359. Shelar S. B., Narasimhan M., Shanmugam G., et al. Disruption of nuclear factor (erythroid-derived-2)-like 2 antioxidant signaling: a mechanism for impaired activation of stem cells and delayed regeneration of skeletal muscle. FASEB Journal. 2016;30(5):1865–1879. doi: 10.1096/fj.201500153. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Drug treatment may be necessary to address other aspects of metabolic syndrome. Hypertension should be treated. Statins may be prescribed to treat unhealthy lipid levels. Some healthcare practitioners also recommend aspirin to decrease the risk of inappropriate blood clots. Some may prescribe medications to increase insulin sensitivity (although there is not widespread agreement on this).

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.
Although the primary purpose of ANT is to exchange newly synthesized ATP in the mitochondrial matrix for cytosolic ADP [129], it shares a common feature with UCPs and other inner membrane proteins in that they translocate anions, including fatty acids. The uncoupling mechanism of ANT, along with UCP2 and UCP3, may be the exchange of protonated fatty acids from the mitochondrial intermembrane space for fatty acid anions in the matrix, thereby dissipating Δp [123, 137–139]. Inhibition studies indicate that ANT may contribute more to uncoupling than UCPs [140, 141].

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.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
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Target organ damage occurs through multiple mechanisms in metabolic syndrome. The individual diseases leading to metabolic syndrome produce adverse clinical consequences. For example, hypertension in metabolic syndrome causes left ventricular hypertrophy, progressive peripheral arterial disease, and renal dysfunction. [12] However, the cumulative risk for metabolic syndrome appears to cause microvascular dysfunction, which further amplifies insulin resistance and promotes hypertension. [13]
Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical intervention for various conditions, such as intractable epilepsy, and the various types of diabetes.[6] In glycolysis, higher levels of insulin promote storage of body fat and block release of fat from adipose tissues, while in ketosis, fat reserves are readily released and consumed.[5][7] For this reason, ketosis is sometimes referred to as the body's "fat burning" mode.[8]

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.


Moving more . Even if you’ve never exercised before, you can start now and markedly reduce your risks. Even moderate amounts of activity will make a difference with heart markers. Walking is a good starter plan for many people. “I tell my patients to get an activity tracker,” Ndumele says. “Aim for 5,000 steps a day and work up to at least 10,000 steps a day.” Talk to your doctor to get the go-ahead on the types of workouts you want to try.
Yeah, odd prescription, I know, but dog owners are more active than non-dog owners. Why? Well…picture those big, brown, sad eyes pleading with you: Pleeeeeeeeeease take me for a walk. Frankly, most of us have a hard time with self-motivation. We’re tired, overworked, and stressed out—but we’re human beings. There’s a root word of humane in there somewhere. Often, we will do for others what we won’t do for ourselves; and pets are the hardest to say no to, because of the whole issue of interspecies communication. You can rationalize with your kid about why you’re too busy to play in the park with her, but your dog isn’t going to take no for an answer.

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.
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.

Yes, beating the egg whites until semi-stiff could trap even more air and result in fluffier bread. If you try it, can you let us know how it went? I’d be super interested to hear. As for the rise, it really depends on your tin. If it’s a large (regular) bread tin, your bread would probably not rise above. If you use a half-sized (ca 500g) tin, it should.
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Jenkins, D. J. A., Kendall, C. W. C., Augustin, L. S. A., Mitchell, S., Sahye-Pudaruth, S., Mejia, S. B., … Josse, R. G. (2012, November 26). Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: A randomized controlled trial. JAMA Internal Medicine, 172(21), 1653–1660. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1384247
Comments are welcomed and encouraged. The purpose of comments on our site is to expand knowledge, engage in thoughtful discussion, and learn more from readers.Criticism and skepticism can be far more useful than praise and unflinching belief.There’s an art and science to critical thinking and how to conduct yourself. There’s a multitude of fallacious appeals we could spell out, but a good rule of thumb is not to attack the person, attack the ideas. Don’t look for the flaws in the person, look for the flaws in the hypothesis. Let’s keep the brawling to movies depicting minor league hockey teams and political “news” shows.Thank you for adding to the discussion.
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.
[Guideline] Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol. 2009 Jan 20. 53(3):298-304. [Medline].

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]
In addition to eating small meals at night, it's best to limit dishes piled high with pasta, rice, sugar, and other carbs. “When you focus on whole-food carbs spread throughout the day, the less pressure there's going to be on your pancreas to constantly chug out insulin,” Wright says. You want your blood sugar to roll like hills over the course of the day rather than spike like mountain peaks and plummet to valleys, she adds.
Because I know people will ask, I have not been on a ketogenic diet “regularly” since about mid- to late-2014. The reasons are too nuanced to describe here, but my deviation is not because I lost confidence in its efficacy. With nearly a decade of clinical experience, I can safely say I was an outlier (in the best sense) with respect to my physiology and response. I was leaner, and more mentally and physically fit during this three year period than during any other period of time as an adult, and my biomarkers were as good as they had ever been. I’ve also seen the benefit of ketogenic diets first-hand on my patients and my own sister, a remarkable story I hope to share one day. But I’ve also been humbled by my inability to explain why some people have suboptimal or even negative responses to NK. I would say, all things considered, my knowledge of ketosis is greater today than when I was writing about it voraciously, but my confidence in my understanding of it, might actually be lower. As the saying goes, the further one goes from shore, the deeper the water gets.
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.
As ketones are the only other metabolic substrate that can fuel the brain, there is a compelling mechanism whereby ketosis could improve brain energy metabolism and therefore improve symptoms of AD. Despite a declining ability of the brain to use glucose, cerebral ketone metabolism is preserved in AD (Castellano2015). This means that ketosis could be used to prevent an energy deficit in the brain. Another possibility is that ketone metabolism decreases mitochondrial damage caused by oxidative stress in the brain52. Individuals with AD tend to have increased mitochondrial oxidative stress, which can worsen brain energy production and increase plaque and tangle formation53.  
Metabolic syndrome is a burgeoning global problem. Approximately one fourth of the adult European population is estimated to have metabolic syndrome, with a similar prevalence in Latin America. [25] It is also considered an emerging epidemic in developing East Asian countries, including China, Japan, and Korea. The prevalence of metabolic syndrome in East Asia may range from 8-13% in men and from 2-18% in women, depending on the population and definitions used. [29, 30, 31]
Where does nutrition info come from? Nutrition facts are provided as a courtesy, sourced from the USDA Food Database. You can find individual ingredient carb counts we use in the Low Carb & Keto Food List. Carb count excludes sugar alcohols. Net carb count excludes both fiber and sugar alcohols, because these do not affect blood sugar in most people. We try to be accurate, but feel free to make your own calculations.
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.
The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
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.
A high proportion of energy from ketone oxidation is transferred to the electron transport chain at the start (as NADH+), in comparison to the energy from fat, where a high proportion is transferred ‘downstream’ (as FADH). This means that, even though there is a high amount of ‘potential energy’ in a fat molecule, less of this can be transferred to ATP.   
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.
If someone has already had a heart attack, their LDL ("bad") cholesterol should be reduced below 70mg/dl. A person who has diabetes has a heart attack risk equivalent to that of someone who has already one and so should be treated in the same way. If you have metabolic syndrome, a detailed discussion about lipid therapy is needed between you and your doctor, as each individual is unique.
The FOXO family of transcription factors is highly conserved and promotes longevity and resistance to cellular stress. Although there are a variety of FOXO isoforms with varying tissue distribution [318–320], FOXO3a has been the most thoroughly studied in relation to energy sensing, mitochondrial function, and antioxidant defense. Similar to PGC-1α, FOXO3a is activated through phosphorylation by AMPK [321–323] and deacetylation by SIRT1 [324, 325] and SIRT3 [326–329], and its transcriptional activity is at least partly dependent on AMPK [322] and SIRT1 [325]. In a variety of organisms, tissues, and cell types, FOXO3a increases mitochondrial biogenesis and expression of TFAM [329], but is more known for increasing expression of antioxidant and repair proteins, including SOD2 [287, 330, 331], catalase [287, 330, 332, 333], glutathione S-transferase (GST) [322], thioredoxins [287, 323], Prx3 [287, 334], Prx5 [287], and metallothioneins I and II [322], as well as UCP2 [287, 322] and the DNA repair enzyme growth arrest and DNA damage-inducible 45 (GADD45) [322, 324, 335, 336]. FOXO3a is also activated by oxidative stress [324, 331, 333], possibly in a SIRT1-dependent manner [324], and likely mediated through c-Jun N-terminal protein kinase (JNK), which allows FOXOs to translocate to the nucleus by promoting dissociation of 14-3-3 [337, 338]. Furthermore, FOXO3a and SIRT3 interact in mitochondria to induce mitochondrial gene expression in an AMPK-dependent manner [339]. FOXO3a also induces expression of LKB1 [340] and NAMPT [341], indicating a feed-forward cycle of activation with AMPK and sirtuins. Like PGC-1α, FOXO3a transcriptional activity is inhibited by insulin through PKB [331].
Back in the really old days (like in the Paleolithic), life had some challenges. Like saber-tooth tigers. What happened when your ancient ancestors encountered a saber-tooth cat? I imagine they threw their hands up in the air, screamed, and ran like hell. To assist in the running like hell, their bodies would dump sugar into their blood for extra energy. To this day, our bodies still do that. The problem is that the modern saber-tooth tiger is the overdue electric bill, the dropped cell phone call, the dinnertime telemarketer, and the annoying neighbor. You can’t run away from any of these tigers. The extra sugar just sits in your body. But you can learn to defeat this ancient biological fight-or-flight response by learning how to relax. You’ll need to make time for you. It might be a warm bubble bath in the evening, a good book at lunch, aromatherapy candles, or even kickboxing. Take that, saber-tooth tiger. Bam!
To get into ketosis without supplementation, you have to keep your insulin levels low. Supplementing with exogenous ketones can help get you into ketosis [17]. However, you won’t have achieved the same beneficial physiological changes as you would have from a well-formulated ketogenic diet or fasting. This is why we at Nutrita don’t recommend exogenous ketones as a substitute for a well-formulated ketogenic diet.

The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
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Engage in exercise. According to the American Diabetes Association, exercise can help lower your blood sugar level by using the excess sugar as fuel. If, however, your blood sugar level is over 240 mg/dL, use a urine test strip to check your urine for the presence of ketones. When ketones are being produced by the body, exercise can cause your blood sugar levels to rise, rather than decrease. Physical activity can have immediate benefit in lowering blood sugar and also long-term benefit by helping to stabilize blood sugar levels.
So, now, I’ve got another loaf in the oven. I doubled the salt, ground up the Psyllium Husk in my Blend Tec (instead of the shoddy thing I used the first time) and reduced the baking soda to 3 tsp. I also (accidentally) ended up with 1 egg yolk in there. Hopefully, that won’t cause too much of an issue. I weighed all my ingredients and I’m hopeful that this batch will give me the results I am looking for. I would *love* a grilled cheese sandwich for a quick-fix dinner with my keto plan. 🙂 Thanks for the recipe. I’ll let you know how this batch turns out.

The SS providing information to the brain mainly send information to the nucleus of the solitary tract (NTS). These signals are generated in the GIT and abdominal viscera, as well as in the oral cavity and provide information about mechanical and chemical properties of food. The information is transmitted via vagal and spinal nerve to the NTS. The ASs arrive to the median eminence through ARC or through the blood-brain barrier (BBB). All these afferents are integrated in a complex and not fully understood network.
Hi there, how many slices you get really depends on the kind of loaf pan you use. I find I get around 20 slices for a bread made in the regular loaf pan (though with this recipe they will be rectangular rather than square) and 12-14 slices using a small loaf pan as described in the post. That’s why I decided to state a portion size – 12 per bread. 1 portion = 0.6 net carbs
Ketones are a special type of fat that can stimulate the pathways that enhance the growth of new neural networks in the brain. A ketogenic diet is one that is high in fats, and this diet has been a tool of researchers for years, used notably in a 2005 study on Parkinson’s patients finding an improvement in symptoms after just 28 days. The improvements were on par with those made possible via medication and brain surgery. Other research has shown the ketogenic diet to be remarkably effective in treating some forms of epilepsy, and even brain tumors.
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]
The Mediterranean diet is palatable and easily sustained. In addition, recent studies have shown that when compared to a low fat diet, people on the Mediterranean diet have a greater decrease in body weight, and also had greater improvements in blood pressure, cholesterol levels, and other markers of heart disease -- all of which are important in evaluating and treating metabolic syndrome.
Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.

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After a period of time, your body becomes adapted to using ketones as fuel instead of glucose. Your muscles begin to learn to convert acetoacetate into a ketogenic substance called beta-hydroxybutyrate, or BHB. BHB then becomes the new preferred ketogenic source of energy, including to fuel all brain activity. What is not needed is expelled from the body as waste.
Metabolic syndrome promotes coronary heart disease through several mechanisms. It increases the thrombogenicity of circulating blood, in part by raising plasminogen activator type 1 and adipokine levels, and it causes endothelial dysfunction. [14] Metabolic syndrome may also increase cardiovascular risks by increasing arterial stiffness. [15] Additional mechanisms include oxidative stress, [16] which has been associated with numerous components of metabolic syndrome. [17]
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.
When your carb intake is that low, your body can't burn glucose (a.k.a the sugar from carbs) for energy like it normally would. So instead, it burns fat for energy, a process that then releases ketones as a byproduct, says Eric Klett, M.D. an endocrinologist and associate professor of medicine and nutrition at the University of North Carolina at Chapel Hill. (This process explains why people on the keto diet see such crazy weight-loss results.)
I have just tried this recipe and I am so pleased with the result ! I am not a confident baker but the recipe is quite easy to follow. I now have bread that I can use for sandwiches and looking forward in particular to toast for breakfast tomorrow. You have made me so happy as I was beginning to think that I would not be able to find an edible low carb/gluten free /dairy free bread. Not eggy at all and a lovely soft texture. I made it with the coconut oil as a dairy free alternative and the taste of the coconut is quite pronounced. I was interested to see that someone else used olive oil . Do you know what amount of olive oil would be appropriate ? Thank you again, I will be trying out your other recipes now that I have found your website.
Lipodystrophic disorders in general are associated with metabolic syndrome. Both genetic (e.g., Berardinelli-Seip congenital lipodystrophy, Dunnigan familial partial lipodystrophy) and acquired (e.g., HIV-related lipodystrophy in patients treated with highly active antiretroviral therapy) forms of lipodystrophy may give rise to severe insulin resistance and many of metabolic syndrome's components.[27]
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This keto bread recipe delivers sweet heat with no corn whatsoever — instead, it uses a blend of coconut flour and sweetener to capture the same taste and texture for about 3 net carbs per serving. Add fresh cranberries and jalapeño slices for a fun twist that pairs well with holiday meals. To keep this recipe more Bulletproof, use grass-fed butter, swap almond milk with full-fat canned coconut milk, and skip the peppers if you have a nightshade sensitivity.
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