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]
People who have metabolic syndrome typically have apple-shaped bodies, meaning they have larger waists and carry a lot of weight around their abdomens. It's thought that having a pear-shaped body — that is, carrying more of your weight around your hips and having a narrower waist — doesn't increase your risk of diabetes, heart disease and other complications of metabolic syndrome.
Hi Maria! Just wanted to say I love this recipe and I found a way to make similar single servings quickly that look like english muffins! I just use a greased ramekin and combine 2 tbsp almond flour, 2 tsp psyllium husk (or 1 tsp powder), pinch of salt and baking powder. Then stir in 2 tbsp + 2 tsp egg whites, 2 tbsp water, 1 tsp olive oil and 1/8 tsp apple cider vinegar. Microwave for 1 min then flip out onto a plate and microwave for another 30 sec. Toast and top with whatever you’d like! 🙂

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.

[…] One of the things I’ve grown to love over the years is fried eggs with runny yolks. They’ve become a regular breakfast for me on the weekends. However, when I do regular low carb high fat meals, I like to have toast to dip into the egg yolks. Psyllium low carb bread seems to be all the rage right now, so I came up with this coconut flour psyllium husk bread that is perfect with my morning eggs. I’m not really sure who started the low carb psyllium bread trend, but one of the first breads I’ve found was Maria Emmerich’s Amazing Bread. […]


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.
The sirtuin isoforms SIRT1 [232, 233] and SIRT3 [234–236] are nicotinamide adenine dinucleotide- (NAD+) dependent deacetylases associated with longevity. Many reactions are regulated by the redox state of NAD+ and its phosphorylated form, NADP+. Among these reactions, a prominent role of reduced NADP+ (i.e., NADPH) is to support reductive biosynthesis and antioxidant defense, requiring the NADP+/NADPH ratio to be kept low [237]. In contrast, the NAD+/NADH ratio is kept high to support energy metabolism [237], thereby linking sirtuin function to bioenergetic status [238]. Although sirtuins are inhibited by high concentrations of NADH, their activity is influenced more by absolute NAD+ concentration than the NAD+/NADH ratio [238].
The gastrointestinal tract (GIT) plays a central role in the control of energy balance. Many molecules produced by the GIT exert hunger or satiety effects on the brain. Ghrelin is a peptide produced mainly by the stomach's oxyntic cells that stimulates ghrelin secretion in the hypophysis and has some neuroendocrine activities. However, its orexigenic properties are the most relevant to us and ghrelin is the only known peripheral orexigenic hormone (Date, 2012). Cholecystokinin (CCK) is a peptide produced mainly in the duodenum and jejunum that acts on the vagus nerve and directly on the hypothalamic nuclei. CCK is an anorexigenic factor and it reduces food intake, meal size and duration (Murphy et al., 2006). Three other related hormones are pancreatic polypeptide (PP), amylin, and peptide YY (PYY). PP is a peptide produced by the endocrine pancreas in relation to the caloric content of meals, and it reduces food intake both in rodents and humans. Amylin is a peptide co-secreted with insulin; its main effect on food control is a reduction of meal sizes and food intake (Murphy et al., 2006). Peptide YY (PYY) is produced in the gut and is similar to PP. PYY is stored in intestinal cells and released into the circulation as PYY3−36, a truncated form of PYY. The release of PYY3−36 is dependent on a meal's caloric and fat content (Veldhorst et al., 2008). The glucagon-like peptide 1 (GLP-1) is produced by the cleavage of pro-glucagon gene in the intestine. It acts as incretin at a pancreatic level, promoting insulin secretion and as neuro hormone on hypothalamic nuclei, inducing satiety (Valassi et al., 2008).
Increasing dietary fiber, especially insoluble fiber from cereal and grains, is associated with a reduced risk of diabetes and has been shown to reduce fasting blood glucose and modestly lower HbA1c in people with type 2 diabetes (Martin, J Nutr 2008; Post,J Am Board Fam Med 2012). In people with type 1 diabetes, 50 grams of dietary fiber per day has been shown to significantly improve blood sugar control and reduce hypoglycemic events (Giacco, Diabetes Care 2000). The American Dietetic Association states that "diets providing 30 to 50 g fiber per day from whole food sources consistently produce lower serum glucose levels compared to a low-fiber diet. Fiber supplements providing doses of 10 to 29 g/day may have some benefit in terms of glycemic control." (Slavin, J Am Diet Assoc 2008). Although ConsumerLab.com has not tested fiber products, we have produced a webinar about that provides more information.
I’m just starting a new low carb diet and I love your channel. You have so many great and easy recipes but I will definitely be trying this bread out. I love burgers, and was sad I won’t be able to have a bun anymore. I tried a different recipe before and it just tasted like eggs. This looks like it will work much better for me. I may try and make a few batches all at once in the oven and then freeze it for later. Rock on! \m/
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Yolks are great. Make a healthified custard, or a custard ice cream (Maria has recipies for both). I’m a diabetic and I got that way eating “real” food, not manufatured food. I baked. All from scratch, all homemade. But that meant traditional sugar and wheat flour. I had developed a number of reduced carb recipies on my own, but Maria’s recipies go all the way with better success than I would have guessed possible. (I still yearn for a good, two-day rise wheat and yeast bread — But I know allow myself this only once a quarter. It is not good for you.) I’m excited to try this. So far my favorite has been her psyllium powder/egg/boiling water version pizza crust. A homemade pizza made with this tastes as good as any pizza.

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Loaded with protein-packed ground beef, sharp cheddar, veggies, and everyone's favorite taco add-ons (salsa and sour cream, anyone?), this skillet from Peace, Love, and Low Carb is like eating nachos for breakfast — minus the chips. The best part: It can be meal prepped ahead of time for a week's worth of breakfasts. (Just leave the toppings off and add them after you've heated up a serving in the morning.) Who says tacos only belong on Tuesdays?
82. Schwarz J. M., Neese R. A., Turner S., Dare D., Hellerstein M. K. Short-term alterations in carbohydrate energy intake in humans. Striking effects on hepatic glucose production, de novo lipogenesis, lipolysis, and whole-body fuel selection. Journal of Clinical Investigation. 1995;96(6):2735–2743. doi: 10.1172/jci118342. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
I can’t find an 8×4 pan in the local stores, so while I wait for one to be shipped I went ahead and made these into hamburger bun shape. I don’t have a kitchen scale so I just measured everything super precise and got great results. I only have NOW brand psyllium husk powder so yes, they are an odd shade of purple but they taste great so I don’t care. What I really wanted was a vessel for butter and it made for a great snack before bed- which I know I’m not supposed to have but I was too curious to wait until morning! 🙂 Thanks for the update on this recipe, it made all the difference!
Blood tests often report the level of total cholesterol (HDL + LDL) as well as the levels of each type independently. It is possible that the relative abundance (ratio) of HDL: LDL is more important to predict the occurrence of cardiovascular disease that the total cholesterol level109. Whilst the ketogenic diet can cause an increase in total cholesterol, the ratio of healthy HDL : less healthy LDL generally increases (i.e more HDL)110 whilst following a ketogenic diet. In contrast, whilst total cholesterol tends to be lower whilst following a low fat diet, the ratio of HDL:LDL tends to be lower (i.e more LDL)21. 
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].
Maria and Craig: I made this recipe (into kaiser roll shapes) on Sunday night for the first time. I just ate my first sandwich (pork roast and mayo, yummy) on it and almost wept with happiness. It is SO good. The texture is PERFECT. It was easy and quick to make. And I can actually see my way to a GF lifestyle…sandwiches have been my bugaboo all along. Thank you, thank you for all your hard work and wonderful recipes!
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.
I made it tonight and use a mini loaf pan. It came out delicious. I used the http://www.tasteofhome.com/article/how-to-cut-down-recipes/ link to adjust the recipe measurements using the one third column. I used 2 egg whites. The slices will be small but it was delicious with melted butter. Keto bread recipes and I have tried quite a few have not turned out well for me. I do not like to waste expensive ingredients that is why I will usually do a small amount first. This recipe has been the exception. It is good simple and delicious. I will make it again using the recipe as written. Note: I whipped the egg whites for 10 minutes to get the right consistency. I hope this helps and thank You Maya for finally for me making a bread that tastes great and is easy to make.
Type II diabetics can reduce their risk of developing these complications by keeping blood glucose levels within a healthy range (4.5 - 6.5 mM). This can be achieved using insulin injections, but using insulin is not without side effects (i.e hypoglycemia requiring assistance and weight gain)101. Therefore dietary carbohydrate restriction is likely to be a good lifestyle change to help with diabetes management,. Companies such as Virta Health are popularising this approach to diabetes management and pioneering the use of technology to improve compliance. The benefits of carbohydrate restriction include:

Insulin resistance also may increase your risk for metabolic syndrome. Insulin resistance is a condition in which the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used for energy. Insulin resistance can lead to high blood sugar levels, and it’s closely linked to overweight and obesity. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.

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.


There is also exciting early research suggesting that ketosis may be beneficial for many other conditions, such as reducing the frequency and severity of migraine headaches, reversing PCOS, perhaps enhancing conventional brain cancer therapies, possibly slowing down the progression of Alzheimer’s disease, along with potentially helping people live longer, healthier lives.

Hi Anita, I double checked my carton egg whites. 3/4 cup of egg whites is equivalent to 4 large whole eggs, not 4 large egg whites. Mine has a chart for converting whole eggs, and the conversion for egg whites only is below the chart. It says 2 tablespoons of liquid egg whites are equivalent to the egg white of 1 whole egg. So, 12 large egg whites would be 24 tablespoons, or 1 1/2 cups as written in the recipe. Hope this helps!


Well my Bread wasn’t tall enough for say sandwich stuff, and I am not sure if I did anything wrong, I know I used the wrong sized bread pan so that is one thing. However, I couldn’t believe how great it tasted, it was more like a moist custard shortbread. The texture and color were perfect. I cut some thick slices and buttered both sides cooked them in a pan. I spread some sugar-free preserves on top, wow is that good. I may not have made it as intended but I can’t complain. The flavor is amazing.
Certain ionophores are capable of completely uncoupling mitochondria by transporting H+ across the inner membrane. Such ionophores are therefore commonly used to measure maximal mitochondrial respiration. In mice fed a ketogenic diet (Bio-Serv F3666, ∼6  :  1 ratio of fat to carbohydrate + protein) for 6 days, respiration of hippocampal mitochondria was fully uncoupled with the ionophore carbonyl cyanide 4-(trifluoromethoxy)phenylhydrazone (FCCP) [146]. The ratio of respiration during oxidation of palmitic acid to maximally uncoupled respiration induced by FCCP was greater in response to the ketogenic diet, indicating increased uncoupling [146]. Although this interpretation relies on the assumption that ATP production was not changed by diet, it is further supported by the higher levels of UCP2, UCP4, and UCP5 detected in mitochondria after the ketogenic diet. Furthermore, mtROS production was lower in the ketogenic diet group [146], supporting the role of uncoupling as an antioxidant defense. Although not based on direct measurement of mitochondrial function, in rats fed a ketogenic diet (% energy: 89.5 fat, 0.1 carbohydrate, and 10.4 protein), increased uncoupling in response to nutritional ketosis is further indicated by increases in fat oxidation and overall O2 consumption occurring in conjunction with decreases in CO2 production and energy expenditure [89]. However, based on observations of greater palmitate-induced uncoupling (determined by measurement of ΔΨ) during state 4 respiration in rats fed a high-fat, low carbohydrate diet (% energy: 50 fat, 21 carbohydrate, and 29 protein) [147] that was likely too high in carbohydrate and protein to induce nutritional ketosis, it is possible that moderate carbohydrate restriction may increase mitochondrial uncoupling independently of ketones.
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.
Consistent with the mechanisms described above, changes in AMPK in response to a ketogenic or low-carbohydrate diet have been reported in several studies. In rodents, a ketogenic diet (Bio-Serv F3666) has increased AMPK activity in skeletal muscle [150] and AMPK phosphorylation in the liver [230], and a low-carbohydrate diet (18.5% of energy) supplemented with ketone esters (6% w/v) increased AMPK content in brown adipose [149]. In humans, a nonketogenic low-carbohydrate diet (% energy: 50 fat, 30 carbohydrate, and 20 protein) has increased AMPK phosphorylation in skeletal muscle [231].

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].


The gastrointestinal tract (GIT) plays a central role in the control of energy balance. Many molecules produced by the GIT exert hunger or satiety effects on the brain. Ghrelin is a peptide produced mainly by the stomach's oxyntic cells that stimulates ghrelin secretion in the hypophysis and has some neuroendocrine activities. However, its orexigenic properties are the most relevant to us and ghrelin is the only known peripheral orexigenic hormone (Date, 2012). Cholecystokinin (CCK) is a peptide produced mainly in the duodenum and jejunum that acts on the vagus nerve and directly on the hypothalamic nuclei. CCK is an anorexigenic factor and it reduces food intake, meal size and duration (Murphy et al., 2006). Three other related hormones are pancreatic polypeptide (PP), amylin, and peptide YY (PYY). PP is a peptide produced by the endocrine pancreas in relation to the caloric content of meals, and it reduces food intake both in rodents and humans. Amylin is a peptide co-secreted with insulin; its main effect on food control is a reduction of meal sizes and food intake (Murphy et al., 2006). Peptide YY (PYY) is produced in the gut and is similar to PP. PYY is stored in intestinal cells and released into the circulation as PYY3−36, a truncated form of PYY. The release of PYY3−36 is dependent on a meal's caloric and fat content (Veldhorst et al., 2008). The glucagon-like peptide 1 (GLP-1) is produced by the cleavage of pro-glucagon gene in the intestine. It acts as incretin at a pancreatic level, promoting insulin secretion and as neuro hormone on hypothalamic nuclei, inducing satiety (Valassi et al., 2008).
When you eat more food than your body needs, it’s converted to triglycerides and stored inside your fat cells. The more often you keep consuming large amounts of glucose through carbohydrate foods, the less your body needs to tap into existing sources (your fat cells or stored glycogen in your liver and muscles) for energy, so your newly added fat cells remain intact and, therefore, weight loss is much more difficult.
Hi, I’ve made this recipe twice and LOVE the taste. However, both times the bread would rise so high in the oven, but as soon as I take it out to cool it deflated and middle sink down. What could’ve gone wrong? Over mixing? I did switch coconut flour to all almond flour instead. Could that be a problem? Please help as I’m anxious to make another batch. Thank you.
The gastrointestinal tract (GIT) plays a central role in the control of energy balance. Many molecules produced by the GIT exert hunger or satiety effects on the brain. Ghrelin is a peptide produced mainly by the stomach's oxyntic cells that stimulates ghrelin secretion in the hypophysis and has some neuroendocrine activities. However, its orexigenic properties are the most relevant to us and ghrelin is the only known peripheral orexigenic hormone (Date, 2012). Cholecystokinin (CCK) is a peptide produced mainly in the duodenum and jejunum that acts on the vagus nerve and directly on the hypothalamic nuclei. CCK is an anorexigenic factor and it reduces food intake, meal size and duration (Murphy et al., 2006). Three other related hormones are pancreatic polypeptide (PP), amylin, and peptide YY (PYY). PP is a peptide produced by the endocrine pancreas in relation to the caloric content of meals, and it reduces food intake both in rodents and humans. Amylin is a peptide co-secreted with insulin; its main effect on food control is a reduction of meal sizes and food intake (Murphy et al., 2006). Peptide YY (PYY) is produced in the gut and is similar to PP. PYY is stored in intestinal cells and released into the circulation as PYY3−36, a truncated form of PYY. The release of PYY3−36 is dependent on a meal's caloric and fat content (Veldhorst et al., 2008). The glucagon-like peptide 1 (GLP-1) is produced by the cleavage of pro-glucagon gene in the intestine. It acts as incretin at a pancreatic level, promoting insulin secretion and as neuro hormone on hypothalamic nuclei, inducing satiety (Valassi et al., 2008).
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, people usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
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Based on the reciprocal activation described above, nutritional ketosis is likely to activate SIRT1 and SIRT3 indirectly through activation of AMPK. However, more direct activation of sirtuins by nutritional ketosis is possible. Since reduction of NAD+ to NADH occurs outside of mitochondria only during glycolysis, which is less active during nutritional ketosis, more cytosolic NAD+ remains oxidized, further facilitating activation of SIRT1 [247]. In addition to the decrease in glucose availability during nutritional ketosis, glycolysis may be further inhibited through activation of pyruvate dehydrogenase kinase and subsequent inhibition of pyruvate dehydrogenase (PDH), which occurs in response to dietary carbohydrate restriction [248–251] or infusion of BHB, ACA, or fatty acids [252]. Consistent with the relevance of these factors to nutritional ketosis, a ketogenic diet (% energy: 89 fat, <1 carbohydrate, and 10 protein) has decreased expression of PDH in mouse liver [36]. More importantly, there is direct evidence of nutritional ketosis promoting an increase in NAD+ concentration. Treatment with BHB + ACA (1 mM each) has increased NADH oxidation in rat neocortical mitochondria [109], and a ketogenic diet (Bio-Serv F3666) has increased NAD+ concentration in rat hippocampus [253]. There is also evidence of nutritional ketosis regulating sirtuin expression. A low-carbohydrate (20% of energy) diet combined with ketone esters (6% w/v) has increased SIRT1 protein content in brown adipose of mice [149], and a ketogenic diet (% energy: 90 fat, 0 carbohydrate, and 10 protein) has increased SIRT3 expression in mouse liver [37].


Add mozzarella and cream cheese to a large microwave-safe bowl. Cover the cream cheese with mozzarella (this will prevent the cream cheese from overheating and making a mess in your microwave). Melt in the microwave at 30 second intervals. After each 30 seconds, stir cheese until cheese is completely melted and uniform and resembles a dough in appearance (see photo for reference). This should only take around 1 minute total cooking time. Do not try to microwave the full time at once because some of the cheese will overcook. You can also melt the cheeses over the stove in a double boiler.
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