300. Aquilano K., Vigilanza P., Baldelli S., Pagliei B., Rotilio G., Ciriolo M. R. Peroxisome proliferator-activated receptor gamma co-activator 1α (PGC-1α) and sirtuin 1 (SIRT1) reside in mitochondria: possible direct function in mitochondrial biogenesis. Journal of Biological Chemistry. 2010;285(28):21590–21599. doi: 10.1074/jbc.m109.070169. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
BMI (body mass index), an alternate measure of obesity that is used by many healthcare practitioners; it is calculated by taking: (Weight in pounds X 705) / (height in inches squared); for example: (150 pounds X 705) / (67 inches X 67 inches) = a BMI of 23.5. An adult with a BMI greater than 30 is considered obese. This calculation does not, however, describe where the excess weight is on the body.
Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change. Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
If you are someone who has struggled with the roller coaster of blood sugar management, I have some good news! Research shows that there are common herbs and spices, likely ones that you already have in your kitchen, that have some potential positive effects on improving blood sugar. Today, I’m breaking down some of the superstar herbs and spices that data has indicated may help with blood sugar management.
We’ve been on the Keto journey since the end of February last year and this is my favourite bread recipe so far, I just made a loaf and it turned out great. I don’t have a food processor so I did use my blender and for ingredients I only used the almond flour, coconut flour, baking powder, butter, salt, 8 egg whites (all I had left in the fridge) and the only optional ingredient I added was stevia. The texture was still really nice without the extra ingredients which is a nice option and this tasted like a regular loaf of bread, I’ll definitely be making this again!!
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
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A study on hippocampal mitochondrial function in rats more directly supports the induction of mitohormesis by a ketogenic diet. After the first day of the diet (Bio-Serv F3666), H2O2 production by isolated mitochondria was increased . After the third day, mitochondrial levels of oxidized glutathione (GSSG) and hippocampal levels of 4-hydroxy-2-nonenal (4-HNE) were also increased, further indicating an increase in oxidative stress. However, at completion of the first week, upregulation of antioxidant signaling occurred, indicated by increased nuclear content and transcriptional activity of nuclear factor erythroid-derived 2-like 2 (NFE2L2), which persisted through the remainder of the study. By the third week, mitochondrial H2O2 production decreased to below baseline . In the liver, content of reduced acetyl CoA, which is indicative of mitochondrial redox status, decreased after three days of the ketogenic diet, but increased relative to the control diet after three weeks, indicating an initial increase in oxidative stress followed by a decrease . This was in conjunction with changes in NFE2L2 nuclear content and transcriptional activity similar to those observed in the hippocampus. As with the previously described C. elegans experiments, the time course of these observations is a strong indication of mitohormesis, and the similarity in results between the liver and hippocampus suggests that a ketogenic diet can induce mitohormesis in a variety of tissues.
I tried this recipe today and I’m blown away. I haven’t started Keto yet but I am soon. I’ve been trying recipes out, and I truly didn’t expect this to come out right the first time because I’ve never whipped egg whites or folded them into anything. I’m a terrible baker. It was so easy! Even my toddler and husband loves this! I didn’t use the sweetener and love the way it tastes!
If you divide the dough in 3 you’ll cook the bread for 90 seconds on high, but if you cook it all together you’ll want to do 150 seconds (2 1/2 minutes). Either way, it’ll come out looking pale and spongy (and not very appetizing at all tbh!). But worry not, just wait for it to cool down until just lightly warm (it continues to cook guys!), and then you’ll definitely want to give it a toast to get some texture on.
I made this over the weekend. I weighed all of my ingredients and it looked beautiful when it came out of the oven. I baked it for the 75 minutes. It fell after it cooled and when I cut it open, it was purple and a little gummy even after 75 minutes of baking time. After toasting the slices, it tasted very good and I even served it to company. The kids all thought it was cool that the bread was purple. Should I reduce the water? If so, by how much? I will try and get Jay Robb psyllium husk powder in the future. I used Vitacost brand and it tasted fine but, it is not always easy to get people to try purple bread. Thanks for the recipe. We will be making purple bread until we run out of the psyllium husk powder we have.
Insulin is a hormone that allows glucose to move into tissue cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen (for short-term energy storage) and/or to use it to produce fatty acids (which then become triglycerides). In people with insulin resistance, additional insulin must be released by the pancreas to overcome the tissue cells' resistance and allow glucose to enter the cells. This resistance and response to resistance can lead to increased insulin and glucose concentrations in the blood. Over time, increased glucose levels can harm blood vessels and organs such as the kidneys. Increased insulin levels can increase sodium retention by the kidneys, resulting in increases in blood pressure (which can lead to hypertension).
As you may recall, about 60% of the energy we expend, say 1,800 kcal/day for someone consuming 3,000 kcal/day in weight balance, is purely devoted to keeping us alive by generating enough ATP (“energy currency”) to do 2 things: allow ion gradients to function and allow muscular relaxation. So, obviously, we can’t tolerate – literally even for one minute – insufficient ATP production. In fact, one of the most potent toxins known to man (cyanide) exerts its effect on this process by inhibiting the electron transport chain which generates the bulk of the ATP our body produces. Even the most transient interruption of this process is fatal.
Bread is one of the foods that people miss most on keto – at least I know I did – and a loaf of almond flour bread is a great alternative. But, for a lot of folks, it’s quite a task to make, because you have to separate eggs, and whisk the whites to stiff peaks and so on. So, for those folks on the go, or those without ovens and those simply without the time or inclination to cook, this 90-second keto bread made in the microwave is the perfect solution. It’s literally as simple as mixing a few ingredients in a mug and popping it in the microwave. And in less than two minutes you have a keto friendly bread, almost as easy as putting bread in the toaster.
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So I was really excited to make this bread. Went and bought all the supplies. The bread didn’t come out good at all. The outside looked good but when I sliced it the center was still moist. So I put it back in the oven with the tented foil probably for another 30 to 45 and still most. I’m def bummed that I waisted a whole carton of eggs. Is there something I could’ve done wrong?
A good low carb breakfast can set the tone for the rest of the day, so we make sure it’s delicious and satisfying! Whether it’s a quick Bulletproof coffee to get your day started or a full blown bacon, egg and cheese, pancake Sunday breakfast, everybody loves the first meal of the day. Our full collection of keto breakfast recipes should inspire you to mix breakfast up a bit and try to include new things in your morning routine.
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)?
There are a few supplements which may worsen blood sugar control or insulin sensitivity in certain people: excessive amounts of niacin may elevate blood sugar levels, and prescription digestive enzymes may cause an increase or decrease in blood sugar levels in people with exocrine pancreatic insufficiency. CLA (conjugated linoleic acid), a popular supplement for slimming, may worsen blood sugar control in diabetics and in obese people without diabetes.
Moreover, in the above study of Sumithran et al. (2013), ketosis maintains post-prandial secretion of CCK as previously demonstrated by other researchers (Chearskul et al., 2008). Note that the orexigenic effect of BHB is blocked by transection of the common hepatic branch of the vagus nerve (Langhans et al., 1985). The hepatic branch contains fibers from the proximal small intestine, stomach and pancreas, and is sensitive to CCK (Horn and Friedman, 2004); ghrelin signals to brain are also transmitted via vagus nerve (Habara et al., 2014). Thus, the effects of ketosis on these two appetite-related hormones could be one of the many factors related to the effects of such nutritional regimen on food control.
Additional evidence, although disparate and primarily based on neuronal mitochondrial function related to epileptic seizures, further supports the potential for nutritional ketosis to induce mitohormesis . Much of this is based on signal transduction, antioxidant defense, and oxidative capacity, all of which will be discussed in proceeding sections.
Hi Howard, You’re right that this bread doesn’t rise much – the volume comes mostly from whipping the egg whites. If the whites fell too much, the bread might not be tall enough. But even if they didn’t, it might still be shorter than some other tall bread loaves. Feel free to multiply the recipe by 1.5 if you prefer a taller loaf. I’m glad you liked the flavor and texture!
Increased reliance on mitochondrial respiration will increase the flow of electrons through the mtETC and, in turn, increase the potential for mtROS formation. Although oxidative stress is traditionally viewed as harmful, a modest increase in ROS is now established as a signaling stimulus that induces hormetic adaptation . In regard to mitohormesis and mtROS, such adaptation is largely centered around antioxidant defense [4–6], making mitohormesis an attractive target for the prevention and treatment of chronic disease.
While there have not been large studies that show the relationship between the ketogenic diet and cancer, we will be publishing a case study about that topic. The author failed to comment that pediatric patients with epilepsy are on the diet for usually about 2 years with no harmful effects. Before the false studies about heart disease and fat, the low carb diet was a respected way to lose weight. Studies into our metabolism show we can use both fat and carbohydrate as fuel. So stepping away from our high carb diet- I am sorry to say that we eat more carbs since the 70s with most of it processed and we now use high fructose corn syrup to sweeten products and we have a wide spread childhood obesity problem. If cholesterol is a concern try plant sterols and stenals to block cholesterol from the receptors in the body. So much more can be said about a keto diet than this article states
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]
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Pizza for breakfast? You betchya! This recipe by All Day I Dream About Food slashes carbs by subbing in cauliflower for the standard wheat flour crust, and racks up plenty of fats and protein with toppings like cheese, sausage, eggs, and avocado. It’s as gooey and crispy as your favorite pizza pie, but costs you a slim 5.43 grams of net carbs a serving. Perfect for relaxing weekend mornings or keto-friendly brunch.
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.
I so miss bread fresh from the oven (I’m going to be adding the yeast)! You are absolutely correct about beaten egg whites creating air pockets. My family has always made buttermilk pancakes from scratch and we always separate the eggs, beat the whites to soft peaks and fold them in at the last minute. The pancakes rise beautifully! Have you tried this with your keto pancakes?
143. Echtay K. S., Winkler E., Frischmuth K., Klingenberg M. Uncoupling proteins 2 and 3 are highly active H+ transporters and highly nucleotide sensitive when activated by coenzyme Q (ubiquinone) Proceedings of the National Academy of Sciences. 2001;98(4):1416–1421. doi: 10.1073/pnas.98.4.1416. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Metabolic syndrome is the commonly observed clustering of obesity, high blood pressure, abnormal blood lipids, and insulin resistance. Some healthy debate exists regarding its definition and existence, but it is clinically apparent that the components of metabolic syndrome occur together more often than expected by chance. Investigations into monogenic diseases that model features of the common metabolic syndrome have uncovered responsible genes. Genome-wide association studies of the components of the metabolic syndrome have been enormously successful. Research will continue to uncover how metabolic pathways interact to form the metabolic syndrome and its subsequent risk for atherosclerosis and diabetes.
Ketosis is deliberately induced by use of a ketogenic diet as a medical intervention in cases of intractable epilepsy. Other uses of low-carbohydrate diets remain controversial. Carbohydrate deprivation to the point of ketosis has been argued to have both negative and positive effects on health. Ketosis can also be induced following periods of fasting (starvation), and after consumption of ketogenic fats (such as medium chain triglycerides) or exogenous ketones.
Having adequate blood levels of vitamin D may reduce the risk of insulin resistance in people who are obese. There is some evidence that a certain blood level of vitamin D is needed for normal glucose metabolism in women who are overweight and obese (but not diabetic), but it is not clear whether any further benefit is gained with higher blood levels.
The coordinated effects of AMPK, SIRT1, and SIRT3 are primarily mediated through PGC-1α, which is activated through phosphorylation by AMPK [242, 265] and deacetylation by SIRT1 [77, 242, 266–269]. SIRT3 also increases PGC-1α activity , possibly through cAMP response element binding protein (CREB) [271, 272], but the exact mechanism has not been elucidated. In addition to phosphorylating PGC-1α, activated AMPK also increases PGC-1α expression [260, 273–276]. Activation of β2-adrenergic receptors [277–280] and the adiponectin AdipoR1 receptor  also increase PGC-1α expression, independently of AMPK activation [278, 281]. PGC-1α activity is increased by oxidative stress [76, 77, 282–284], possibly through activation of AMPK [259, 260] or p38 mitogen-activated protein kinase (MAPK) [283, 284], or inhibition of glycogen synthase kinase 3β, which inhibits PGC-1α through phosphorylation [77, 283]. In contrast, insulin decreases PGC-1α activity through phosphorylation by PKB . Once activated, PGC-1α interacts with the PPAR family of nuclear receptors  and the FOXO family of transcription factors  to influence expression of a variety of bioenergetic and antioxidant proteins. PGC-1α most notably increases transcription of proteins involved in mitochondrial biogenesis and respiration [76, 242, 265, 267, 269, 274, 279, 282, 285, 288–293] but also increases transcription of antioxidant proteins including SOD1 , SOD2 [76, 282, 289, 292–294], catalase , GPx [76, 294], thioredoxins [282, 283, 292], TRXR [282, 292], Prx3 [282, 292], and Prx5 [282, 292], as well as the mitochondrial uncoupling proteins UCP2 [76, 265, 282, 288, 294], UCP3 [76, 265, 294], and ANT [76, 295].
Hi Leo, almond flour bread will always taste of almond flour – there’s no way around it. Since there is no way you can make bread with almond flour using only one egg – it would simply not hold together – it sounds like you’ll have to look for a substitute that is more to your taste. Thank you for taking the time to comment on this recipe, and I hope you find other recipes on my site that are more to your liking 🙂
I just want to say that I love your blog and am in love with your brownie recipe!! It’s a godsend and I was just as excited with this recipe as a result. Unfortunately, my bread fell short for some reason..No matter how long I toast it, it’s spongy and moist in the center…I’ve done everything as directed but substituted the butter for coconut oil. I measured it exactly too. Could that be why the bread is awfully wet in the middle or is there another reason? I tasted quite a bit of the psyllium husk as well which was okay..I’m thinking of making it with flax seed next time.
Eat 15 g less carbohydrates at your next meal. While skipping meals is not a healthy option for individuals with high blood sugar, decreasing the number of carbohydrates consumed at the next meal can help force your body to use the excess sugar. Check your blood sugar an hour after the meal and if your sugar level has decreased but is still high, decrease the next meal by 30 g of carbohydrates.
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.
According to the National Institutes of Health, a mother’s high normal blood sugar levels can put their baby at risk for birth problems. If the mother’s blood sugar levels were high, it is more likely that the baby will have high insulin levels as well at birth. Therefore it is important that during your pregnancy, you are following under the directions of your physician any guidelines which will help you balance your blood sugar levels.
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.
Hi Christy, It might be a little more difficult, but in theory possible. You’d need to stir the dry ingredients, then use a hand mixer instead of food processor to mix them with the butter. Then, after beating the egg whites separately, you’d need to mix in part of them, trying not to break them down, then fold in the rest once it’s easier to fold.
You need to take your medicine, but sometimes, meds for the other things that ail you can raise your blood sugar. We’ve got a list of them here. If you take one or more of these, talk to your doctor about alternative meds that could control your other conditions without affecting your blood sugar. Remember that everyone is different. Just because you take a medication on the list doesn’t mean that it raises your blood sugar—or, if it does, that it raises it enough to worry about. If your doctor says it’s safe to do so, you can stop taking a suspect med for a few days, carefully monitor your blood sugar, and see if it improves. If you want to be a proper scientist, you should then re-start the med to see if the sugar goes up again. And don’t try this at home! Do it only under your doc’s guidance.
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.
Hi Maya, I have made this twice and the first was actually closer than the second! The second one was raised really well when I put the foil on for the last 10-15 mins of cook time and when I took it out 12 mins later it had completely fallen! Now it is almost wet in the center though there are air pockets in it, it’s very odd. The first loaf was pretty flat the whole time and I am pretty sure that was because I didn’t have my egg whites whipped enough but they were spot on for the second loaf. I am also thinking it might be my baking powder after reading some of the comments. I plan to try again and just use a baking soda/cream of tartar mix rather than the baking powder. Any other suggestions? Anyone? LOL!
There is one exception to exercising with diabetes. If your blood sugar is too high (such as over 240) and you are spilling ketones into your urine, then exercise is only going to increase your blood sugar. You can buy a dipstick urine test to check for ketones, but the best thing to do would be to talk to your doctor about what is safe for you to do.
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, people usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
This way of eating has made me feel better in so many ways. I just had such a craving For the texture of cake or bread last night that I had a piece of cake and a sandwich wrap! I knew I had to find a way to satisfy that craving and considered eating a sandwich once a week. Now I can do it without too many carbs. Thanks for taking the time to make it come out right. No more carb BINGES for me.
Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold . According to the American Heart Association, 47 million Americans have it. That's almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age.
I tried this recipe and it is not at all easy to incorporate 1/2 the egg whites in the food processor. When attempting to pulse just 2-3 times, only part of the egg whites incorporated, leaving 1/2 the whipped egg whites still sitting at the top of the mixture. I then had to use a spatula to force it down and pulsed 3 more times and ended up with a heavy batter because the egg whites completely fell. Then trying to fold the mixture into the rest of the egg whites was like trying to fold in cookie dough. The result was a loaf of baked eggs whites that had clumps of batter in the middle.
This is the best keto bread I have ever made! By far! My bread was a little flat, but I think my baking powder needs to be replaced. I did make two substitutions with this recipe. I replaced egg whites with whole eggs, and ghee with coconut oil. Everything else, I already had on hand. I will definitely make this again and play with it a little. Really delicious bread.