All cells of the human body require ATP as the fundamental energy source to support life. Because mitochondria produce the majority of ATP, impaired mitochondrial function is implicated in the majority of today's most concerning chronic and degenerative health conditions including obesity, cardiovascular disease, cancer, diabetes, sarcopenia, and neurodegenerative diseases [1]. Much of this association between mitochondrial function and disease can be attributed to excessive mitochondrial production of reactive oxygen species (ROS) [2].
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]
Ketolysis is the process of breaking down ketones to ultimately provide energy through the Krebs Cycle and mitochondrial oxidative (using oxygen) phosphorylation. Ketone bodies are broken down in the mitochondria of virtually all tissues in the body. The liver is a notable exception, being unable to utilise ketones as a fuel because liver cells lack acetyl-CoA thiolase, a key enzyme in the ketone oxidative pathway. BHB enters the mitochondria of the cell through a monocarboxylate transporter, undergoes conversion to acetoacetate by BHB dehydrogenase and then addition of a CoA group from succinyl-CoA by 3-oxo-acid transferase. The resulting acetoacetyl-CoA acts a substrate for the formation of two molecules of acetyl-CoA in a reaction catalysed by acetyl-CoA thiolase. Acetyl-CoA is then available to condense with oxaloacetate and enter the Krebs cycle.

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)
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For a given quantity of fuel, the maximum amount of work that can be obtained from that fuel in a closed system is called ‘the Gibbs free energy’ (G). This takes into account the inherent ‘heat’ (combustion enthalpy (H)) and a property called entropy (a measure of tendency towards ‘disorder’ (S). The change in Gibbs free energy (∆G) is related to the change in combustion enthalpy (∆H), change in entropy (∆S) and the temperature (T):
As previously mentioned, numerous studies have demonstrated a profound increase in fat oxidation in response to ketogenic and low-carbohydrate diets. Some studies have even shown an increase in O2 consumption [148, 155–158]. However, fats contain fewer oxygen atoms per carbon than carbohydrates, thereby necessitating greater O2 intake to produce the same amount of energy [159]. Furthermore, since β-oxidation and ketolysis produce a greater proportion of FADH2 to NADH, the resulting decrease in passage of electrons through complex I decreases potential for ATP production per unit of O2 consumption [160]. Increased O2 consumption in response to a ketogenic diet may therefore merely be an effect of the differences in the metabolism and molecular structures of fat and carbohydrate rather than a true indication of increased capacity for oxidative phosphorylation. However, in rat hearts perfused with glucose, the addition of ketones has decreased O2 consumption [161]. This discrepancy may be related to variations in mitochondrial uncoupling. Either way, several studies have shown ketogenic diets to increase mitochondrial content, and numerous studies have shown these diets to increase expression, content, or activity of mitochondrial proteins involved in oxidative phosphorylation and fat oxidation. Compared to O2 consumption alone, these findings provide more conclusive support for an increase in oxidative capacity in response to nutritional ketosis.
Thanks so much for this recipe – it’s a staple. I always have some in the fridge and take it with me to restaurants – no more lettuce buns! I tweaked it a bit using some other keto supplies i had on hand – 1/4 tsp xanthan gum makes it less dense, 1-2 tsp of psyllium husk makes it a bit more bready, and then a spash of avacado or coconut oil to add moister and fat. I will sometimes fold in chedder and jalapenos for added flavor boost. Again, thank you -this recipe has helped me fulfill my need for bread on this diet.
To conclude, athletes may consider adopting a ketogenic diet in the hope of improving endurance, well being and body composition but unless the diet is well formulated they risk causing fatigue, under fuelling and ultimately compromising performance. There is currently insufficient scientific research to definitively support the use of ketogenic diet for athletes to improve performance, although beneficial effects on fat oxidation, body composition and well-being have been described. However, the anecdotal reports of success and the increasing number of pro and elite athletes claiming to be experimenting with the ketogenic diet is compelling. Furthermore, people who are training and competing at a sub elite level may have a greater net benefit from the effects of the diet on recovery, wellness and body composition that may outweigh the loss of top end power resulting from the diet. Finally, it is unknown if there would be a beneficial effect of following the ketogenic diet but adding in strategic carbohydrate refeeds around more intense training and competition periods. Given the popularity of the ketogenic diet, one hopes these questions will be addressed in the near future. 
Beginning the ketogenic diet is different than making most other dietary changes, including many popular low-carb diets, because it involves actually changing your metabolism is pretty significant ways. Most people find that if they ease into the diet, giving themselves about 3–4 weeks to adjust, they experience fewer negative symptoms associated with the early stages.
By dramatically shifting energy metabolism towards ketogenesis and fatty acid oxidation, ketogenic diets are likely to have a profound effect on mitochondrial function. However, despite the rapidly growing amount of research on ketogenic diets and their effects on various disease states, only a small amount of this research has focused on mitochondrial function or oxidative stress. The well-established increase in fat oxidation induced by a ketogenic diet [7, 8] clearly indicates prominent connection with mitochondrial function and, in turn, oxidative stress and mitohormesis [5, 6, 9]. Therefore, the purpose of this review is to describe the current, but limited, understanding of how ketogenic diets may affect mitochondrial function and resistance to oxidative stress, particularly within the context of extending human healthspan.
The signs and symptoms for high blood sugar are the same for both type 1 and type 2. Signs usually show up quicker in those who have type 1 because of the nature of their diabetes. Type 1 is an autoimmune disease that causes the body to stop making insulin altogether. Type 2 is caused by lifestyle factors when the body eventually stops responding to insulin, which causes the sugar to increase slowly. People with type 2 can live longer without any symptoms creeping because their body is still making enough insulin to help control it a little bit.
This paleo keto bread recipe makes a delicious option for coconut lovers. For a low-fuss loaf, blend coconut flour with ingredients like eggs, coconut oil, and salt — then bake away for a sturdy bread with only 1.3 net carbs per serving. Make this recipe totally nut-free (and more Bulletproof) by swapping almond milk with full-fat canned coconut milk.
These complications are not caused by a spike in the blood sugar. They are caused by an increased number of high blood sugar events over a period of time. Do not think that one or two high blood sugars are going to cause you to go blind. However, it is important to know what caused those high sugars so that you can prevent it from happening again. Hemoglobin A1C levels are checked to see what the average blood sugar has been over the past 120 days. Your doctor will check this to see if how your blood sugar levels have been trending.
I have tried four times to make the bread recipe with no success, but on my next try I will make sure the egg whites are truly room temp. I have not seen that come up in any discussion but it’s the only thing I can think of at this point. I am an experienced baker, not a novice. I added 1/8 tsp each garlic powder and onion powder and added 1/2 tsp stevia powder. These make the flavor a little more complex and definitely solves the complaint of vinegar or fiber taste. The taste is very good. However unlike some other disappointed bakers on this site, I did not throw away the failed attempts. I took the wet heavy bread from one failed try and tore it into small bits to dry for bread pudding with whiskey sauce. That is DELICIOUS, the next failed batch was sliced very thin and cut in half vertically for “toast points.”. I dried the pieces on a cookie sheet in a 300 degree oven until dry and somewhat brown and crispy. They taste EXACTLY like bagel chips we used to buy. My next batch became seasoned bagel crisps. I still want bread, but these are GREAT! Please don’t throw away failed attempts! There are other uses! I also fried some of my dried cubes in garlic oil for croutons, which were also delicious. I’m still trying, because I think if you can do it, surely I can do it.
The Inuit are often cited as an example of a culture that has lived for hundreds of years on a low-carbohydrate diet.[42] However, in multiple studies the traditional Inuit diet has not been shown to be a ketogenic diet.[43][44][45][46] Not only have researchers been unable to detect any evidence of ketosis resulting from the traditional Inuit diet, but the ratios of fatty-acid to glucose were observed at well below the generally accepted level of ketogenesis.[44][47][45][46] Furthermore, studies investigating the fat yields from fully dressed wild ungulates, and the dietary habits of the cultures who rely on them, suggest that they are too lean to support a ketogenic diet.[48][49] With limited access to fat and carbohydrates, cultures such as the Nunamiut Eskimos—who relied heavily on caribou for subsistence—annually traded for fat and seaweed with coastal-dwelling Taremiut.[48]
The only reason to continue to give this bad advice is the lingering fear of natural fat. If you’re going to avoid fat you need to eat more carbohydrates in order to get satiated. But in recent years the old theory about fat being dangerous has been proven incorrect and is today on its way out. Low-fat products are simply unnecessary. So this reason doesn’t hold up either.
The sirtuin isoforms SIRT1 [232, 233] and SIRT3 [234–236] are nicotinamide adenine dinucleotide- (NAD+) dependent deacetylases associated with longevity. Many reactions are regulated by the redox state of NAD+ and its phosphorylated form, NADP+. Among these reactions, a prominent role of reduced NADP+ (i.e., NADPH) is to support reductive biosynthesis and antioxidant defense, requiring the NADP+/NADPH ratio to be kept low [237]. In contrast, the NAD+/NADH ratio is kept high to support energy metabolism [237], thereby linking sirtuin function to bioenergetic status [238]. Although sirtuins are inhibited by high concentrations of NADH, their activity is influenced more by absolute NAD+ concentration than the NAD+/NADH ratio [238].
Inducing ketosis requires severely limiting your carbohydrate consumption, this way you cut off supply of glucose to your cells. In addition to severely restricting carbs, you also need to limit your protein consumption, since protein can be converted into glucose in small amounts. This is the exact reason that most low-carb diets (such as Atkins or the Paleo diet) do not result in ketosis, because they allow a high intake of protein that keeps supplying the body with enough energy that it doesn’t need to burn fat.
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Following a low calorie diet: The exact mechanism whereby caloric restriction can slow or prevent cancer is unknown. It may be linked to: decreased blood glucose (less fuel for cancer cells), raised ketones (antiinflammatory, decreased oxidative stress, decreased ability to use glucose) . Animal models have shown that caloric restriction is closely related to tumour incidence and progression94.
I also had the problem of gumminess. I watched your video and did as you did…I didn’t make any replacements or anything. I didn’t use Jay Robb psyllium. Mine came from a bulk bin somewhere (and I ground it into powder myself), did that make a difference? the loaf was purple but i don’t care about color, i just want it to taste good and not vinegar-y and not gummy!! thanks so much for any suggestions!

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.
^ Greenberg CR, Dilling LA, Thompson GR, Seargeant LE, Haworth JC, Phillips S, Chan A, Vallance HD, Waters PJ, Sinclair G, Lillquist Y, Wanders RJ, Olpin SE (April 2009). "The paradox of the carnitine palmitoyltransferase type Ia P479L variant in Canadian Aboriginal populations". Molecular Genetics and Metabolism. 96 (4): 201–7. doi:10.1016/j.ymgme.2008.12.018. PMID 19217814.
Hi Kerstin, Sorry you had issues whipping the whites. It can sometimes be more difficult with the kind from a carton. The cream of tartar helps, but sometimes isn’t enough. Did you wait for the whites to be at room temp before beginning? This can help with whipping. Unfortunately the bread won’t turn out very well without getting the whites to stiff peaks. I hope it works for you next time, and if the cartons don’t work for you, you can try with the whites from whole eggs. You can use the yolks to make hollandaise sauce or creme brulee like this.
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Like fiber and protein, fat buffers blood sugar spikes. In fact, unsaturated fats have been specifically linked to improved insulin resistance. Just be sure to avoid refined fats, including trans fats and processed vegetable oils, like corn, soybean, and safflower oils, which can be pro-inflammatory. Sources of quality fats to consider adding to your diet include: nuts, olive oil, ghee, coconut oil, avocado, and fatty fish like salmon.
In recent times there has been an exponential increase in the rates of obesity and diabetes. Popular opinion has blamed (in turn) overconsumption of fat, overconsumption of carbs and sugar and overconsumption of calories. Whilst the overall calorie balance is a crucial factor that cannot be overlooked, it is also the case that different macronutrients in the diet (especially carbs and fat) have different effects on the body when consumed.  
Nutrient-sensitive neurons reacting to glucose but also to fatty acids (FAs) concentrations are present at many sites throughout the brain and may play a key role in the neural control of energy and glucose homoeostasis. Central administration of oleate, for example, inhibits food intake and glucose production in rats. This suggests that daily variations in plasma FA concentrations could be detected by the CNS as a signal that contributes to the regulation of energy balance (Moulle et al., 2014).
Maya, this is a beautiful looking bread. I’m going to try it, but before I do, I’d like to know if you have ever tried doubling the recipe. It seems that it would work–based on the fact that my almond flour bread that I have made for years uses 3 1/4 cups flour, and turns out pretty well. (I’m pretty content with my recipe, but admit that yours looks better due to the whiteness and it appears to have more air bubbles, indicating it’s probably lighter.) If I don’t hear from you, I’ll probably go ahead and double it, and use a 9×5 pan–wish me luck.
These fluffy, colorful pancakes from The Big Man’s World satisfy any cravings for a decadent, comfort food breakfast without totally sabotaging ketosis. Made with almond flour and coconut flour instead of the conventional stuff, these pillowy cakes are much higher in fats, protein, and fiber than your average stack—and at 2.1 grams of net carbs per serving, much lower in carbs. Did we mention they’re also vegan and take just 10 minutes to whip up?
Finally, an important consideration is the effect of the ketogenic diet on blood lipids. This is because the levels of various lipids in the blood have been shown to predict the likelihood of cardiovascular disease. Lipids and cholesterol are carried through the blood in biochemical assemblies called ‘lipoproteins,’ because they do not dissolve in water. There are two broad classes of lipoproteins in the blood: high density lipoprotein (HDL) and low density lipoprotein (LDL). HDL is thought of as more ‘healthy’ (H = ‘Healthy’) because it responsible for moving cholesterol and lipids from the peripheral tissues into the liver for metabolism. LDL is demonised as bad cholesterol (L = ‘Lethal’), levels are elevated after a fatty meal and elevated LDL is associated with cholesterol build up in the arteries. 
Acetyl-CoA can be metabolized through the TCA in any cell, but it can also undergo a different process in liver cells: ketogenesis, which produces ketone bodies.[27] Ketone bodies are also produced in mitochondria, and usually occur in response to low blood glucose levels.[28] When glucose levels are low, oxaloacetate is diverted away from the TCA cycle and is instead used to produce glucose de novo (gluconeogenesis). But when oxaloacetate is unavailable to condense with acetyl-CoA, acetyl-CoA cannot enter the cycle, and so the body has evolved an alternative way to harvest energy from it.
While it is believed that carbohydrate intake after exercise is the most effective way of replacing depleted glycogen stores,[72][73] studies have shown that, after a period of 2–4 weeks of adaptation, physical endurance (as opposed to physical intensity) is unaffected by ketosis, as long as the diet contains high amounts of fat, relative to carbohydrates.[74] Some clinicians refer to this period of keto-adaptation as the "Schwatka imperative" after Frederick Schwatka, the explorer who first identified the transition period from glucose-adaptation to keto-adaptation.[75]
Under conditions of abundant glucose (and sufficient insulin sensitivity) the brain is primarily converting glucose to pyruvate (left side of figure).  Pyruvate is then shuttled into the mitochondria and converted into acetyl CoA with the help of a very important enzyme called pyruvate dehydrogenase (PDH).  I’m going to come back to this enzyme, in part II of this series, because this is where the story gets very interesting.  Acetyl CoA (which is also a direct byproduct of fatty acid breakdown) is then combined with oxaloacetate and so begins the Krebs Cycle, which generates all the reducing agents to feed the ETC and generate massive amounts of ATP.
Several additional rodent studies have shown ketogenic diets to increase protein content of UCPs. However, since mitochondrial function was not measured in these studies, it is not known if uncoupling was affected by these changes in UCP content. In obese mice fed a ketogenic diet (0.4% of energy as carbohydrate), expression of UCP1 and UCP2 increased in adipose and the liver, respectively [148]. Similarly, expression of UCP1 has increased in brown adipose of mice fed a low-carbohydrate diet (18.5% of energy) supplemented with ketone esters (6% w/v) [149]. The increase in hepatic UCP2 expression during a ketogenic diet has been demonstrated by other studies as well [37, 150, 151]. Ketogenic diets also induce expression of UCP3 in skeletal muscle. In rats fed a ketogenic diet (% energy: 78.1 fat, 0 carbohydrate, and 21.9 protein) for 8 weeks, UCP3 expression increased in the soleus but not the extensor digitorum longus, which is consistent with the soleus containing mostly oxidative, type I muscle fibers [152]. In humans, glycogen depleting exercise followed by two days of a low-carbohydrate diet (0.7 g/kg body mass) increased UCP3 expression in the vastus lateralis [153].
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This bread looks amazingly awesome and I will be trying it soon, but with a gluten free psyllium husk brand. I just wanted to point out that J Robb’s Psyllium Husk package declares the presence of WHEAT. Read the label listed on his website. Using his Psyllium Husk would make the bread NOT gluten free. It also states that it has a multitude of other allergens and possibly all of them are in a package at the same time. Just a heads up.

Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
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Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.
Insulin is the medication that will bring blood glucose down the fastest. Someone who uses mealtime insulin can take correction doses to lower blood glucose. This requires a thorough understanding of when to inject, how often to give correction doses, and how much insulin to use. You will need to work with your doctor or diabetes educator to learn how to do this.
Emerging data suggest an important correlation between metabolic syndrome and risk of stroke. [58] Each of the components of metabolic syndrome has been associated with elevated stroke risk, and evidence demonstrates a relationship between the collective metabolic syndrome and risk of ischemic stroke. [59] Metabolic syndrome may also be linked to neuropathy beyond hyperglycemic mechanisms through inflammatory mediators. [60]
Prediabetes: When blood glucose (also called blood sugar) levels are higher than normal and not yet high enough to be diagnosed with diabetes. That’s an A1C of 5.7 percent to 6.4 percent (a way to estimate your 3-month average blood sugar reading), a fasting blood glucose level of 100 to 125 mg/dl, or an OGTT (oral glucose tolerance test) two hour blood glucose of 140 to 199 mg/dl.
Choose foods that are less likely to cause an additional sudden rise in blood sugar. These foods can be identified by determining their glycemic index value (see Resources). Look for foods with a low glycemic index value, such as beans and legumes, and avoid high glycemic foods, such as white potatoes. Don't assume a food has a low glycemic number, even if it appear healthy; many healthy foods can cause a rise in blood sugar, particularly in susceptible individuals.
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!
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.
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