snack when you need a little something to keep you going.
Consequently, when you begin a ketogenic diet, it acts as a metabolic stressor on the body. In the process of relearning how to burn fat for energy, a mild metabolic stress is inflicted upon your mitochondria. This stress is just powerful enough to kill off old and dysfunctional mitochondria which stimulates the growth of new and more powerful mitochondria (5). The end result is more energy and a higher level of vitality.
Creaming the butter properly with the sweeter is paramount here to build a nice structure for the cookies (think rise and crunch!). And creaming with sweetener, in case you haven’t done it before, takes a bit longer to incorporate than with good-old sugar. But don’t give up, and keep going until you’ve got the sweetener well incorporated into soft and fluffy butter.
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.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
My favorite sugar-free low carb BBQ sauce is a family recipe that I tweaked to make keto friendly. It is simple to prepare without a lot of added ingredients that aren’t necessary. You can find my recipe here. If you are looking for convenience, there are several brands that make a sugar-free variety that can be ordered from Amazon or you may find in your local stores. The only brand of store-bought sugar-free bbq sauce I have tried is by G. Hughes. They offer several different varieties, but I prefer hickory. I might be a little partial, but my homemade BBQ sauce makes this recipe taste much more authentic and flavorful.
Not in the mood for cake? Brownies definitely come second on that list of delicious treats that we want once we turn to a ketogenic diet. You can easily make keto brownies that you can fully enjoy without having to fight against the craving to have more. Besides using almond flour and other mixtures of flours, you can make them out of avocado as well.
Rod, With a ketogenic lifestyle, the point is to stay within your macros, so if you’re not gluten-intolerant and the flour fits into your macros, you should be fine. Have you calculated what your macros should be? We have a post talking about which macro calculators we like best, if you’re interested: https://theketoqueens.com/macro-calculator-review/ Additionally, a doctor can help you figure out the macros that will work best for your health and fitness goals. Best of luck and welcome to the keto family!
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
Almond Meal is made slightly different than almond flour. Instead of blanching the almonds to remove the skins, the skins on the almonds are kept on. It’s a little bit coarser than almond flour and still bakes the same. For baked goods, I like to use a super fine ground almond flour but I will equally use almond meal as it seems to perform just as well in most recipes, at a reduced cost.
Shirataki Noodles: There are people who like this pasta, but I don’t know many of them. You probably should try it yourself just in case you’re one of those few who likes them. With essentially zero calories, carbs, fat, or protein (in other words: void of nutrition whatsoever), these “noodles” are made with yam flour (konnyaku) and water. There are a variety of brands and you can find them just about everywhere these days. In your grocery store, you’ll probably find them within the produce section. Even stranger is that they are packaged in a bag full of water. What’s the downside to a pasta that has basically zero carbs? They smell gross. They taste gross. The texture is gross. Ick. You’re encouraged to rinse them thoroughly in an effort to rid them of their funky taste and smell, but I found that no amount of rinsing was good enough. If you’re someone who does like these noodles, please let us know how you managed to make them edible!
For those who prefer to weigh ingredients rather than volume measure everything, here are my weights: using Honeyville almond flour, 2 cups is 6.5 ounces; and NOW brand psyllium husk you need 1 ounce. (I have the husks so I ground some to a fine powder in my coffee/spice grinder and measured 1/4 cup of the powder, which weighed 1 ounce or 31 grams. In future, I will just weigh 31 grams of husks into the grinder and know I have the right amount.) A quarter cup of coconut oil, like other fats, weighs 2 ounces.
I have been reading all the above comments about the gluten verse other ingredients. As a pastry chef, the information that has been missing here is that not only is gluten a protein, it is also the “elastic” that holds the pasta together. 80% of the proteins in flour are called glutenin and gladin. When combined with liquid, they form the elastic substance called gluten.

Amongst all the sugar-filled cereals on our supermarket shelves, there are the occasional good one. But I always get sick of them so quickly, and I find they’re usually quite bland. But, thankfully there are some easy, low carb breakfast options that don’t involve cereal! Have a look at the list below and hopefully you’ll get inspired to try a few for yourself.
This is the second recipe for a cinnamon toast cereal I’ve tried and failed at miserably! I want to know details when baking, it is a science after all. How did you spread this on the sheet pan, how thick, was it rolled? Too much missing I formation! I’m finding a lot of keto or low carb recipes are like this, very discouraging and extremely disappointing from this community. Details PLEASE!

So rather than giving one-size-fits-all dietary advice or weaponizing the word “balanced” it might be better if the medical community suggested that there are Individual differences that need to be considered. This might also help those lay folk who have had success with one dietary lifestyle or another also realize that what’s valid for them may not be good advice for others.
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.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
Thank you for such a through list. I have been wondering how to count the spices used in cooking and now I know. I do have one question though that I can not find the answer to. When breaking down the macros for a recipe how do you count items that are listed as having fewer than 1 carb? Do you just count it as one? I am in a stall and wondering if I am not accounting for enough carbs.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
So I made this recipe and the taste is amazing! However, mine is still in more of a powder form and never got any crispness to it. So we really can’t eat it. Any suggestions on what I can do to make it right? The only difference I had was I used stevia instead of 1/3 cup of a sweetener. I even tried cooking it another 10 minutes thinking my oven just needed more time to crisp it. Thank you for your help! I have loved all the recipes I’ve tried from your site.
I’ve been seeing a lot of recipes on pinterest that use peanut flour (not touted as low-carb necessarily)…was wondering if it would be good for baking keto recipes. There are carbs in it but if you bake something and only eat a serving, I’m thinking it might not be too carby. Not sure how it does as a sub for other flours that others use for keto recipes.
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.
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.
If you enjoy flaked cereal, grab a box of Special K Protein from your grocer’s shelves. A ¾-cup serving has 19 grams of carbohydrate, and it’s sweetened with both sugar and sucralose. Natural food stores may carry Julian Bakery Paleo Coconut Flakes, which has no added sweeteners and contains only three ingredients – coconut meat, coconut water and palm starch – and 14 grams of carbs per 1-ounce serving. Hi-Lo cereal, original flavor, which can be ordered online, contains only 13 carb grams per ½ cup and gets its sweetness from evaporated cane juice.
Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP, Oleaga A, Moreno B, Casanueva FF. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes. 2016 Sep 19;6(9):e230. [PMC free article: PMC5048014] [PubMed: 27643725]

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.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]

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.

×