Thank you for the terrific recipe. I must admit that this really turned out to be “oopsie bread” for me. Due to the expensive nature of the recipe (organic eggs, almond flour, grass fed butter) I really attempted to follow the recipe perfectly instead of going with my usual improvisational style. I also do not have a food processor however that did not impede anything… a hand mixer and a deft hand did the trick. I did add the optional xanthum gum and erythritol but not the cream of tartar. The batter filled my silicone loaf pan to the top, I smoothed it out and popped it into the oven. Then, to my horror, I saw the little pot of melted butter still on the stovetop. There was nothing to be done except cross my fingers and hope for the best.
Whilst the diet is broadly acknowledged to be safe strategy where medications have failed, side effects such as kidney stones, hyperlipidemia and can occur47. Furthermore, maintaining dietary adherence in young school age children can be very challenging for caregivers. Exogenous ketones may be an alternative or a adjunct to the ketogenic diet in epilepsy. Early work suggests that exogenous ketones could have antiseizure effects. Injection of the ketones acetoacetate and acetone have been found to have anticonvulsant properties in animal models48, and an acetoacetate diester was found to protect against seizures in rats exposed to high levels of oxygen49. Further studies are required to understand specifically how ketone bodies affect seizure control, however for children who experience daily seizures a combination of the ketogenic diet and exogenous ketones could be helpful to manage their condition.    
One of the hardest things to do when I travel is to find something to take for lunch OTHER than salads–that gets old fast! This will be a HUGE help so that I can add “bread” back into my lunch menus! Thank you VERY much! So fast, so easy, and VERY usable for those of us stuck in hotel rooms with limited options for eating in. It really does have the texture of whole-grain type of bread!! You’re a life saver! 😀
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.

People with type 1 diabetes do not produce enough insulin, so their bodies are unable to regulate ketones, which can lead to a dangerous environment. Always consult with your doctor if you have diabetes before changing your diet, and look out for warning signs of ketoacidosis including: excessive thirst, increased urination, nausea, vomiting, abdominal pain, shortness of breath, weakness, fatigue and confusion.
Although there are numerous sites of mtROS formation, the most prominent are those in the mtETC, where the superoxide radical (O2•−) is formed through reduction of O2 by leaked electrons, particularly at complexes I and III [41, 53–55]. Production of O2•− at complex I is particularly high during reverse electron transport (RET), which occurs when a high proton-motive force (Δp) develops across the inner mitochondrial membrane in conjunction with the pool of coenzyme Q (CoQ) being in a highly reduced state (i.e., mostly present as ubiquinol) as a result of electron transfer through complex II and electron transfer flavoprotein:ubiquinone oxidoreductase (ETF-QO) [56–62]. This dependence of mtROS production on Δp during RET is mainly influenced by proton gradient (ΔpH) [59].
Eat more fruits and vegetables. According to the 2015-2020 Dietary Guidelines, a person on a 2,000-calorie-per-day diet should eat 2.5 cups of vegetables and 2 cups of fruit a day. This amount will vary depending on how many calories you need. Be sure to choose a variety of fruits and vegetables. Different fruits and vegetables have different amounts and types of nutrients.
I have a question I hope you can set me straight. I was putting the almond flour in my dry measuring cup and it didn’t seem right. I checked around the internet and found someone who said always weigh almond flour. So, I did. 8oz. = 1 cup so 8oz almond flour. It looks like enough but so much more than one dry measure cup. I got as far as doing the food processor part and realized I needed more eggs. So, I’m kinda in holding until I go to the store so, I thought I’d ask.. have I made a terrible mistake and wasted a lot of supplies or am I cool?
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].
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
In dairy cattle, ketosis is a common ailment that usually occurs during the first weeks after giving birth to a calf. Ketosis is in these cases sometimes referred to as acetonemia. A study from 2011 revealed that whether ketosis is developed or not depends on the lipids a cow uses to create butterfat. Animals prone to ketosis mobilize fatty acids from adipose tissue, while robust animals create fatty acids from blood phosphatidylcholine (lecithin). Healthy animals can be recognized by high levels of milk glycerophosphocholine and low levels of milk phosphocholine.[76] Point of care diagnostic tests are available and are reasonably useful.[77]
Recent research indicates prolonged chronic stress can contribute to metabolic syndrome by disrupting the hormonal balance of the hypothalamic-pituitary-adrenal axis (HPA-axis).[23] A dysfunctional HPA-axis causes high cortisol levels to circulate, which results in raising glucose and insulin levels, which in turn cause insulin-mediated effects on adipose tissue, ultimately promoting visceral adiposity, insulin resistance, dyslipidemia and hypertension, with direct effects on the bone, causing "low turnover" osteoporosis.[24] HPA-axis dysfunction may explain the reported risk indication of abdominal obesity to cardiovascular disease (CVD), type 2 diabetes and stroke.[25] Psychosocial stress is also linked to heart disease.[26]

Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
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. 
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].
I’m so glad you love it, Tanya! Yes, $17 sounds like a lot for xanthan gum. I use this one here. Swerve is sweeter than erythritol, so you’d need less of it – I have a conversion chart here. You’re absolutely right about the xanthan gum and texture – it will make the bread more chewy. It will still be more of a “light and fluffy” bread, but definitely less muffin-like with the xanthan gum. I haven’t tried add-ins yet – let me know how it goes if you try!

In low carb and keto baking, we’re concerned with two things: 1) keeping carbs low, and 2) still achieving a baked good that has great flavor and texture (because if we can’t gag it down there’s just no point, right? Lol). Low carb bread recipes are usually gluten free and grain free (although we’ve seen a couple that use oat fiber), but then the challenge is to get creative to get the right combination of ingredients to yield something that rises properly and tastes good.
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