Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).
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 . 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 . 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 . 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 . 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.
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."
Yes, some ideas on meal plans and very easy recipes would be very helpful. I’m 67, very overweight, diabetes, high blood pressure. My big love are all the carbs. This way of life seems impossible to me, all that fat just doesn’t sound appealing. I can’t see how to eat that much fat a day. Years ago, I did try Dr. Atkins diet but I had a very hard time with the very limited carbs. But now, I need to something drastic but haven’t a clue how to start.
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!
Where does nutrition info come from? Nutrition facts are provided as a courtesy, sourced from the USDA Food Database. You can find individual ingredient carb counts we use in the Low Carb & Keto Food List. Carb count excludes sugar alcohols. Net carb count excludes both fiber and sugar alcohols, because these do not affect blood sugar in most people. We try to be accurate, but feel free to make your own calculations.
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!
Natural fat, high-fat sauces – Most of the calories on a keto diet should come from fat. You’ll likely get much of it from natural sources like meat, fish, eggs etc. But also use fat in cooking, like butter or coconut fat, and add plenty of olive oil to salads etc. You can also eat delicious high-fat sauces including Bearnaise sauce etc., or garlic butter (recipes).
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
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.
This article originally appeared in Personal Training Quarterly (PTQ)—a quarterly publication for NSCA Members designed specifically for the personal trainer. Discover easy-to-read, research-based articles that take your training knowledge further with Nutrition, Programming, and Personal Business Development columns in each quarterly, electronic issue. Read more articles from PTQ »
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.
On the other hand, the types of foods you’ll avoid eating on the keto, low-carb food plan are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of “empty calories”).
Hi John, Thank you for the feedback. Sometimes this bread takes a little more effort to rise and the batter has to be mixed well to create air bubbles. Use very fresh baking powder, too. The bluish tint can come from an interaction with the psyllium husk powder, and the brand I use (linked on the recipe card) doesn’t usually do this, but either way it’s safe to eat. I’m glad you still liked it!
I made these donuts super skeptically but holy crap am I impressed. They taste like the little mini donuts you get from the carnival. I baked them until I thought they were dark brown enough but I ate a donut as soon as the timer went off and it crumbled quite a bit. Luckily I had the oven on and could just pop them back in. I would recommend these to everyone!!!
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
"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.
In addition, on the day the diet was initiated, diabetes medications were reduced – generally, insulin doses were halved, and sulfonylurea doses were halved or discontinued. Due to the possible diuretic effects of the diet soon after initiation, diuretic medications were discontinued if of low dosage (up to 25 mg of hydrochlorothiazide or 20 mg of furosemide) or halved if of higher dosage. Participants were also instructed to take a standard multivitamin and drink 6–8 glasses of water daily, and were encouraged to exercise aerobically for 30 minutes at least three times per week.
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.
While there are many different types of pasta today, the classic cooked, unenriched traditional pasta is about 30 grams of carbohydrates per 100 grams. That’s your entire daily carbohydrate intake on the ketogenic diet, if you’re lucky. After that comes a minuscule 0.9 grams of fat, about 6 grams of protein and minimal micronutrients. Even whole wheat pasta, advertised as a health food, contains 37 grams of total carbohydrates[*].
Everyone responds to different levels of carbs, fat, and protein differently. It’s not enough to just eat what you think is a low amount of carbohydrates. Your metabolic history, daily activities, or any other factor may mean you can only tolerate 25 grams of carbs per day before getting kicked out of ketosis whereas someone else can tolerate up to 100 grams of carbs per day.
If you’re new or just still learning the ropes for the keto diet food list, your biggest questions probably revolve around figuring out just what high-fat low-carb foods you can eat on such a low-carb, ketogenic diet. Overall, remember that the bulk of calories on the keto diet are from foods that are high in natural fats along with a moderate amount of foods with protein. Those that are severely restricted are all foods that provide lots of carbs, even kinds that are normally thought of as “healthy,” like whole grains, for example.