It is known that different dietary components exert some effects on gut microbiome composition, mainly in relation to obesity and inflammatory states. In general, a Mediterranean diet has a positive effect while a high-protein diet seems to have detrimental effects due to putrefaction phenomena (Lopez-Legarrea et al., 2014; Flint et al., 2015). Few data are available at this time about the effects of KD on gut microbiota. For example, a study by Crawford et al. (2009) investigated the regulation of myocardial ketone body metabolism by the gut microbiota and demonstrated that, during fasting, the presence of gut microbiota improved the supply of ketone bodies to the heart where KBs were oxidized. In the absence of a microbiota, low levels of KB was associated with a related increase in glucose utilization, but heart weight was still significantly reduced. The myocardial-mass reduction was completely reversed in germ-free mice feeded with a ketogenic diet. Regarding food control we can hypothesize that the particular metabolic state of ketosis could provide some benefit to weight and food control via synergic actions between butyrate production by gut bacteria and circulating high blood ketones (Sanz et al., 2015).

Metabolic syndrome is increasing in prevalence, paralleling an increasing epidemic of obesity. In the United States, where almost two thirds of the population is overweight or obese, more than one fourth of the population meets diagnostic criteria for metabolic syndrome. [25] In the United States, data from a 1999-2000 survey showed that the age-adjusted prevalence of metabolic syndrome among adults aged 20 years or older had risen from 27% (data from 1988-1994) to 32%. [26]
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The fact that the diagnostic criteria for metabolic syndrome vary between ethnic populations is testimony to significant nuances in the manifestation of metabolic syndrome in these groups. The original metabolic syndrome criteria were derived in mostly Caucasian populations, and some have argued for modification of individual criteria for specific ethnic subgroups, as has been done with waist circumference for patients of Asian origin. [39]
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!
In some cases epilepsy cannot be treated successfully using anticonvulsant medications. In some cases where drugs have failed, the ketogenic diet has been widely documented to deliver transformative seizure control, reducing frequency by anywhere between 40-90%43. Whilst the exact mechanisms underlying the beneficial effect of the ketogenic diet are unclear, the hypothesised mechanisms include:
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.

Why is the keto diet good for you? A keto diet is one that prioritizes fats and proteins over carbohydrates. It can help reduce body weight, acne, and the risk of cancer. Find out about the mechanisms through which it achieves these benefits and the research that supports it. This MNT Knowledge Center article also discusses the risks of the diet. Read now


In 1977 and 1978, Gerald B. Phillips developed the concept that risk factors for myocardial infarction concur to form a "constellation of abnormalities" (i.e., glucose intolerance, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and hypertension) associated not only with heart disease, but also with aging, obesity and other clinical states. He suggested there must be an underlying linking factor, the identification of which could lead to the prevention of cardiovascular disease; he hypothesized that this factor was sex hormones.[66][67]

Nutritional ketosis may facilitate PGC-1α activity through multiple mechanisms. Since PGC-1α is activated by AMPK and SIRT1, nutritional ketosis may initiate PGC-1α activity through these enzymes. As previously mentioned, catecholamines and adiponectin facilitate PGC-1α activity by promoting its expression, and insulin inhibits PGC-1α through downstream phosphorylation, all independent of AMPK. As previously discussed, a ketogenic diet may increase catecholamines and adiponectin and is well known to decrease insulin, indicating that nutritional ketosis may directly facilitate PGC-1α activity through these hormones. Supporting these potential mechanisms, a ketogenic or low-carbohydrate diet has increased expression, protein content, and activation of PGC-1α [149, 231, 317], as well as expression of its target PPARα [87, 148]. Furthermore, in skeletal muscle of mice following a ketogenic diet, the resulting increases in O2 consumption and expression of genes related to fat oxidation appear to be dependent on PGC-1α [157]. Ketones likely contribute to this signaling as well based on the recent observation that the increased hepatic expression of PPARα targets induced by a ketogenic diet did not occur with a nonketogenic low-carbohydrate diet [37].
The involvement of the endocannabinoid system in the development of metabolic syndrome is indisputable.[33][34][35] Endocannabinoid overproduction may induce reward system dysfunction[34] and cause executive dysfunctions (e.g., impaired delay discounting), in turn perpetuating unhealthy behaviors.[medical citation needed] The brain is crucial in development of metabolic syndrome, modulating peripheral carbohydrate and lipid metabolism.[33][34]

I finally made this recipe. (I have made many of your others and use them often.) It did fall slighty but I was still able to slice it after it cooled. It was also purple, which is just fine with me. I toasted in the oven this morning and it was nice and crisp. I can’t tell you have happy I was to dip it in my fried egg this morning. Thanks, Maria, for all you do!
Can you put any yeast in the mixture? And if you did, would it help it rise more in addition to tasing more “yeasty”? I have been making (with great results) a browner, wheat colored bread from a recipe called Diedre’s For Real Low Carb Bread. It uses yeast and only has one rise after kneading with my dough hook attachment on my mixer. I would like to try some white bread.
Hi Maya, I’m new to your website and I’m anxious to try out this bread recipe. I’m helping my 27 year old son lose some weight. He’s on some pretty potent medication that has caused him to crave carbs thus putting on quite a bit of weight over the past few years. Since I’m his caregiver and also a Certified Nutritionist, I’m looking for some healthy alternatives to make his transition a bit easier and he loves bread.
I was reading through the comments on this recipe and noticed a number of posts by people who were disappointed because they had followed the recipe to the letter and the bread still didn’t turn out like yours. You did your best to help them sort out what the problem might be, but there were two issues that I didn’t see addressed that might make a difference: altitude and relative humidity. I live in Irvington, Alabama (near Mobile). I have been baking gluten-free for over twenty years and I realized long ago that nearly every recipe I used from Bette Hagman’s books had to be adjusted or they wouldn’t turn out. Then I remembered something from my earlier baking days using wheat flour. Most of the recipes I used noted that liquids and leavening have to be adjusted based on altitude and relative humidity to get recipes to rise properly and to avoid gumminess. That is, if you live at a much higher or lower altitude than Maria, or you live in a much wetter or drier climate, you will have to tweak the liquids and leavening to suit the area where you live. Start with about two tablespoons less water if you’re getting gummy results. Start with about one teaspoon less baking powder if your bread is rising too fast and forming a bubble. I imagine getting this recipe to work is like making any other kind of bread; after you’ve made it come out right a few times, you get a feel for what the dough should look/feel like in order to turn out.
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.

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.)
Fortunately, since peaking in 2001-2002, the overall prevalence of metabolic syndrome in the United States has fallen, primarily due to decreases in the prevalences of hypertriglyceridemia and hypertension—and in spite of increases in the prevalences of hyperglycemia and obesity/waist circumference. [27]  Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) showed that the age-adjusted prevalence of metabolic syndrome had fallen to approximately 24% in men and 22% in women. [28]
In the absence of acetyl CoA (several ways this can happen, including substrate shortage, as I’m describing here) we evolved a cool trick.  Our liver can make – out of fat or protein, though we much prefer to use fat so we can spare our protein and prevent severe muscle wasting – something called beta-hydroxybutyrate, one of the 3 ketone bodies I described above.

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One hypothesised contributor to neuronal death is insufficient energy production, secondary to impaired mitochondrial function. However, it is unclear if this is in fact a cause or effect of PD. Whatever the case may be, patients with PD have been shown to have impaired mitochondrial energy production in the brain59 and lower brain glucose utilisation60. Another factor may be neuro-inflammation, which is also common in PD, and is thought to lead to further accumulation of Lewy Bodies and neuronal death.
Ketones may also have effects in neurons beyond their use as an energy source. Preliminary work shows ketones can affect neurotransmitter release, reduce inflammation in the brain and reduce damage caused by oxidative stress8. Whilst the strength of the clinical evidence supporting the use of ketosis varies according to the condition, future work should look to explore the efficacy and underlying mechanisms further. Ketosis (by diet or by exogenous ketones) could offer an intervention that has good efficacy, but without the side effects profile of many drugs currently in use. It should be noted that the use of ketogenic diet or exogenous ketones in the conditions discussed below is still classified as ‘experimental’ in the most part and so individuals should not their alter medication or diet without full medical supervision.  
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So I made my own coconut-flour from flaked coconut(according to a recipe I found on line). Psyllium Husk i managed to find only in whole husks form so I grind it up to a powder in a blender. I understand now it sounds like a recipe for disaster but I don’t have another choice (getting the ingredients from the internet will take about 2 weeks and until then it is all I have).

Instead of a complicated keto bread recipe, this breakfast sandwich from Hey Keto Mama gets creative and simple by using spicy pork sausage patties in place of an English muffin or bagel. An egg plus a sriracha and cheese mixture are sandwiched in between, along with any veggies of choice (a slice of tomato and spinach would fit right in). To lighten it up, swap in turkey sausage patties and use just egg whites instead of the whole egg.


The difference between ketosis and ketoacidosis is the level of ketones in the blood. Ketosis is a physiological adaptation to a low carbohydrate environment like fasting or a ketogenic diet. There are situations (such as treatment-resistant epilepsy) where ketosis can be beneficial to health. Ketoacidosis is an acute life-threatening state requiring prompt medical intervention; its most common form is diabetic ketoacidosis where both glucose and ketone levels are significantly elevated.
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.
Some investigators feel that mitochondrial dysfunction and compromised brain glucose metabolism may play a role in the development of autism. As autism is sometimes accompanied by seizures such as those seen in epilepsy (which could be improved by the ketogenic diet), the diet has been trialled in a small number of case studies. These cases have shown that the ketogenic diet can lead to improvements in the childhood autism rating scale score 78 ,79, however dietary adherence may prove even more of a challenge with these children, decreasing the viability of the ketogenic diet as an intervention.   

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When you eat out at a nice place, what comes first? Oh, right. The so-perky-you-want-to-strangle-her girl named Brittany whose pleasure it is to serve you today. But I was talking about the meal itself. Most non-fast-food meals start out with a good salad. What could be healthier? Salads are generally low in both calories and carbohydrates. That means they are good for controlling blood sugar and controlling waistline expansion. An added bonus: if you get filled up with salad, you’ll be less hungry when it comes to the rest of the meal—so you’ll eat less of the stuff that’s “bad” for your blood sugar log. Eating less of that other stuff will help you with Tip Number 4.
The yeast in this low carb and keto bread ensures a wonderful texture and taste. Now, how much your bread will rise (and fall!) post-bake depends quite a bit on your altitude. But note that you still won’t get that gummy and wet texture here of most low carb breads. Plus, as mentioned, we’re baking at over 7,000 feet (Mexico City here!!), so if we can make this keto sandwich bread work so can you.

388. Little J. P., Safdar A., Wilkin G. P., Tarnopolsky M. A., Gibala M. J. A practical model of low-volume high-intensity interval training induces mitochondrial biogenesis in human skeletal muscle: potential mechanisms. Journal of Physiology. 2010;588(6):1011–1022. doi: 10.1113/jphysiol.2009.181743. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
After being in ketosis for a while, you may notice being able to tolerate a bit more carbs. If you so desire, gradually increase them and check for changes in your ketone levels and how you feel, look and perform (as Robb Wolf fond of saying). You could start by eating dairy products again. But beware if you’re highly insulin resistant, milk and yogurt can have enough carbs to kick you out of ketosis.
When you are choosing types of exercise, pick activities which are going to be enjoyable for you. When you perform activities that you enjoy, you have a better chance of sticking with them. You can occasionally change up the exercises that you do to prevent yourself from getting tired of following the same routine. Great examples of fun exercises are swimming, walking with a friend, or a dance class.
The metabolic syndrome quintuples the risk of type 2 diabetes mellitus. Type 2 diabetes is considered a complication of metabolic syndrome. In people with impaired glucose tolerance or impaired fasting glucose, presence of metabolic syndrome doubles the risk of developing type 2 diabetes.[28] It is likely that prediabetes and metabolic syndrome denote the same disorder, defining it by the different sets of biological markers.
SIRT1 is present in the cytosol and nucleus [239], while SIRT3 is primarily located in mitochondria where it regulates bioenergetics and ROS production [239–241]. The sirtuins, particularly SIRT1, appear to participate in a feed-forward cycle of reciprocal activation with AMPK. In skeletal muscle, AMPK indirectly activates SIRT1 by increasing NAD+ through increased mitochondrial β-oxidation [242] and increased expression of nicotinamide phosphoribosyltransferase (NAMPT) [243], which is the rate-limiting enzyme in NAD+ synthesis [244]. Completing the cycle, SIRT1 and SIRT3 can deacetylate and activate LKB1, thereby promoting further activation of AMPK. LKB1 is known to be activated by SIRT1 in adipose and liver [245] and by SIRT3 in cardiac muscle [246].
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The goal of the ketogenic diet is to keep you in this fat-burning metabolic state of ketosis. This is achieved by following a very low-carbohydrate, high-fat diet that includes only moderate amounts of protein. Foods like bread, cereal, processed snacks and sugary drinks are therefore off the table, while fattier foods like butter, grass-fed beef, fish and also non-starchy veggies take center stage, providing the majority of daily calories (as much as 70–80 percent).
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Another lipid marker of interest is blood triglyceride levels. Blood triglycerides are frequently elevated in the metabolic syndrome, and are a risk factor for cardiovascular disease111. A common misconception is that consuming high levels of fat leads to persistently high levels of blood triglycerides. However, there is data that suggests that a high fat diet does not affect blood triglyceride levels, and may even lower them21 ,112, especially following a period of adaptation113. 
Like many variables in diet, health, and disease, it behooves us to look beyond the bumper sticker explanation. I want to highlight a couple of posts I wrote, to attempt to provide a little more nuance and understanding to the subject: “Ketosis — advantaged or misunderstood state?” Parts I and II. Part I follows below. I’m hoping to write more on the topic in the not-too-distant future since there’s been a number of intriguing papers published recently (certainly since 2012). But I also wanted to bring these back into focus in light of the information I’m seeing more of on the interwebz. (You can also visit the Ketosis section of the site to view more articles on the subject.)
Fill half your plate with non-starchy vegetables. Split the other half in two between protein and whole-food carbs such as brown rice, quinoa, beans, legumes, or ancient grains such as amaranth, millet, or farro. These complex carbohydrates have more fiber and nutrients than processed carbs such as white rice, bread, and pasta, and the fiber helps control blood sugar levels.
If you are diagnosed with metabolic syndrome, the goal of treatment will be to reduce your risk of developing further health complications. Your doctor will recommend lifestyle changes that may include losing between 7 and 10 percent of your current weight and getting at least 30 minutes of moderate to intense exercise five to seven days a week. They may also suggest that you quit smoking.

In less time than it takes to order delivery, you can have this keto bread base ready to enjoy — plus, it requires no baking! A quick dough made from almond and coconut flours, xanthan gum, and egg, then sizzles in your skillet before taking on your favorite toppings. To keep this 2-carb pizza crust more Bulletproof, avoid eating xanthan gum too often.
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