Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
Providing additional support Paoli et al. (17) examined the effect of a modified KD diet (~55% fat, 41% protein, and 4.5% CHO) on performance and body composition in gymnasts. In a crossover design, researchers compared independent 30-day dietary regimens consisting of “normal diet” (WD; 46.8% CHO, 38.5% fat, and 14.7% protein) and modified KD in nine elite male gymnasts. There were no significant changes from pre to post during either dietary intervention for measures of physical performance, indicating the absence of significant dietary CHO did not negatively impact physical ability. The post-KD measurements, however, saw a significant decrease in fat mass (pre: 5.3; post:
My daughter loves cereal, but I rarely let her have it because it jacks her blood sugar like crazy, and is rarely filling enough. This is low carb enough that if she likes it, I can fill her up with other stuff, too, while letting her have the cereal she so badly wants. I was just admonished by the nutritionist at her endocrine clinic for letting her often have a nutritionally vacant breakfast (toaster waffles; we get so busy in the morning! I need to be better at pre-prep).
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]

This study examined the relationship between low-carbohydrate diets, all-cause death, deaths from coronary heart disease, and cancer in 24,825 people. Compared to those in the highest carbohydrate group, those who ate the lowest carbohydrates had a 32 percent higher risk of all-cause death over six years. In addition, risks of death from heart disease and cancer were increased by 51 percent and 35 percent, respectively.
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
If no food processor is at hand, you can also do it by hand (it just takes a little more time and arm muscle!). Add all the dry ingredients to a large bowl and whisk until thoroughly combined. Pour in vinegar and whisk until thoroughly distributed. Pour in egg while whisking vigorously and keep whisking until the dough becomes too stiff to whisk. Using your hands, knead the dough until thoroughly incorporated, adding a teaspoon of water at a time as needed (we use 2). 
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
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! 

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.
Carbohydrates are used to make glycogen, which is required for muscle function. The difference between this and common meal plans is the amount of carb intake is limited to enough for the glycogen production of a normal person. Not every carbohydrate is created equal. Sugar alcohols don’t affect most people’s blood sugar levels. Nor does most fiber. A keto eater is interested in net carbs, figured by total carbohydrate minus fiber minus sugar alcohols.
If you are looking for the best keto meal prep recipes, then you’ve found them. I have created low carb keto recipes that are exciting to eat and cook, if you are tired of fat bombs and need real food, I am going to hook you up. I’ve got keto meal prep recipes that are easy to make and so tasty, you will be happy you prepped them for a full week of eating. These low carb recipes cover breakfast, lunch, snacks, dinner, and even my wife’s famous keto dessert recipes. Check them out and let me know if you have any special requests.

There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
Made the bread but it didn’t rise and it is probably my fault. My almond flour is stored in the freezer. I probably should have let it come to room temperature first. I watched the video and the loaf shown seems to be narrower than the pan I used. The texture is good. The taste isn’t bad. I just need a “taller” bread to make my husband paninis. Anything you can tell me will be appreciated. 

Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.

Next, the noodles are tasteless, so they make a great vessel for your pasta sauces. These are 6g net carbs per serving, but the servings are huge! We generally aren’t big fans of the concept of eating less of something to make it seem lower in carbs. But, we have found that when cooked, even half of the recommended serving is pretty sizable for these noodles.

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.
However, replacing high carb flours like all-purpose flour, wheat flour, corn flour, and rice flour with low-carb flour is not as simple as just using one for the other. Due to the difference in composition between high-carb and low-carb flours, you will need to use different amounts of low-carb flour together with other essential ingredients that you don’t typically find in traditional baking recipes like psyllium husk, xanthan gum, and protein powder.

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.
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.
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
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