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.
Keep in mind that the ketogenic diet takes into account net grams of carbohydrates, not simply total grams. Net carbohydrates are the amount of carbohydrates left over after you subtract grams of fiber from total grams of carbohydrates. For example, if vegetables you’re eating have 5 grams of carbohydrates total, but 3 grams come from fiber, the total number of net carbohydrates is only 2 grams, which is the number you add to your daily total.
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While there’s no such thing as a diabetic diet anymore, there’s only so much your system can handle at once when it comes to foods that turn into sugar quickly. Here’s my advice: deprive yourself of no food, but limit yourself to one carb portion per meal. Carbs tend to be white in color: things made of flour (including pasta), potato, rice, and sugar. Oh, and corn is pale yellow, so it’s a white food, too. If you make sure every meal has only one white food, you’ll lower the blood sugar impact of the entire meal. If you want a baked potato, that’s not the meal to have a dessert with. If you want some ice cream, keep the meal to a pork chop, some green beans, and some cottage cheese (along with cauliflower, the only white-colored food that isn’t on the white foods list).
In order to best investigate the efficiency of different fuels, one needs a closed system, where the substrate conditions can be changed and the oxygen consumption and work done can be accurately measured. Isolated (ex-vivo) animal hearts are the best model to study these variables, as it is easy to manipulate the fuel provided (i.e glucose, ketones), to measure the oxygen use and also the amount of work (how much fluid is pumped). 

^ Lockyer, Christina (1991). "Body composition of the sperm whale, Physeter cation, with special reference to the possible functions of fat depots" (PDF). Journal of the Marine Research Institute. 12 (2). ISSN 0484-9019. Retrieved 2014-04-25. The significant levels of carbohydrate, probably mostly in the form of glycogen, in both blubber and muscle, may represent an instant form of energy for diving via anaerobic glycolysis.


AMP competes with ATP for binding to the γ regulatory subunit of AMPK [177, 178] and by doing so, greatly increases AMPK activity, but only in the presence of an upstream kinase such as liver kinase B1 (LKB1) [179]. This binding of AMP to the γ subunit appears to promote AMPK activity through at least two mechanisms: facilitated phosphorylation of the α subunit [180–183] and inhibition of dephosphorylation by protein phosphatases 2Cα and 2Ac [179, 181, 183, 184]. ADP also binds to the γ subunit of AMPK to inhibit dephosphorylation [183, 185, 186] and possibly facilitate phosphorylation [185]. This is important to the energy sensing sensitivity of AMPK based on the much higher physiological concentration of ADP compared to AMP [186]. Data on changes in AMP and ADP levels in response to a ketogenic diet are lacking. However, the decreased availability of carbohydrate and increased mitochondrial uncoupling (previously described) during nutritional ketosis suggest a decline in ATP production, at least until compensatory adaptations occur. A decline in ATP implies a relative increase in AMP and ADP, which would facilitate AMPK phosphorylation and activation. In addition, ketogenic diets are commonly reported to have a satiating effect [187], which may further increase the AMP and ADP to ATP ratios through spontaneous caloric restriction.

Hi Melissa, Are you beating the whole eggs? It needs to be egg whites only. Whole eggs will never form peaks. Adding a little cream of tartar helps, as well as making sure you start with a very clean bowl (preferably not plastic if you’re having issues). Having the egg whites at room temperature can be a little easier, too, though I usually don’t need to. Hope this answers your question!

I made the bread yesterday but came out wet and gummy. I will try again but I would recommend anyone trying this bread for the first time to just make half the recipe until you get it right so you are not wasting expensive ingredients. This is what I am going to do. Also it was a good point about humidity. I live in a very humid area so I will have to try decreasing the water.
Hi Ashley, Usually egg whites take just a few minutes to beat to stiff peaks. Definitely not 40 minutes. Old eggs can sometimes be the culprit, or a bit of leftover fat/grease from something else in the bowl can prevent stiff peaks (this is especially common when using a plastic bowl). Lastly, it could be that your mixer isn’t powerful enough to beat that many whites to stiff peaks, but this reason is a last resort and probably less likely. Cream of tartar is a huge help in reaching stiff peaks so you can try adding that next time.
We are brazilian, living in Brazil. My daughter, Isabel, 21y. o., born in 1996, has syndrome of deficiency of Glut1. She was diagnosed around her first year of life. At that time her baby bottle, her begining diet meal, was 50ml water plus 50ml oil plus vitamin. Since then, which means, for 20 years, she is under this diet. For almost 18 years under 4:1 proportion. At this right moment 3:1. The only problem she had since started the diet were kidney stones in 2002. Nothing else. Grateful to the diet she doesn’t take any kind of medicine to avoid seizures. Her health is perfect, no colesterol at all. We are at your will for any issues related to her health.

Your muscles need blood glucose for fuel, which means that when you take that barre or CrossFit class, you’re helping move blood sugar from the bloodstream into the muscles where it’s then burned up. Over time, this can lower blood sugar levels and increase insulin sensitivity (i.e. how well your cells are able to absorb glucose from the blood and use it for energy). Intense exercise can temporarily raise blood sugar, so if you have poor blood sugar control, it make sense to start moderate (think: walking, jogging, or yoga), and then work your way up.


I made this bread several times by grinding the jay robb psyllium husks, but never got a good loaf. Then I bought the now brand psyllium husk powder and it worked without turning purple. I did have to weigh everything and cook it about an hour and a half or longer. When I cooked it the first time it sank in the middle. If you don’t have a vitamin or blend tech this is the way to go.
In contrast to most other diet plans, remaining in ketosis doesn’t require counting calories, measuring portions or dealing with hunger pangs for the sake of eating as little as possible. In fact, most people feel satisfied and energized while in ketosis and find that they can go for longer periods without the need to eat (which is why intermittent fasting is commonly practiced with a keto diet).
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].
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The brain is a particularly greedy organ when it comes to energy requirement. To put this comment in perspective consider the following: though our brain represents only about 2% of our body mass, it accounts for about 20% of our energy expenditure.  (In children, by the way, this may be closer to 40-50% of basal metabolic demand.) So, beyond the ATP issue, above, there is a substrate issue with the brain as neurons derive most of their energy from glucose.  While there is emerging evidence that neurons can also oxidize fatty acids directly in small amounts and may even prefer lactate (over glucose), these two substrates do not approach the levels of consumption by neurons that glucose does.  So, for the purpose of this discussion, let’s just focus on the need of the body to provide glucose to the brain.
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].
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.
I had the same problem. Everything blended beautifully, rose in oven, then fell. Toothpick came out clean after 45 min of baking. I let it cool and then cut into it this morning and it has raw spots throughout the loaf. I am so disappointed because I killed a dozen eggs to make it and really don’t want to do it again. I wonder if the oven needs to be warmer and the cooking time needs to be increased?
As for the bacon, I lay it out in my biggest iron skillet and bake it in the oven while the eggs are in the Instant Pot, the timing works out almost perfectly.  If you’ve got a busy week at work or are going through finals week as a student (or teacher) make these bad boys the Sunday before and roll them into 10 balls rather than 8 and have 2 for breakfast all week long, rather than skipping breakfast and subjecting yourself to UIF (Unintentional Intermittent Fasting).
Losing weight is 80% diet. Volek and Phinney did a study where they put people on a High fat (65-80% of calories from fat, 50-75 grams protein and low carb) and had one group do no exercise, one do resistance training and one to resistance training and cardio. All 3 groups lost the same amount of weight on average. But the resistance training group lost almost entirely fat while preserving muscle mass, which is important. So I always advocate some resistance training. 🙂
I have been making Maria’s bread in my convection oven for a while and I had to lower the temp considerably to make sure it didn’t burn on the outside (even with a shorter baking time). I have a “portable” convection oven and I had always assumed that convection was the way to go for baking. Then I read some more about it and saw that convection is best for meats, etc. but not for baking, and I tried using the ‘normal” baking setting. My bread was MUCH better baked on normal. I used the temperature in the recipe and the timing and it came out perfect. No monkeying around with settings or duration.
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-
Hey Maya!! This is the 2nd recipe I’ve tried off your website and again I love it!! Turned out really well. I can have sandwiches again or a quick piece Of toast when I’m in a hurry to get out the door. I was skeptical about the xanthan gum since I tried a recipe using psyllium husk powder. I did not like it. I can’t taste the xanthan gum so I have no problem using it going forward. Thanks again for the recipe!!!
White mulberry (Moruns alba or Morus indica) has been traditionally used in Asia to help treat type 2 diabetes, and there is some preliminary evidence to support this use. Mulberry leaf extract (species not given) may lessen increases in blood sugar after ingestion of table sugar in healthy people and people with type 2 diabetes (Mudra, Diabetes Care 2007). Among people with type 2 diabetes, taking 1 gram of powdered white mulberry leaf three times daily (after breakfast, lunch and dinner) for four weeks was found to lower fasting blood sugar by 27%, while taking 5 mg of the anti-diabetes drug glibenclamide lowered fasting blood sugar by only 8% (Andallu, Clin Chim Acta 2001).
Losing weight is 80% diet. Volek and Phinney did a study where they put people on a High fat (65-80% of calories from fat, 50-75 grams protein and low carb) and had one group do no exercise, one do resistance training and one to resistance training and cardio. All 3 groups lost the same amount of weight on average. But the resistance training group lost almost entirely fat while preserving muscle mass, which is important. So I always advocate some resistance training. 🙂
Interestingly, one study showed that weightlifters on a ketogenic diet lost lean body mass, but this did not lead to a decrease in performance [16]. This suggests that the measured reduction of lean body mass was not due to a loss in actual muscle tissue, but probably due to a loss of water and glycogen content in the muscles. Muscles can be made to look bigger or achieve ‘the pump’ by eating lots of carbs which fills them with water and glycogen.
Once your yeast is proofed, add in the egg, egg whites, lightly cooled melted butter (you don't want to scramble the eggs or kill the yeast!) and vinegar. Mix with an electric mixer for a couple minutes until light and frothy. Add the flour mixture in two batches, alternating with the sour cream, and mixing until thoroughly incorporated. You want to mix thoroughly and quickly to activate the xanthan gum, though the dough will become thick as the flours absorb the moisture. 

Hey Maria, I am baking my third loaf of your amazing bread. I’ve been having trouble with it rising and keeping risen, but it is still delicious. This time it has risen to new heights and I’m hoping it stay high. I don’t usually make comments because I almost always make changes to recipes. I added onion powder, garlic powder and caraway seeds. It bothers me when people give recipes poor ratings after they have changed them. Anyway, the reason for my comment is to thank you and tell you how brilliant, amazing and stupendous you are. Using psyllium is genius. I have been making various low carb breads for years, some that I invented, others not. Anyway, nothing I have made has ever come close to the taste or texture of yours. Thank you, thank you, thank you.
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):

Although the majority of links between energy sensing and antioxidant defense are manifested further downstream, there is some direct influence at the level of AMPK and sirtuins. AMPK is activated by oxidative stress [259, 260], likely through ATP depletion and a subsequent increase in the AMP to ATP ratio, or facilitation of tyrosine phosphorylation, which occurs independently of AMP and ATP concentrations [259]. SIRT3 contributes more directly to antioxidant defense by deacetylating and activating SOD2 [261–263]. The overlapping effect of SIRT3 on antioxidant defense and bioenergetics is further supported by SIRT3 knockout increasing lipid peroxidation in conjunction with decreased O2 consumption in mouse skeletal muscle and also by SIRT3 knockdown increasing H2O2 production and decreasing O2 consumption in myoblasts [264].
Typically, to gain lean body mass one needs to have some degree of caloric surplus, or at the very least, not be in a significant deficit. This is especially true when looking to add muscle mass. It is certainly possible to gain muscle mass on a ketogenic diet. For most individuals this would require consuming adequate protein (while still remaining in ketosis), enough calories to support growth, sufficient electrolytes to support muscle function, as well as incorporating progressive resistance training. The type and volume of resistance exercise needed to add lean body mass will be very dependent on the individual and their age, training status, health status, etc. Therefore, the answer to this question can become quite nuanced, but in simple terms, yes, it is very possible to gain lean body mass on a ketogenic diet while still taking advantage of the health promoting effects this way of eating provides.

Ok, My last question before I try it for the 5th time. Thank you for taking the time to answer!! I know you say grind it more, but here is my dilemma. You says yours weighs 90 grams for 10 tablespoons. So, i weighed mine out (I grind in a high power vitamix) my 10 tablespoons weight 115 grams…so mine is more dense than yours. I’m torn, should I actually grind less? Buy another brand? Maybe Frontier? Thanks for any help. I am so frustrated not having a bread sub for my grain free family 🙁 I tried protein bread but I have this awful aversion to cream cheese taste and can’t seem to get over it 🙁 Even if I could just get a baguette or roll to work out I’d be so happy! I get my hubby’s hopes up every time it bakes because it smells so good! Thanks again!


In a subsequent series of experiments, glucose metabolism in C. elegans was inhibited by knockdown of the insulin receptor, insulin-like growth factor 1 (IGF-1) receptor, and insulin receptor substrate 1 (IRS-1) [73]. Consistent with the previous study [72], inhibition of glucose metabolism increased mitochondrial respiration concomitant with ROS-dependent increases in lifespan, stress resistance, and antioxidant enzyme activity. However, in this case, detection of ROS was mitochondria-specific, and repeated measures allowed for changes in antioxidant enzyme activities to be evaluated more closely in relation to the timing of changes in mtROS. Compared to controls, inhibition of glucose metabolism resulted in higher mitochondrial O2 consumption at 12 h, higher mtROS production at 24 h, and higher activities of SOD and catalase at 48 h, suggesting a dependence of antioxidant activity on mtROS and a dependence of mtROS on mitochondrial respiration. The most striking result is the lower mtROS at 120 h, indicating that the initial increase in mtROS and subsequent increase in antioxidant enzyme activity ultimately lowered net mtROS production to a level lower than controls, which is the proposed explanation for the more than twofold increase in lifespan. As with the previous study, this demonstration of mitohormesis is further supported by the changes in ROS production, antioxidant enzyme activity, and lifespan having been prevented with antioxidant treatment.

My loaves always had air pockets and a gummy texture. I made a loaf yesterday and when I was putting it in the oven, the power went out. The dough sat on the counter for 3 – 4 hours until the power came back on and I was able to bake it. The finished loaf cooled in the oven all night (I took it out of the loaf pan) and when I cut into it this morning, the texture was perfect – no gooey middle, no air pocket! Perhaps the secret is to let the dough rest before baking??
Just wanted to share that I made this recipe yesterday. I don’t have a lot of success with loaves so I used my bun top pans and the recipe gave me 12 rolls and a small loaf which I cut into 6 slices for a couple of french toast breakfast treats for me! I used a 1/4 cup measure for the rolls (not packed) and pressed the dough into the round shape. I thought I’d only get 6 actual burger buns but they were big enough to carefully slice in half so I got 12! I baked the rolls for 30 min and the loaf for 60. This will be my go to from now on! Thank you!
Thanks for starting a new recipe since the comments were getting out of hand on the sub rolls post 🙂 Can you say what size loaf pan you used for this. I have tried the recipe twice in a loaf pan of 2 very different sizes, and they turned out radically different. I think there is a sweet spot which you obviously found with yours. I’d like to find it for mine, too. Thanks for the great bread recipe. It’s one of the only recipes I know by heart because it is so elegantly simple.
Adipose tissue can be used to store fatty acids for regulating temperature and energy.[21] These fatty acids can be released by adipokine signaling of high glucagon and epinephrine levels, which inversely corresponds to low insulin levels. High glucagon and low insulin correspond to times of fasting or to times when blood glucose levels are low.[23] Fatty acids must be metabolized in mitochondria in order to produce energy, but free fatty acids cannot penetrate biological membranes due to their negative electrical charge. So coenzyme A is bound to the fatty acid to produce acyl-CoA, which is able to enter the mitochondria.
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.
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).
Considering the high rates of obesity now facing most developed nations — along with an increased risk for health conditions like diabetes or heart problems as a result — researchers have been anxiously working on how to suppress appetite and achieve weight loss in a healthy, sustainable manner. The keto diet has emerged over the past several decades as one potential answer to this large-scale weight loss problem. (1)

Love how quick and easy these are to whip up and they’re really satisfying to eat. Made them tonight to use as hamburger buns; sliced them in half and grilled them and they worked great. I think the coconut gives them some sweetness that reminds me of cornbread (I used a coconut/almond milk blend for the liquid). I think we’ll be making a lot of these!
Swigging ACV may not sound appealing, but it could help keep blood sugar in balance if taken before you eat. Some research has found that consuming apple cider vinegar before meals reduced blood glucose levels of patients with prediabetes by nearly half. The theory is that acetic acid, a component of the vinegar, slows down the conversion of carbohydrates into sugar in the bloodstream. Pro tip: Mix a tablespoon or two into a glass of water—taking it straight will burn!
A hearty breakfast satisfies the soul — that is, unless your syrupy plate of pancakes sends you into a sugar rush and carb coma. If you’re following a ketogenic diet, though, you still have options for keto breakfast recipes. Even if you enjoy a frothy cup of Bulletproof Coffee most days, these dishes are the perfect way to kick off your weekend or change up your morning routine.
Brittany, Thank you so much for leaving a comment! Without being there in the kitchen with you, it’s difficult to say what the issue was; however, I can definitely help you troubleshoot…did you cook it for the full amount of time the recipe calls for, and did you cover the top with foil for the last 15 minutes? If so, there might be an issue with your oven’s calibration (you can get an inexpensive oven thermometer to check this). Another tip is to let your eggs come to room temperature first. Another factor is the altitude at which you’re baking; if you’re at high altitude, you might need to slightly adjust the oven temperature and bake time. The other thing to remember is that there will usually be a little bit of fall to most keto breads (in fact, every keto bread we’ve ever made) because keto flours lack gluten and are naturally quite dense; however, you can see in the photos, we still got a good rise on this loaf. I hope these tips help!
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