Ok I will try this with the physillium since no sub will work. 🙂 I have a Q though-I read that too much physillium may interfere with how medicines work-my son is on 5 seizure meds, and we are going keto to help with his seizures. This looks like a good and tasty bread to replace his beloved loaf…what would you say is a safe amount for him to eat daily or weekly? Any resources on daily physillium allowances for kids so I can adapt his servings? THanks! 🙂 🙂
Cinnamon supplements may modestly improve blood sugar in people with type 2 diabetes whose blood sugar is not well controlled with medication. In addition, one small study found that a branded cinnamon extract reduced fasting blood sugar by an average of about 10 mg/dL in prediabetic men and women with metabolic syndrome. Keep in mind, however, that only certain varieties of cinnamon have been shown to have this effect, and long-term safety studies have not been conducted.
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This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
The hypothalamus is the brain's main center responsible for hunger/satiety (H/S) control. In the theory that Mayer proposed more than 60 years ago, he assigned a central role to glucose levels in the H/S control: the so-called “glucostatic theory” (Mayer, 1955). Mayer suggested that depletion of carbohydrate availability leads to hunger, and the hypothalamic centers with receptors sensitive to glucose levels might be involved in the short-term regulation of energy intake (Mayer, 1955). The “feeding center” in the lateral hypothalamic area (LHA), according to the glucostatic theory, reacts to the between-meal fall of blood glucose and stimulates food intake. The LHA contains glucose-inhibited neurons that are stimulated by hypoglycemia, a process crucial to mediating the hyperphagia normally induced by hypoglycemia. The subsequent post-prandial hyperglycemia activates the “satiety center” in the ventromedial hypothalamus (VMH), which contains glucose-excited neurons and inhibits both “feeding center” and food intake.
A stack of pancakes might sound like the opposite of a keto-friendly breakfast, but where there's a will, there's a way. These ones from A Big Man's World are made with the perfect combination of almond flour, coconut flour, and eggs for a result so fluffy, you'll hardly be able to tell they're low in carbs. The blueberries add a touch of sweetness (but they contain sugar, so be careful about the portions).
The last point I’ll make on the starving patient is that, as you can see in the figure below, the glucose level normalizes at about 65-70 mg/dL (about 3.7 mM) within days of fasting, despite no sources of exogenous glucose.  Why?  Because with so much fat being converted into B-OHB and acetoacetic acid by the liver, a significant amount of glycerol (the 3-carbon backbone of triglycerides) is liberated and converted by the liver into glycogen.  As an aside, this is why someone in nutritional ketosis – even if eating zero carbohydrates – still has about 50-70% of a normal glycogen level, as demonstrated by muscle biopsies in such subjects.
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An increase in fat burning ability could decrease the efficiency of exercise: one adaptation to a high fat diet is an increase in a process called mitochondrial uncoupling. This means that some of the stored energy from metabolic substrates is not used to generate ATP but is ‘dissipated’ leading to a decrease in efficiency of energy production 26 ,19.  
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.
Ketosis is a metabolic state in which the liver produces small organic molecules called ketone bodies at “sufficient” levels, which I’ll expand upon later.  First, let’s get the semantics correct. The first confusing thing about ketosis is that ketone bodies are not all – technically — ketones, whose structure is shown below. Technically, the term ketone denotes an organic molecule where a carbon atom, sandwiched between 2 other carbon atoms (denoted by R and R’), is double-bonded to an oxygen atom.
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.
.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.
Several other rodent studies provide additional evidence of ketogenic diets upregulating antioxidant defense, but without enough data to convincingly attribute the results to mitohormesis. Content of SOD2 has increased in the livers of mice fed a ketogenic diet (% energy: 89 fat, <1 carbohydrate, and 10 protein), which occurred in conjunction with increased median lifespan and decreases in tumors and age-associated losses of physical and cognitive performance [36]. In addition, activity of GCL and the protein content of its two subunits increased in the hippocampal homogenate of rats fed a ketogenic diet (Bio-Serv F3666) for 3 weeks [97]. This was in conjunction with higher levels of reduced glutathione (GSH) and lower ROS production in hippocampal mitochondria. The ketogenic diet also increased resistance to mtDNA damage in hippocampal mitochondria exposed to H2O2 [97]. Consistent with these results, total antioxidant capacity and activities of GPx and catalase were increased in hippocampal homogenate of rats fed a ketogenic diet (% energy: 86 fat, <1 carbohydrate, and 13 protein) for 8 weeks [98]. Furthermore, in cortical homogenate of rats induced with traumatic brain injury, a ketogenic diet increased cytosolic and mitochondrial protein contents of NAD(P)H:quinone oxidoreductase 1 (NQO1) and SOD1, as well as mitochondrial protein content of SOD2, and also prevented mitochondrial oxidative damage (indicated by 4-HNE) [99].

Most of these side effects happen completely “in your head” — they’re literally caused by your brain. See, every healthy cell in your body except brain cells can derive energy from one of three sources: glucose, ketone bodies and fatty acids (for a short period of time). However, your brain can’t utilize fatty acids since they don’t cross the blood-brain barrier (BBB). When you’ve restricted glucose intake and before your liver starts producing ample ketone bodies, your brain thinks it’s running out of energy, leading to at least a few days of uncomfortable keto flu side effects. (2)

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.
I am a little confused about beating the egg whites with a hand mixer. I used 12 large egg whites as the recipe says. However, I did not add cream of tartar as I have none. I have been beating these egg whites for almost 40 minutes with an electric hand mixer and I still have not yet come to the consistency as your photo shows for stiff egg whites. So my questions are, is this amount of time normal for beating the egg whites? And what amount of time would you recommend if this is not the normal amount of time?
141. Khailova L. S., Prikhodko E. A., Dedukhova V. I., Mokhova E. N., Popov V. N., Skulachev V. P. Participation of ATP/ADP antiporter in oleate- and oleate hydroperoxide-induced uncoupling suppressed by GDP and carboxyatractylate. Biochimica et Biophysica Acta. 2006;1757(9-10):1324–1329. doi: 10.1016/j.bbabio.2006.04.024. [PubMed] [CrossRef] [Google Scholar]
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To conclude, athletes may consider adopting a ketogenic diet in the hope of improving endurance, well being and body composition but unless the diet is well formulated they risk causing fatigue, under fuelling and ultimately compromising performance. There is currently insufficient scientific research to definitively support the use of ketogenic diet for athletes to improve performance, although beneficial effects on fat oxidation, body composition and well-being have been described. However, the anecdotal reports of success and the increasing number of pro and elite athletes claiming to be experimenting with the ketogenic diet is compelling. Furthermore, people who are training and competing at a sub elite level may have a greater net benefit from the effects of the diet on recovery, wellness and body composition that may outweigh the loss of top end power resulting from the diet. Finally, it is unknown if there would be a beneficial effect of following the ketogenic diet but adding in strategic carbohydrate refeeds around more intense training and competition periods. Given the popularity of the ketogenic diet, one hopes these questions will be addressed in the near future. 
How does high blood sugar (hyperglycemia) feel? To maintain the right amount of blood sugar, the body needs insulin, a hormone that delivers this sugar to the cells. When insulin is lacking, blood sugar builds up. We describe symptoms of high blood sugar, including fatigue, weight loss, and frequent urination. Learn who is at risk and when to see a doctor here. Read now
At the University of Leicester, scientists have showing that the level of sugar in your blood can affect blood vessels which in turn can have potentially dangerous effects on your heart and blood pressure. Glucose has an important role to play in the normal functions of the cardiovascular system.  Untreated high sugar levels can lead to life threatening illnesses.
Enter these delightfully low carb Keto Silver Dollar Pancakes. They give you all the fluffy scrumptious-ness you’ve come to expect from a pancake without all those daunting carbs. Aside from being low carb they’re easy to make as well. They’re actually no more difficult to make than standard pancakes. Just mix all the ingredients together and pour them into a pan. Simple, painless and oh so tasty!

In addition to BHB inducing upregulation of antioxidant defense, ketones have direct antioxidant capacity. BHB scavenges •OH, as does ACA, although to a lesser extent [108]. The applicability of this antioxidant capacity has been investigated in vitro and in vivo in the context of hypoglycemia. In cultured hippocampal neurons, treatment with BHB or ACA decreased ROS during hypoglycemia induced through inhibition of glycolysis, and in hypoglycemic rats, infusion of BHB decreased hippocampal lipid peroxidation [108].
20 g of carbs represents very little carby food. Even most keto foods contain a few carbs, and it simply adds up. Many people find it easier to abstain from dairy products, at least in the initial phase. Most dairy, even the full-fat versions, have around 4g carbs per 100 ml. By not eating diary there are more carbs left for things like veggies and nuts.
Ketogenesis is the pathway that forms ketone bodies from fatty acids. Starvation (specifically low levels of blood insulin and glucose) triggers ketogenesis in the liver cells’ mitochondria. Two molecules of acetyl-CoA from the breakdown of fatty acids are condensed via acetyl-CoA transferase to form acetoacetyl-CoA; a third is added to form 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) in a reaction catalysed by HMG-CoA synthase. HMG-CoA lyase then splits this to re-generate acetyl-CoA and form one molecule of AcAc. Beta-hydroxybutyrate (BHB) is formed from reduction of AcAc by BHB-dehydrogenase enzyme, and acetone results from spontaneous, non-enzymatic decarboxylation of AcAc. Acetone is a volatile molecule which is primarily excreted in the breath, although some evidence suggests that a small amount can be metabolised and oxidised4.

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.
Some people may ask: Why not just have liposuction of the abdomen and remove the large amount of abdominal fat that is a big part of the problem? Data thus far shows no benefit in liposuction on insulin sensitivity, blood pressure, or cholesterol. As the saying goes, "If it's too good to be true, it probably is." Diet and exercise are still the preferred primary treatment of metabolic syndrome.
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.
We’ve been on the Keto journey since the end of February last year and this is my favourite bread recipe so far, I just made a loaf and it turned out great. I don’t have a food processor so I did use my blender and for ingredients I only used the almond flour, coconut flour, baking powder, butter, salt, 8 egg whites (all I had left in the fridge) and the only optional ingredient I added was stevia. The texture was still really nice without the extra ingredients which is a nice option and this tasted like a regular loaf of bread, I’ll definitely be making this again!!

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No single food, supplement, or workout session is going to be the magic bullet. To lower blood sugar (and keep it balanced for good), start eating a minimally processed diet that contains fiber, protein, healthy fats, and high quality carbohydrates; get regular exercise; make sure you’re hydrated and well rested; play around with meal composition; and experiment with research-backed superfoods and supplements.
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Fantastic! So easy to make. Not sure if I didn’t mix mine well enough, but it had a couple of “air holes” in it after baking. Did not matter…tastes great. I made a grilled cheese out of two of the slices…delicious! I can’t wait to try some of the ideas from the comments: adding herbs and/or spices, adding cinnamon and stevia, etc. Seems the possibilities are endless.

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].

The brain is different as it is dependent on carbohydrates as a fuel source. This is because fats cannot easily cross the blood-brain barrier. The inability to make use of energy within fat poses a problem during periods where there is limited carbohydrate in the diet. If blood glucose levels fall to low, brain function declines. Relatively little energy is stored as carbohydrate (2,000 kCal) compared to fat (150,000 kCal). The body's store of carbohydrates runs out with a few days of carbohydrate restriction. Once glycogen is depleted, a cascade of hormonal signals causes the body to increase the release of stored fats (from adipose tissue). Signals include the fall in blood insulin, rise in a hormone called glucagon and an increase in cortisol (stress hormone) 1. The increase in blood fatty acids is a key trigger for ketone production (ketogenesis). Unlike fats, ketones are readily used as a fuel in the brain. Fatty acids are converted into ketone bodies in the liver, and ketones can provide up to 60% of the brain's energy requirements during starvation 2. The graph below shows how BHB (black triangles) builds up in the blood over many days until it reaches a level of around 6 mM.
I made this yesterday and had 3 pieces. Had another 2 for breakfast today and after a few minutes I started feeling nauseated. The nausea got worse and worse, and I ended up projectile vomiting in the bathroom. I looked it up and it’s a symptom of psyllium husk overdose. I read that the max dosage per day is around 2tsp. I had around 10 times the daily dosage in my breakfast alone… I love all of Maria’s recipes but this is just a warning to watch out with the husk powder in this recipe! I did not grind mine to decrease the density of it. I am semi comatose in bed now while my husband takes care of our kids. 😁😁😁
The advice on carbohydrate-rich foods, for example, may make a person with type 2 diabetes require initiation of treatment with insulin injections. One single year’s insulin-consumption may easily cost $2000 or more. Multiply this number by the 422 million diagnosed people diabetes worldwide and you will see the enormous economical interests in this.
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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).
While tender, chocolatey donuts are perfect on their own, this keto breakfast recipe amps them up with a rich and sweet glaze. Pair with coffee and tea, or enjoy as dessert (if you can wait that long). At just over 2 net carbs per donut, they’re basically guilt-free. For more Bulletproof donuts, use grass-fed butter and mold-free coffee, plus full-fat coconut milk instead of heavy cream in the glaze.
I’m a little late to comment but I had to say how amazing this bread tastes. It has a chewy crust and light a fluffy inside. I’ve been keto for over two years and trust me I’ve tried every bread recipe out there. My husband and two kids, 10 and 7 years old, are also full keto and it’s unanimous that this was their favorite. I made this recipe adding 1/2 more of all the ingredients and ended up with a nice sized loaf. Thank you. Will definitely keep trying all your recipes. You certainly hit this one out of the park.
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Metabolic syndrome is the commonly observed clustering of obesity, high blood pressure, abnormal blood lipids, and insulin resistance. Some healthy debate exists regarding its definition and existence, but it is clinically apparent that the components of metabolic syndrome occur together more often than expected by chance. Investigations into monogenic diseases that model features of the common metabolic syndrome have uncovered responsible genes. Genome-wide association studies of the components of the metabolic syndrome have been enormously successful. Research will continue to uncover how metabolic pathways interact to form the metabolic syndrome and its subsequent risk for atherosclerosis and diabetes.
This is the best keto bread I have ever made! By far! My bread was a little flat, but I think my baking powder needs to be replaced. I did make two substitutions with this recipe. I replaced egg whites with whole eggs, and ghee with coconut oil. Everything else, I already had on hand. I will definitely make this again and play with it a little. Really delicious bread.