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Moreover, recent studies show that the Inuit have evolved a number of rare genetic adaptations that make them especially well suited to eat large amounts of omega-3 fat.[57][58][59] And earlier studies showed that the Inuit have a very high frequency—68% to 81% in certain arctic coastal populations—of an extremely rare autosomal recessive mutation of the CPT1A gene—a key regulator of mitochondrial long-chain fatty-acid oxidation[60][61]—which results in a rare metabolic disorder known as carnitine palmitoyltransferase 1A (CPT1A) deficiency and promotes hypoketotic hypoglycemia—low levels of ketones and low blood sugar.[62] The condition presents symptoms of a fatty acid and ketogenesis disorder.[62] However, it appears highly beneficial to the Inuit[60] as it shunts free fatty acids away from liver cells to brown fat, for thermogenesis.[63][64] Thus the mutation may help the Inuit stay warm by preferentially burning fatty acids for heat in brown fat cells.[64] In addition to promoting low ketone levels, this disorder also typically results in hepatic encephalopathy (altered mental state due to improper liver function), enlarged liver and high infant mortality.[65] Inuit have been observed to have enlarged livers with an increased capacity for gluconeogenesis, and have greater capacity for excreting urea to remove ammonia, a toxic byproduct of protein breakdown.[57][66][67][68] Ethnographic texts have documented the Inuit's customary habit of snacking frequently [69] and this may well be a direct consequence of their high prevalence of the CPT1A mutation[70] as fasting, even for several hours, can be deleterious for individuals with that allele, particularly during strenuous exercise.[57][70] The high frequency of the CPT1A mutation in the Inuit therefore suggests that it is an important adaptation to their low carbohydrate diet and their extreme environment.[57][60][70]
I have made this bread and as everybody knows it is wonderful. I have one problem though, my son loved it but the next day he told me he was gasy and a bit painful. I know that fiber causes some gas but I was wondering if you know from your experience with so many people, if this will go away after a while or does it mean that he shouldn’t eat any psyllium husk anymore…

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If you’re just starting the keto diet, breakfast might seem like the most challenging meal of the day. Lunches and dinners can easily be made keto by preparing recipes you already enjoy. Meals like salads, steak, salmon, and stuffed peppers are inherently low carb. But what about your favorite breakfast foods? Waffles, oatmeal, and pancakes are all off-limits.
In a separate post, I explained the difference between nutritional ketosis (NK) and diabetic ketoacidosis (DKA). If this distinction is not clear, I’d suggest giving this separate post a quick skim for a refresher.  DKA is a pathologic (i.e., harmful) state that results from the complete or near absence of insulin.  This occurs in the setting of type 1 diabetes or very end-stage type 2 diabetes, and often as the result of a physiologic insult (e.g., an infection) where the patient is not receiving sufficient insulin to bring glucose into his cells.  A person with a normal pancreas, regardless of how long he fasts (including the fellow I reference above who fasted for 382 days!) or how much he restricts carbohydrates, can not enter DKA because even a trace amount of insulin will keep B-OHB levels below about 7 or 8 mM, well below the threshold to develop the pathologic acid-base abnormalities associated with DKA. Let me reiterate, it is physiologically impossible to induce DKA in anyone that does not have T1D or very, very, very late-stage T2D with pancreatic “burnout.”
Most breakfast foods are very high in carbohydrates, which is exactly what you don’t want on a ketogenic diet. If you can do a mental shift as to what foods are classified as breakfast, you will spare yourself a lot of headaches. No matter what you’ve been told in the past, any food can be eaten for breakfast. A bowl of beanless chili made with ground beef, pulled pork, or baked salmon can all be “breakfast foods.”

Rick, Yes, I would try baking it longer if it’s coming out gummy. If it’s starting to brown too much outside, but the inside doesn’t seem to be fully cooked, you could cover it with foil to prevent over-browning. Another trick I sometimes use is to leave the bread in the oven to cool once it’s done baking (sometimes covering the loaf with foil to prevent over-browning). I hope these tips help!
To Make Sure You Get the Best Rise: Make sure your baking powder and yeast are fresh. Let your egg whites come to room temperature before using. Cook for the recommended amount of time (and make sure your oven is properly calibrated). Measure all ingredients carefully (we recommend weighing the dry ingredients). Try to avoid the temptation to slice it while it's hot because this can cause the loaf to fall. 
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
You can’t find Jay Robb Psyllium Husk anywhere online. I called their company today and they have no idea when it will be back in stock. They said they were restructuring, whatever that means. So my question is this, is there a similar brand I can try that won’t turn my bread purple. It tastes great, but I’m not crazy about the color. Thanks for this recipe, it’s just wonderful!

Improved insulin markers: In Type II diabetes, fasting insulin levels are often elevated, and insulin has less of an effect (meaning it takes longer for blood glucose to fall after the post-meal increas). Whilst evidence is not conclusive, some studies have claimed to demonstrate an improvement in insulin sensitivity with the ketogenic diet104. The evidence supporting a decrease in fasting insulin levels with a ketogenic diet has been demonstrated more consistently 104 , 105 .
Last point of background: Everything I’ve just presented is based on data from starving subjects.  If one restricts carbohydrate intake, typically to less than about 20-50 gm/day (dependent on timing and carbohydrate composition), and maintains modest but not high protein intake (because protein is gluconeogenic – i.e., protein in excess will be converted to glycogen by the liver), one can induce a state referred to as “nutritional ketosis” with similar physiology to what I’ve just presented without resorting to starvation.  Why you’d do this is something I will discuss later.
Ketogenic diets (around 50 grams of carbs per day) are extremely effective for getting lean because you reset the body’s enzymatic machinery to use fat as its primary fuel source in the absence of carbs. I see three problems with your diet that are certainly causing your fat-loss plateau—too much protein, not enough good fat, and residual carbohydrates.

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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.
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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.

Look, the good doctor is right – he only forgot to stress “portion control” which is why many fanatical dieters are so kee-jerk reactive to any discussion – odds are you over ate like a hog before your keto diet, and are weak and insecure in your diet plans. Eat EVERYTHING in small amounts, and you will live long and prosper. The only thing to avoid are processed foods. Cook your meals from scratch using quality ingredients.

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.


Metabolic syndrome is a clustering of cardiovascular risk factors that leads to an increased risk for premature cardiovascular disease and increased susceptibility of developing type 2 diabetes mellitus. The syndrome represents a collection of multiple derangements that include elevated blood pressure, impaired glucose tolerance or insulin resistance, atherogenic dyslipidemia (i.e., high triglycerides, low high‐density lipoprotein [HDL] cholesterol, and small low‐density lipoprotein [LDL] particles), proinflammatory and prothrombotic properties, and obesity, with a particular contribution of abdominal obesity. There are two definitions for adults: World Health Organization, 1998 and the National Cholesterol Education Panel (NCEP), Third Adult Treatment Panel, 2001.
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NOTE:  Make sure to weigh your ingredients to ensure it rises properly and doesn’t get hallow and gummy.  Also, if you do weigh and grind your psyllium and still have a problem, try grinding the psyllium again.  We have a batch of psyllium that we ground and didn’t work.  Stay really wet.  So we ground it again and it works great!  Also, if your loaf looks nice and big but then deflates after removed from the oven, try reducing the baking powder to 3 teaspoons.

Preparing a keto breakfast is no different than preparing any other meal. Simply focus on your macros, then fill in those macros with nutrient-dense foods. For example, if you know you’re sticking to 70% fats, 25% protein, and 5% carbs, you know you need a protein source, a low carb vegetable, and a fat source, either for sauteing or by preparing a sauce.

In skeletal muscle, impaired mitochondrial function contributes to age-associated atrophy, impaired contraction, and insulin resistance [2]. While exercise provides a direct stimulus for mitochondrial adaptation in muscle, with great potential to prevent or treat the aforementioned conditions, the global effects of exercise on bioenergetic homeostasis may lead to mitochondrial adaptations in other tissues as well. Based on this, exercise has the potential to influence any condition for which impairments in global energy metabolism or local mitochondrial function are a contributing factor, which is arguably the case for a majority of chronic diseases. Exercise is therefore an excellent adjunct to nutritional ketosis because it facilitates β-oxidation and ketogenesis by increasing energy demand and depleting glycogen storage, which is likely to augment the signaling induced by nutritional ketosis.


One side effect of ketosis that some people experience is the keto rash. It is rare but can be very irritating. The keto rash occurs in the armpits, chest, and back. These areas are red and itching. There are several theories about the causes of the rash. Because it is found in regions where sweat accumulates, the most plausible explanation is that acetone in the sweat irritates the skin. [7].
As will be discussed in the following sections, many of the signaling proteins involved in regulating antioxidant defense also regulate oxidative phosphorylation and fat oxidation. There is abundant evidence (Table 1) showing ketogenic and low-carbohydrate diets to increase expression, content, or activity of many targets of these signaling proteins, further indicating increased oxidative capacity. It is particularly striking that ketogenic or low-carbohydrate diets upregulate expression of proteins associated with each of the five mtETC complexes.
Like you say on your show, I am a foodie and hate it when recipes on websites turn out tasting bleh. This bread has a great texture. After making it a few times plain now, I added some sesame seeds to the batter and that turned out great too. I make an open faced breakfast sandwich with a slice of this almond flour bread, plenty of cream cheese and scrambled eggs. Paired with coffee. So tasty, that I can’t tell it isn’t a regular scrumptious egg sandwich.
I have a loaf cooling on the counter right now. I couldn’t wait to take a piece of it so I hacked a piece off after 5 minutes and tasted it. I don’t get it, it’s the closest thing to real bread but does’t have any wheat in it! How can the crust taste so good?! I’m on a low carb diet so I have suffered through all sorts of weird tasting bread. This one is chewy, with nooks and crannies for sauces and butter. Mine came out purple, but I think it’s a lovely color. I used the bulk psyllium husk powder at my local health food store.
Although there are numerous sites of mtROS formation, the most prominent are those in the mtETC, where the superoxide radical (O2•−) is formed through reduction of O2 by leaked electrons, particularly at complexes I and III [41, 53–55]. Production of O2•− at complex I is particularly high during reverse electron transport (RET), which occurs when a high proton-motive force (Δp) develops across the inner mitochondrial membrane in conjunction with the pool of coenzyme Q (CoQ) being in a highly reduced state (i.e., mostly present as ubiquinol) as a result of electron transfer through complex II and electron transfer flavoprotein:ubiquinone oxidoreductase (ETF-QO) [56–62]. This dependence of mtROS production on Δp during RET is mainly influenced by proton gradient (ΔpH) [59].
Keeping a log of your blood sugars is a great way to be knowledgeable about your body and how it is reacting to foods and events. To start, check before and after every meal, along with one in-between meal check. It is important that you keep a log of these blood sugars, along with all of the foods that you are eating, activities you are performing and any insulin or medications that you are taking. Do this for a week, and see if you can identify any patterns. Take this log to your doctor and talk to them about your findings.

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Cheryl, We use beef gelatin in this recipe to act as a binder and add a bit more chewiness to help simulate regular bread. (If you’re interested, we talk more about using beef gelatin in keto baking in this post: https://theketoqueens.com/crispy-low-carb-indian-flatbread-recipe/.) We haven’t experimented with this recipe to omit the beef gelatin, but you might be able to get a similar result using a bit more psyllium husk powder, flaxseed meal, ground chia seeds, xanthan gum, or guar gum. If you decide to play around with the recipe, please let us know how it goes!

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