There are many physiological reasons for eating enough carbohydrates throughout the waking hours to maintain a steady blood glucose level…a couple of important reasons are to minimize the hepatic release of glucose (from the liver) and to help prevent hypoglycemia which can be very dangerous and lead to hypoglycemic unawareness over a short period of time. Each person is different of course..if you aren’t taking insulin, or pills that lower your blood glucose levels, you may not have to worry about low blood sugars. The reality is, most people with diabetes do; it can be very dangerous for some to not get enough carbohydrates at each meal.
Obviously, if you could keep the weight off, it may help in preventing diabetes. There are many risk factors for diabetes, but the Diabetes Prevention Program in 2002 followed 1,079 people with prediabetes. This groundbreaking study showed that 58% were able to prevent the progression of developing diabetes through diet and exercise. Want to know what the great news is? They didn’t have to eat 20 carbohydrates per day to achieve this!
I had type 1 diabetes for 30+ yrs; CKD/ESRD x8 yrs and did peritoneal dialysis for 5 yrs before getting a kidney pancreas transplant nearly 5 years ago. Then had a below knee amputation and a rather sedentry life since-need to lose weight. Is this a safe diet for me? I am terrified of ketosis (DKA nearly killed me when i was 12 yrs old) so anything messing with stuff like that really makes me nervous. TIA!

Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].

ME: It is not essential. You can be fully ketogenic without any intermittent fasting. However, most people find it natural to do intermittent fasting as their hunger is reduced to where they don’t need a third meal. Keeping feeding time reduced to a smaller window during the day enables the body to use stored body fat for fuel longer, which benefits weight loss. My husband Craig and I still do intermittent fasting every day as maintenance. It just makes life easier only having to make two meals a day instead of three.
By now, most of us have heard about the ketogenic diet. Whether it's because of the benefits of eating high-fat and low-carb, or because you can eat cheese all day long, it's officially become one of the hottest diets of the year. It may not be easy to cut out all the carbs, but emerging research suggests that eating fat can actually help burn fat. So, for anyone trying to lose weight, you may find it worth the carb cut. Beyond weight loss, recent research has found some other serious health benefits of keto that may impact your life later on. Let's take a look at what the research has to say.
But wait, there’s one loophole. Have polycystic ovary syndrome (PCOS)? Then the keto diet may help regulate your periods. “Women with PCOS have high insulin levels, which cause sex hormone imbalances,” notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles — and a small number of women became pregnant, overcoming previous infertility obstacles. “This study was very small, so we can’t make recommendations for all women with PCOS based on its findings,” says Yawitz. “And really, any diet that leads to weight loss should help in PCOS.” 

Incidentally , there’s a very informative article on the bbc website about one of the last remaining hunter/gather societies left in the world, living in Tanzania. They have amazing gut health and no t2d. Would you like to guess at the type of diet they follow? This would be the caveman diet that the writer mentions, and yes these people might not live as long as us but the cause of death is never a lack of motivation to stay on a keto diet.
In fact, the diet first gained popularity in the 1920s when it was discovered to have benefits for children suffering from extreme epilepsy. Now, researchers are conducting studies to determine whether it could have benefits for any number of disorders, including the treatment of ALS, Alzheimer’s disease, brain tumors, traumatic brain injury, diabetes, weight loss, polycystic ovary syndrome, glaucoma, Parkinson’s disease, narcolepsy, and some cancers.
To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.
7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!
In March 2018, our friend Vickie, who is a type 1 diabetic, told us about the keto way of life. She shared some interesting data Dr. Ken Berry puts out on YouTube. The things Dr. Berry said made total sense to us and we decided we needed to give keto a try. Both I and my girlfriend decided to give this Keto way of life a try. We officially started on March 5, 2018.

The Service offers health, fitness and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.
Lorraine Turcotte,  a metabolism researcher at the USC Dornsife College of Letters, Arts and Sciences, said that although it’s less trendy, long-term healthy eating is the tried-and-true solution. She’s not sure why people prefer “difficult dietary manipulations than to say ‘I’m just going to eat moderately — a well balanced diet, lots of fruits and vegetables.’”

Cutting out a whole food group (or in this case, more than one) is a dietitian’s worse nightmare. It not only makes it a really hard diet to follow, but also stresses the hell out of your body and makes it work a lot harder to keep up. In a US News & World Report’s review of 2018 diet, the ketogenic diet came in last place as a sustainable means to weight loss because of its restrictive nature.


Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
Switching from a high-carb diet to a very-low-carb diet lowers insulin levels in your body. This is not only healthy but also one of the primary goals of a ketogenic diet. When insulin levels are very low, your liver begins converting fat into ketones, which most of your cells can use in place of glucose. When your body is mainly using ketones and fat for energy, you’re in a state of ketosis.
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
There is a reason why we store hundreds of thousands of calories in the form of fat in our body and only about 2000 calories in the form of glucose (with only a small amount of this useable by the brain). The reason is simple - The body prefers fat as its fuel source. Mark Sisson explains this in his article ‘A metabolic Paradigm Shift, or Why Fat is the Preferred Fuel for Human Consumption’.
Also, as I believe is mentioned, this diet has been around for along time and was the only way to treat diabetes. And some people did die. However, people still end up dead from t2d even after all the diet advice from educators and with all that pharmacy has to offer. An industry which gains nothing if people just choose to eat less. But has lots to gain if we just keep taking the tablets.

However, the ketogenic principles can absolutely be abused. I’ve seen many people use this way of eating as an excuse to fill their plates almost entirely with bacon and butter from conventionally raised cattle. So make no mistake, an ideal ketogenic diet is a predominantly plant-based diet with healthy fats at its core. Eating a variety of whole foods that are high in healthy fats is essential to “doing keto” the right way.
I suffered through a year on 20 grams of carbs per day and it was the worst year of my life. Yep, I lost weight, but at my current weight of 130 lbs and eating 30 carbs per meal and remaining in a prediabetes state for 15 years, I am healthy AND happy now. None of us know the long term effects of most of what is offered to us…medications, diet drinks, processed foods, restrictive diets. The point I was trying to make was eating healthier, more natural foods will be better in the long run, I believe we all have the common sense to agree on that, even if we can’t agree on how many carbs we will eat!
It may be because all we have ever known is what we have been told by the FDA or who are the people in our country that tell you what you should eat. Do you realize how much money is in the grain , corn and sugar business in this country? A lot more than you can imagine. Bottom line I think its money telling people what they should eat. I’m gonna try the diet and see if it helps me. Thx for letting me voice my opinion.

“If someone with diabetes is [taking insulin or oral type 2 meds in the sulfonylurea or meglitinide class and is] following this diet, they need to know that their blood sugar can drop really quickly, so it’s critical that they check it more frequently,” says Toby Smithson, MS, RDN, CDE, author of Diabetes Meal Planning & Nutrition for Dummies. “Don’t wait for it to happen. Meet with your doctor or diabetes educator in advance so that you can troubleshoot exactly what to do if your blood sugar drops.” If it’s an infrequent occurrence, you may be advised to treat with fast-acting glucose. But frequent lows may require medication adjustments or the addition of more carbs to your eating plan.


One problem with the keto diet, however, is that to date, research studies aimed at investigating its efficacy and safety have involved only men or animals (mainly mice). Some have been skeptical then that the keto diet can work equally well for women. Others question whether it’s necessarily a good idea for women to even try keto given the fact that women’s hormones tend to be more sensitive to most dietary and lifestyle changes.
The only evidence I could find for the long-term safety of a keto diet is from one 12 month trial. As a result of the study, the researchers found that overweight adults with elevated A1c that followed the keto diet experienced more significant reductions in A1c, lost more weight, and decreased their medications more than those instructed to follow a moderate-carbohydrate, calorie-restricted, low-fat diet.

In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.
In a 2016 meta-analysis and systematic review, the researchers found that the low carbohydrate diet decreased fat in the liver significantly, but liver function tests did not improve significantly. When we look closely at the studies in the meta-analysis, they either found no effect on liver enzyme levels or a significant effect. In other words, the liver function of some people stayed the same on the low-carbohydrate diet while others improved significantly. Why the difference?
Coal, on the other hand, burns evenly, and continues to burn for hours. Not only that, but it is fairly simple to adjust the amount of coal you burn to keep the house nice and warm, but not hot, for extended periods of time. The only problem is, it is kind of a hassle to get it to start burning at first (again, in the analogy we are assuming you are simply trying to light bare coal on fire, no aids). But once it is started, maintaining it is no sweat. So what is the solution? You use a tiny bit of kerosene, which lights easy and burns hot, to get the coals started (we need a few carbs, but not much).
The recommendations I made in the Grain Brain Whole Life plan favor a mild state of ketosis, which may be the natural state of human metabolism. To be clear, our ancestors didn’t have access to such rich and unlimited sources of sugars and carbohydrates like we do. So, if you are going to adopt the ketogenic diet, as I have, here are three quick tips for ensuring you’re doing it the right way.
The truth is, I could have drank all the water in the world, and it wouldn’t have solved the problem, because the diet kept me from holding it. I was on the diet approximately six months when it started happening, with warning signs, in retrospect, a month before. When I wrote my story on a blog, I was contacted by a law firm who wanted to investigate my story, because they had a few other clients with similar experiences. I declined their services.
Clinical trials that compare various diets’ outcomes among patients with mental health conditions are sorely lacking. For example, while currently there are 2822 clinical trials registered at Clincaltrials.gov for schizophrenia, none of them are examining the ketogenic diet’s impact on this debilitating chronic condition (three however, are examining gluten-free diets.) Likewise, there are NO ketogenic interventions among 1180 clinical trials for bipolar disorder, 2711 studies for anxiety, and 5370 for depression. (Although there are still a number of trials for these conditions that are looking at “low-fat healthy diets” or “Mediterranean diets” with plenty of fruits, grains and vegetables.)
The keto diet dates back to the 1920s, explains Michelle Hyman, MS, RD, CDN a registered dietitian at Simple Solutions Weight Loss. "The original keto diet was designed for patients with forms of epilepsy that were resistant to standard treatments. The macronutrient breakdown was designed to mimic the fasting state — which seemed to help with relieving seizures — yet provide energy and nutritions to function," Hyman says.
Diet Doctor has a number of videos and posts about positive impacts of the ketogenic diet for migraines, brain cancer, and traumatic brain injury. Recently, two psychiatrists reviewed the research base for psychiatric issues and noted that while promising, it is slim. Dr. Ede takes a more hopeful view. “My mantra is that the most powerful way to change your brain chemistry is by food, because that’s where brain chemicals come from in the first place,” she says.
The good news is, it is not necessary to stay on a ketogenic diet at all times to reap this benefit. Our ancestors went through fast and feast cycles and the body is designed for flexibility. We may be able to reduce cancer risk, prolong life, improve brain function, and benefit from ketosis otherwise by being in ketosis or fasting a few days a week.
What about heart health and the keto diet? Previous older schools of nutrition would purport that a diet rich in fats (specifically saturated fats) would be detrimental for heart health, but more recent research suggests that saturated fat is not as bad as previously believed.  There is actually a tiny little bit of evidence that a keto diet may improve triglyceride, HDL and LDL levels. Like here and here. An even more recent study found that a keto diet improved triglyceride, HDL and LDL levels. We’ll definitely have to wait to see how that research unfolds because there is definitely a lot of competing elements at play.
Keto cycling is a way to cycle in and out of ketosis while enjoying a more balanced diet on your "days off." One keto cycling approach includes five days of traditional keto diet and two non-keto days per week. Some people choose to save their off days for special occasions holidays, birthdays, and vacations. For best results, eat wholesome carbohydrate-rich foods on your off days, including fruits, starchy veggies, dairy products, and whole grains (rather than added sugars or highly-processed fare).
Earlier this year Seattle family doctor Dr. Ted Naiman, who has been helping patients with low-carb or ketogenic diets for 20 years, described how his own obsessive compulsive disorder was resolved almost instantly — never returning — on a low-carb high-fat diet. Naiman over the years has seen dramatic mental health improvements in his patients who adopt low carb ketogenic diet. “Definitely bipolar, depression, anxiety, OCD, are all much, much better on a low-carb diet,” he says.
Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising.
Fatty acid production in fat tissue is stimulated by epinephrine and glucagon, and inhibited by insulin. Insulin is one of the hormones the pancreas secretes in the presence of carbohydrates. Insulin's purpose is to keep blood glucose levels in check by acting like a driver, pushing the glucose into cells. If insulin were not to be secreted, blood glucose levels would get out of control.
On May 24, 2018, I had a 90-day follow-up appointment with my doctor. When he came to the exam room with my chart he immediately started to fist pump me with praise of congratulations, he was ecstatic. I am now at 233 pounds (106 kg)! I have lost 51 pounds (23 kg) and my girlfriend has lost 25 pounds (11 kg). I went from a 42-inch (107 cm) waist to a 38-inch (96 cm) waist. But, here’s the best part, my A1c came down to 5.7 and all my health markers have improved. He called me his poster child for being on the path to curing my Type 2 diabetes.
Several recent studies indicate that a low-carbohydrate diet is effective at improving glycemia. A few studies have shown that in non-diabetic individuals, low-carbohydrate diets were more effective than higher carbohydrate diets at improving fasting serum glucose [13,14] and insulin [6,14-16], and at improving insulin sensitivity as measured by the homeostasis model [6]. One of these studies also included diabetic patients and noted a comparative improvement in hemoglobin A1c after 6 months (low fat diet: 0.0 ± 1.0%; low carbohydrate diet: -0.6 ± 1.2%, p = 0.06) [6] and 12 months (low fat diet: -0.1 ± 1.6%; low carbohydrate diet: -0.7 ± 1.0%, p = 0.019) duration [5]. In a 5-week crossover feeding study, 8 men with type 2 diabetes had greater improvement in fasting glucose, 24-hour glucose area-under-the-curve (AUC), 24-hour insulin AUC, and glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet [7]. In a 14-day inpatient feeding study, 10 participants with type 2 diabetes experienced improvements in hemoglobin A1c and insulin sensitivity as measured by the euglycemic hyperinsulinemic clamp method [8]. Hemoglobin A1c also improved in an outpatient study of 16 participants who followed a 20% carbohydrate diet for 24 weeks [9].
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.”
You would be surprised how many people do read the comments. I wouldn’t say the article is crap. You are excited about keto because you have heard about it yesterday, or last week, or last month or last year or 2 years ago or 5 years ago or may be you were born in 20’s-30’s when it all started but I doubt you were born in 20’s-30’s because your language would differ a lot.
Missing Nutrients. One of the biggest concerns for dietitians is the keto diet’s lack of key foods. Many question the eating plan’s impact on the development of certain chronic diseases. Without milk, for example, getting enough calcium and vitamin D for sturdy bones becomes a challenge. Take away whole grains, fruit, beans, and potatoes, and it’s nearly impossible to consume enough potassium for healthy blood pressure or enough fiber to stay regular. And unless you’re eating lots of low-carb, leafy green vegetables, you miss out on vitamins A, C, K, and folate, too. 

Adding salt to food might be new to you, since most people are used to being told to limit salt intake. However, when you’re eating a ketogenic diet of less than 60 carbohydrates each day, you’ll need to make up for this loss of salt. That being said, those with high blood pressure who take medication should check with their doctors before making a change.


Healthy fats are crucial on a ketogenic diet, but people who have been following the official dietary advice don’t know what healthy fats are. In short: all natural fats that you find in fish, meat, nuts, olives, coconut, and full-fat raw dairy products are healthy for diabetics. On the other hand, oxidized seed oils and the trans fats in margarine should be avoided. Learn more about good fats vs bad fats here.
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much.  In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept.  In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
While many of the problems that develop with prolonged ketosis may be addressed simply by minding intake of prebiotic fibers, not all are, such as selenium deficiency and stunted growth. (Note that the ideal intake of prebiotic fibers, the level we aim for in Wheat Belly and Undoctored programs, is 20 or more grams per day.) Some have argued that higher beta-hydroxybutyrate ketone levels that develop with a ketogenic diet is all you need to do to maintain healthy bowel flora, but this is a huge extrapolation that does not make sense in light of the newest insights into the microbiome and its metabolites. It ignores the role of hundreds of other microbial metabolites that are required and/or produced that are changed with prolonged deprivation of prebiotic fibers. Also, some have blamed the adverse long-term effects in kids on the seizure medications they take, but the side-effects of, say, drugs such as tegretol, valproic acid, or topiramate do not include the above phenomena.
Note: Because you'll be excluding some major food groups on the keto diet (grains, many fruits) you should definitely think about taking a multivitamin—especially one that contains folic acid, which helps your body make new cells and is often found in enriched breads, cereals, and other grain products, says Julie Upton, R.D., cofounder of nutrition website Appetite for Health.
7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!
There are a number of different causes of acne, and one may be related to diet and blood sugar. Eating a diet high in processed and refined carbohydrates can alter gut bacteria and cause more dramatic blood sugar fluctuations, both of which can have an influence on skin health. Therefore, by decreasing carb intake, it's not a surprise that a ketogenic diet could reduce some cases of acne.
What makes the the ketogenic diet unique among low-carb diets is that it’s characterized by a drastic reduction in carbohydrates (usually less than 30–50 grams per day, depending on individual goals) and also a significant increase in fats, as opposed to protein. The goal of the KD is to enter the metabolic state of ketosis, which happens after a few days of strict carbohydrate restriction.
During the first few weeks of the ketogenic diet, the body has to go through the "metabolic shift," as Dr. Mauro DiPasquale calls it. While going through this, the body will experience a small degree of fatigue, brain fog, and even dehydration due to the increased water loss associated with ketoic-induced diuresis and water loss from depletion of glycogen stores.
I’m sorry…no we don’t. Sure, more studies will happen, and more information is always good. But, we KNOW that keto works. You can argue that all you want…but in truth, facts don’t care about your feelings. There are plenty of studies, both in groups and in individuals, that prove beyond any reasonable doubt that going on a proper keto diet WILL improve your life as a diabetic, and will often allow the person to reverse diabetes completely (type 2, obviously). Not to mention the weight loss and the myriad of other health benefits it provides.
Participants completed take-home food records (4 consecutive days, including a weekend) collected at baseline and at weeks 2, 8, and 16 during the study. Participants were given handouts with examples of how to complete the records. A registered dietician analyzed the food records using a nutrition software program (Food Processor SQL, ESHA Research, Inc., Salem, OR).
Other potential culprits, Dr. Ede notes, are grains and legumes, which not only interfere with absorption of brain-healthy nutrients but are also high in lectins and other factors that may pose risks to brain health. Cutting out refined carbohydrates, refined oils, grains and legumes through the low-carb high-fat (LCHF) or ketogenic diet may improve mental health, just as doing so can reverse diabetes and promote weight loss, she notes. 
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing- 
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