The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
Hi Jen, It sounds like it needed to bake for longer – this is why it sunk and was still moist. The timing varies by ovens and even different pans. I hope you’ll try it again and just keep it in there for longer. You can cover the top if it starts to brown too much. For the one you made, depending on how moist it was in the middle, you may be able to salvage it somewhat by pan frying the slices.
264. Jing E., Emanuelli B., Hirschey M. D., et al. Sirtuin-3 (Sirt3) regulates skeletal muscle metabolism and insulin signaling via altered mitochondrial oxidation and reactive oxygen species production. Proceedings of the National Academy of Sciences. 2011;108(35):14608–14613. doi: 10.1073/pnas.1111308108. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Metabolic syndrome (metabolic syndrome X, insulin resistance syndrome, dysmetabolic syndrome, hypertriglyceridaemic waist, obesity syndrome, Reaven syndrome) is the name for a group of risk factors that increase the risk for ischaemic heart disease (IHD), diabetes and stroke (Fig. 23.1). The metabolic syndrome is diagnosed when at least three of the IHD risk factors listed in Table 23.1 are present. Whether the syndrome, which affects possibly 25% of the US population, is a specific syndrome, and nothing more than the sum of its parts, is controversial.
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)?
Has anyone tried this using a substitute for the eggs/egg whites? My husband seems to be sensitive to eggs (not sure which part, to be honest) and we’ve been making most recipes using agar agar as a substitute (for either whites or whole eggs) but this only works if the egg is a binder. I’m guessing that they are a leavening agent in the bread (please correct me if I’m wrong!) and I don’t know if agar would work in this recipe. I do have VersaWhip 600 – anyone ever tried that in a bread recipe?
Oregano and Sage: One group of researchers tested a variety of herbs and spices for a specific antioxidant activity that help to prevent an increase in hemoglobin A1C, a protein maker in the blood that is affected by blood sugar levels. They found that two of the herbs with the highest antioxidant levels were oregano and sage (1)…can you say Italian food?
Whilst the diet is broadly acknowledged to be safe strategy where medications have failed, side effects such as kidney stones, hyperlipidemia and can occur47. Furthermore, maintaining dietary adherence in young school age children can be very challenging for caregivers. Exogenous ketones may be an alternative or a adjunct to the ketogenic diet in epilepsy. Early work suggests that exogenous ketones could have antiseizure effects. Injection of the ketones acetoacetate and acetone have been found to have anticonvulsant properties in animal models48, and an acetoacetate diester was found to protect against seizures in rats exposed to high levels of oxygen49. Further studies are required to understand specifically how ketone bodies affect seizure control, however for children who experience daily seizures a combination of the ketogenic diet and exogenous ketones could be helpful to manage their condition.    
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.

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Like fiber, protein tempers insulin secretion, leading to a more gradual rise in blood sugar after a meal. It also fills you up better than any other nutrient. Eating a protein-rich breakfast may be particularly important, as it helps set the tone for the rest of the day. The amount of protein you need in your diet depends on a number of factors, but general protein recommendations for healthy adults are 0.8 to 1.0 gram per kilogram of body weight (55 to 68 grams per day for someone who’s 150 pounds). Good animal sources include wild-caught fish, grass-fed beef, and pasture-raised chicken and eggs. If you’re vegetarian or vegan, load up on these eight plant-based protein sources.
A reduced availability of dietary carbohydrates leads to an increased liver production of KBs. The liver cannot utilize KBs because it lacks the mitochondrial enzyme succinyl-CoA: 3-ketoacid (oxoacid) CoA transferase (SCOT) necessary for activation of acetoacetate to acetoacetyl CoA. KBs are utilized by tissues, in particularly by brain. KBs enter the citric acid cycle after being converted to acetyl CoA by hydroxybutyrate dehydrogenase (HBD), succinyl-CoA: 3–CoA transferase (SCOT), and methylacetoacetyl CoA thiolase (MAT). Modified from Owen (2005), Paoli et al. (2014).
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)
In sheep, ketosis, evidenced by hyperketonemia with beta-hydroxybutyrate in blood over 0.7 mmol/L, occurs in pregnancy toxemia.[78][79] This may develop in late pregnancy in ewes bearing multiple fetuses,[78][79] and is associated with the considerable glucose demands of the conceptuses.[80][81] In ruminants, because most glucose in the digestive tract is metabolized by rumen organisms, glucose must be supplied by gluconeogenesis,[82] for which propionate (produced by rumen bacteria and absorbed across the rumen wall) is normally the principal substrate in sheep, with other gluconeogenic substrates increasing in importance when glucose demand is high or propionate is limited.[83][84] Pregnancy toxemia is most likely to occur in late pregnancy because most fetal growth (and hence most glucose demand) occurs in the final weeks of gestation; it may be triggered by insufficient feed energy intake (anorexia due to weather conditions, stress or other causes),[79] necessitating reliance on hydrolysis of stored triglyceride, with the glycerol moiety being used in gluconeogenesis and the fatty acid moieties being subject to oxidation, producing ketone bodies.[78] Among ewes with pregnancy toxemia, beta-hydroxybutyrate in blood tends to be higher in those that die than in survivors.[85] Prompt recovery may occur with natural parturition, Caesarean section or induced abortion. Prevention (through appropriate feeding and other management) is more effective than treatment of advanced stages of ovine ketosis.[86]
Transfer bread dough to prepared loaf pan, using a wet spatula to even out the top. Cover with a kitchen towel and place in a warm draft-free space for 50-60 minutes until the dough has risen just past the top of the loaf pan. How long it takes depends on your altitude, temperature and humidity- so keep an eye out for it every 15 minutes or so. And keep in mind that if you use a larger loaf pan it won't rise past the top. 
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What is the link between ketones and diabetes? Ketone is a chemical produced by the body when fats are broken down for energy. Ketone testing is important for people with diabetes, because high levels can lead to diabetic ketoacidosis (DKA), when acid levels become too high in the blood and the person loses consciousness. Find out when and why to do ketone testing. Read now
The easiest way to make sure that your carb intake is appropriate is to count carbohydrates. It is a simplified way to evaluate foods based on their nutritional value. The best place to start when counting is to aim for 45 to 60 grams of carbohydrates per meal and roughly 15 to 30 grams for each snack in between meals. You may have to adjust this based on your individual needs and your blood sugar readings. It is a lot easier to calculate the carbohydrates when you have a food with a label, but many foods do not. Check the serving size on the label to be sure that you are counting correctly. The US Department of Agriculture has a website that allows you to type in any food and it will give you the nutritional values. Check it out at https://ndb.nal.usda.gov/ndb/. A few examples of 15 grams of carbs include:
Luckily, DKA has some pretty glaring signs, so someone experiencing it can get help ASAP—symptoms include rapid and heavy breathing, having to pee a lot, and thirst that can’t be quenched, says Klett. As things progress, they’ll also “get confused, become delirious, and eventually have cardiovascular collapse because the blood pH gets so low,” and their organs will stop functioning properly. So again, treatment is necessary.

Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.  The Merck Manual was first published in 1899 as a service to the community.  The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America.  Learn more about our commitment to Global Medical Knowledge.
Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.

4. Tapia P. C. Sublethal mitochondrial stress with an attendant stoichiometric augmentation of reactive oxygen species may precipitate many of the beneficial alterations in cellular physiology produced by caloric restriction, intermittent fasting, exercise and dietary phytonutrients: “Mitohormesis” for health and vitality. Medical Hypotheses. 2006;66(4):832–843. doi: 10.1016/j.mehy.2005.09.009. [PubMed] [CrossRef] [Google Scholar]

Although convincing, the bulk of evidence in relation to the inhibitory effects of ketosis on appetite is still anecdotal. Preliminary scientific reports seem to support this phenomenon, and the evidence shows that KD is more effective, at least in the short/medium-term, on fat loss (Paoli, 2014). It was demonstrated that diet-induced weight loss leads to changes in energy expenditure and in appetite-regulating hormones that facilitate weight regain and the return to initial energy homeostasis (Sumithran et al., 2011). This response to alteration of energy balance nullifies the success of many dietary approaches. It is well-known that the long-term success of a nutritional approach is defined by the amount of weight regain and is the main problem regarding the so-called weight cycling or “yo-yo” effect (Jeffery, 1996). A recent study by our group has demonstrated that a brief ketogenic period, if followed by a longer period of correct Mediterranean diet could avoid this yo-yo effect (Paoli et al., 2013). During the ketogenic period subjects reported less hunger, confirming previous studies (Nickols-Richardson et al., 2005; Johnston et al., 2006; Johnstone et al., 2008) on hunger-suppression effect of ketogenic diet. Despite these clinical findings, the mechanisms of action of ketosis on appetite reduction are still not completely understood. Clinical results are suggestive of both direct and indirect (via modifications of hunger-related hormones concentration) actions of KBs on appetite (Sumithran et al., 2013).
I waited awhile to try this, certain it would be blah but decided to give it a go. I did add a pinch of salt and I used Brummel and brown butter, made with yogurt, as it lowered the fat and calories. toasted and spread some sugar free strawberry preserves. really good! texture took a bit to get used to but so excited to be able to eat bread! not on keto but recently diagnosed as diabetic so bread is a nono bc of all the carbs.

I could go on for days about how a good diet can keep your blood sugar in control. To receive the most efficient information, set up a meeting with a dietician to look at your specific needs and you recent sugar readings. They can provide you with recipes and tools which make it easier for you to know exactly what you are putting into your body. 40 states in the United States require insurance companies to cover a meeting with a dietician for those with diabetes. Check with your insurance to see if this benefit is available for you.
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All recipes, headnotes, photos, and stories on this site are the original creations and property of Joy Filled Eats. You are welcome to share a photo and link to the recipe from this site, however, re-publishing the recipe in its entirety is strictly forbidden. Simple substitutions do not make it an original recipe, so please refrain from adapting the recipes without properly linking back to the original recipe.

Patterns can be great because they help you figure out what is causing undesirable blood sugar values. A good way to track of it is to keep a journal of all of the food you eat, activities you do and your blood sugar levels for 1 week. During this week, check your sugar before and after you eat, as well as in between meals. Also document any insulin that you give yourself.


Also frequently seen with metabolic syndrome are tendencies for excessive blood clotting and inflammation. While obvious symptoms may be absent, these features are a warning of an increased likelihood of clogged arteries, heart disease, stroke, diabetes, kidney disease, and even premature death. If left untreated, complications from diseases associated with untreated metabolic syndrome can develop in as few as 15 years. Those who have metabolic syndrome and also smoke tend to have an even poorer prognosis.
Clinical results suggest both direct and indirect actions of ketones via modifications of various hunger-related hormones concentrations. While it’s not completely clear how ketosis reduces appetite, studies have found that ketosis is effective at lowering food intake and regulating appetite by altering levels of the hunger hormones including cholecystokinin (CCK) and ghrelin. At the same, ketone bodies seem to affect the hypothalamus region in the brain, positively impact leptin signals, and avoid slowing down the metabolism like most other diets do. (5)
Appetite regulation: One of the first things people notice when they’re in ketosis is that they’re no longer hungry all the time. In fact, research has shown that being in ketosis suppresses appetite. One study looked at people who lost weight by following a ketogenic diet for eight weeks and then reintroduced small amounts of carbs. The researchers reported that the levels of ghrelin (the “hunger hormone”) were suppressed in those who remained in ketosis, whereas those who were no longer in ketosis had higher ghrelin levels.

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Would highly recommend listening to Tim Noakes and his trail in Cape Town – he was pretty much the trigger for me to switch to LCHF and now I am starting to educate myself on what I need to follow a path that works for me. The information on Verta is giving me more information to enable me to ask my Dr for what I want – I know this will be an uphill battle and this information will help me avoid getting railroaded into the so called norms. It also give the Dr a way out because then I am asking him to help me go down a certain path that he is not responsible for recommending if it bucks the system.

In addition to increased mitochondrial demand and mtROS production, there are several other commonalities in the mechanisms through which exercise and nutritional ketosis induce adaptive signaling. Exercise-induced activation of AMPK is greater when the exercise is performed in a glycogen depleted state [209–211, 382, 383], and exercise-induced activation of p38 MAPK [315] and PGC-1α [277–279] occurs at least partly through β-adrenergic signaling. Although changes in NAD+ and NADH are difficult to measure and are complicated by conflicting results, exercise is also likely to increase sirtuin activation by increasing the NAD+ to NADH ratio [402].
I went to buy Xanthan gum at a store in my little town and it was like $17! I wasn’t paying that much, so I made it without but I will be ordering some online. I followed your directions exactly (minus Xanthan) and used Swerve for the sweetener. I couldn’t wait for it to cool so I had a piece right after it came out of the oven, it was delicious! I find it a tad sweet for bread, but that’s ok I’ll just cut back on the sweetener if I want to eat it for a sandwich..all sweeteners are a little different. It had a beautiful crust on it and was a tiny bit crumbly, almost reminds me more of muffin texture, I’m thinking maybe the Xanthan will give it more of a chewy bread texture?
Aside from managing your diabetes, a diabetes diet offers other benefits, too. Because a diabetes diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to reduce your risk of cardiovascular diseases and certain types of cancer. And consuming low-fat dairy products can reduce your risk of low bone mass in the future.
Yes, you read that right. Meat. Bagel. It's basically ground pork cooked into the shape of a bagel (or a donut, however you'd like to think of it). After it's cooked, cut it in half and fill it with lettuce, tomato, avocado, and onions for one hell of a breakfast sandwich. They also freeze up nicely. Meat lovers, you've got Ditch The Wheat to thank for this creation.

First of all, almond flour bread will never have EXACTLY the same texture as wheat bread because it lacks the gluten. It will be slightly softer. But. Baking with almond flour is never an exact science. If your almond flour is coarser, just add an extra couple of tbsp next time and the bread will be firmer. Or try reducing the amount of water so it dries out more. I would not recommend changing the amount of egg (unless you used extra large eggs). Hope this helps!


Rookie experiment, I tried to add 1/4 C of Almond Flour to the Coconut based recipe 1st time all whites and 2 T less, ground psyllium – rise was high, then sunk down quite a bit & was still gummy. 2nd attempt 1 C egg whites and 4 whole eggs, looked a bit better, but the loaf didn’t rise a lot. Not too gummy though. 2nd one tasted better according to husband. Help! London.
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Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Patterns can be great because they help you figure out what is causing undesirable blood sugar values. A good way to track of it is to keep a journal of all of the food you eat, activities you do and your blood sugar levels for 1 week. During this week, check your sugar before and after you eat, as well as in between meals. Also document any insulin that you give yourself.

AMPK and sirtuins are the interface between the metabolic stimuli of nutritional ketosis and the downstream signaling that influences expression of proteins related to bioenergetics and antioxidant defense. Some of the primary downstream signaling molecules involved include PGC-1α, FOXO3a, nuclear respiratory factors 1 and 2 (NRF-1 and NRF-2), mitochondrial transcription factor A (TFAM), and NFE2L2.


Nuclear factor erythroid-derived 2-like 2 (NFE2L2 or NRF2) is a transcription factor that has a prominent role in antioxidant signaling and also influences mitochondrial bioenergetics. The NFE2L2 abbreviation is used in this review to avoid confusion with nuclear respiratory factor 2, which despite being a different protein, has overlapping function with NFE2L2 and shares the same NRF2 abbreviation [349]. Although the mechanisms of NFE2L2 signaling are not fully elucidated [350], oxidative stress has a clear role in interacting with cysteine residues of Kelch-like ECH-associated protein 1 (Keap1), which decreases proteasomal degradation of NFE2L2 and thereby allows entry of NFE2L2 into the nucleus to induce transcription [351–355]. Although the influence of PGC-1α on antioxidant enzyme expression is not dependent on NFE2L2 [76, 356], PGC-1α increases NFE2L2 expression [357], indicating that NFE2L2 activity is influenced by perturbations in both energy and redox homeostasis. NFE2L2 primarily increases expression of antioxidant enzymes, including SOD1 [358], SOD2 [358], catalase [358–361], GPx [360], NQO1 [354, 359–362], GCL [359–361], GST [362], GSR [359–361], and Prx1 [352], but also increases expression of proteins involved in mitochondrial biogenesis and bioenergetics including NRF-1, NRF-2, TFAM, cytochrome c oxidase, and citrate synthase [358].
I tried this with the Psyllium husk powder I had (Konsyl) and it was too gummy. It looks like the Jay Robb is out of stock everywhere. If you had success with this bread using a different brand, would you share with me what brand worked? I could taste in the crust that this will be wonderful once I get the right psyllium. Thanks, everyone! I’m excited to nail this.
Agree with post regarding salt omitted salt, grilled it first time. It definitely reminds me of corn muffins texture. This morning make recipe added 1 T. of swerve brown sugar and dash or cinnamon,nutmeg and chopped walnuts OMG. It was great topped with cream cheese frosting(cream cheese,butter ,vanilla and swerve confection .Thanks can’t wait to try pumpkin spice next time I’m craving carrot cake thanks so much!
.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.
So when i made this bread it didnt really stay the way i wanted it to be because when i took it out it looked like regular bread but after like 5-10 minutes it sunk down and mine turned blueish-purpleish….is that good?? I dont think i will be making this again….and i measured out all the ingredients too so i dont know what i did wrong…. PLEASE HELP!!!!!!!!!!!!!
Metabolic syndrome is a serious health condition that affects about 23 percent of adults and places them at higher risk of cardiovascular disease, diabetes, stroke and diseases related to fatty buildups in artery walls. The underlying causes of metabolic syndrome include overweight and obesity, physical inactivity, genetic factors and getting older.
Jenkins, D. J. A., Kendall, C. W. C., Augustin, L. S. A., Mitchell, S., Sahye-Pudaruth, S., Mejia, S. B., … Josse, R. G. (2012, November 26). Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: A randomized controlled trial. JAMA Internal Medicine, 172(21), 1653–1660. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1384247
Metabolic syndrome is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. [4] It is a risk factor for coronary heart disease, as well as diabetes, fatty liver, and several cancers. The clinical manifestations of this syndrome may include hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol (HDL-C), and abdominal obesity. (See Prognosis, Workup, Treatment, and Medication.)

Thank you Mira for your quick reply. I didn’t make it that same day but I just made a batch now and they are excellent! I really enjoyed them. I made the recipe times 10 for 12 large muffin slots in the muffin tin. I’m thinking of shaping a larger round of batter on a parchment lined pan next time and after baking, carefully cutting in half to make 2 rounds to make a pizza crust. Thank you so much!!!
I had the same effect but I used the same pan. The issue I had was the egg whites. I beat them with a mixer for 2 minutes with the cream of tartar and still couldn’t get them whipped. I’d say they were half whipped. I gave up and put them in the loan pan anyway. The bread looked the same and tasted great but it was somewhat spongy. I’m wondering if the egg whites really wouldn’t whip because I didn’t realize they had to be room temp. The bread is great but it won’t hold up for sandwiches. Any tips on egg whipping? I felt egg defeated today!
4. Tapia P. C. Sublethal mitochondrial stress with an attendant stoichiometric augmentation of reactive oxygen species may precipitate many of the beneficial alterations in cellular physiology produced by caloric restriction, intermittent fasting, exercise and dietary phytonutrients: “Mitohormesis” for health and vitality. Medical Hypotheses. 2006;66(4):832–843. doi: 10.1016/j.mehy.2005.09.009. [PubMed] [CrossRef] [Google Scholar]
Hi Maria! I am your new biggest fan! I made all of my favorites of your recipes for my extended family over the holidays and the bread and almond joys were such a huge hit! I love to add carraway seeds to the bread which gives it a Rye – European flavor to it! I’ve been following your HFMPLC philosophy for about 3 weeks now and I was wondering why you mentioned you make the protein buns for yourself but the bread for your husband. Do you not like the bread or is it too high in carbs for you? I know I need an induction period of a couple of weeks so I am off nuts for now but I can’t wait to have the bread again!
The 2 major issues that will lead to a flat loaf is not whipping the egg whites and gently folding them in OR using almond meal instead of a finely ground almond flour. If you've tried everything and they don't seem to be working for you, the next best option will be to make a larger recipe. Try making 1.5x this recipe (it's easy to do using the servings slide bar) and you'll have a much larger loaf.
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