As you may recall, about 60% of the energy we expend, say 1,800 kcal/day for someone consuming 3,000 kcal/day in weight balance, is purely devoted to keeping us alive by generating enough ATP (“energy currency”) to do 2 things: allow ion gradients to function and allow muscular relaxation.  So, obviously, we can’t tolerate – literally even for one minute – insufficient ATP production.  In fact, one of the most potent toxins known to man (cyanide) exerts its effect on this process by inhibiting the electron transport chain which generates the bulk of the ATP our body produces.  Even the most transient interruption of this process is fatal.
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.

The approximate prevalence of the metabolic syndrome in patients with coronary artery disease (CAD) is 50%, with a prevalence of 37% in patients with premature coronary artery disease (age 45), particularly in women. With appropriate cardiac rehabilitation and changes in lifestyle (e.g., nutrition, physical activity, weight reduction, and, in some cases, drugs), the prevalence of the syndrome can be reduced.[27]
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.
Like fiber and protein, fat buffers blood sugar spikes. In fact, unsaturated fats have been specifically linked to improved insulin resistance. Just be sure to avoid refined fats, including trans fats and processed vegetable oils, like corn, soybean, and safflower oils, which can be pro-inflammatory. Sources of quality fats to consider adding to your diet include: nuts, olive oil, ghee, coconut oil, avocado, and fatty fish like salmon.
Yes, you read that right. Meat. Bagel. It's basically ground pork cooked into the shape of a bagel (or a donut, however you'd like to think of it). After it's cooked, cut it in half and fill it with lettuce, tomato, avocado, and onions for one hell of a breakfast sandwich. They also freeze up nicely. Meat lovers, you've got Ditch The Wheat to thank for this creation.
Just made this and as a normal bread lover, I am very impressed! But do have a question. Can you over cook this? Mine seems a bit light inside, like a teenie bit mooshy, and can’t see it holding up in a sandwich. The temp was at 200 inside but I had already had it in for like 50 minutes longer than the posted time and I could still hear a little squish but didn’t want to over cook.

That said, the nutrition facts that I get after entering the recipe into my app came up with almost twice the calories. My Tillamook Mild Cheddar cheese is 110 calories per ounce—so that alone gets me to 385 calories. Overall I end up with 51.5 grams of fat, 34.5 grams protein, 4.5 grams of carbs, and 632 calories. I am hoping to try it again with half the cheese to see if I can still get the great flavor and wonderful crispy taco shell.


A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
Ketone esters (BHB-BD) increases activation of protein synthesis 31. Following exercise, complex signalling pathways within the muscle are activated to trigger the synthesis of muscle protein. A key regulator of muscle protein synthesis is a ‘kinase’ enzyme called mTOR. When athletes mixed ketone ester with a protein and carbohydrate recovery drink , muscle samples revealed that mTOR was much more strongly activated with ketone drinks compared with carbohydrate control drinks. This could help to promote gain of muscle mass occurring as a result of exercise.   
Research shows that Western diet habits are a factor in development of metabolic syndrome, with high consumption of food that is not biochemically suited to humans.[21] Weight gain is associated with metabolic syndrome. Rather than total adiposity, the core clinical component of the syndrome is visceral and/or ectopic fat (i.e., fat in organs not designed for fat storage) whereas the principal metabolic abnormality is insulin resistance.[22] The continuous provision of energy via dietary carbohydrate, lipid, and protein fuels, unmatched by physical activity/energy demand creates a backlog of the products of mitochondrial oxidation, a process associated with progressive mitochondrial dysfunction and insulin resistance.
Ultimately, cancer is highly complex, whereas some tumors may be highly responsive to carbohydrate restriction, others may become adapted to utilise fats or ketones. Cancer, and the treatments currently in use cause unpleasant systemic effects such as muscle wasting and compromise of the immune system, therefore any interventions should be undertaken under the guidance of a doctor. There are limited treatment options available for some types of cancer, many drugs have toxic side effects and many types of cancer have a poor prognosis. In these cases, considering metabolism as an adjunct to conventional treatments is interesting, and offers the potential of another avenue of attack on cancer.  

Maya, this is a beautiful looking bread. I’m going to try it, but before I do, I’d like to know if you have ever tried doubling the recipe. It seems that it would work–based on the fact that my almond flour bread that I have made for years uses 3 1/4 cups flour, and turns out pretty well. (I’m pretty content with my recipe, but admit that yours looks better due to the whiteness and it appears to have more air bubbles, indicating it’s probably lighter.) If I don’t hear from you, I’ll probably go ahead and double it, and use a 9×5 pan–wish me luck.


Another aspect of mitochondrial function influenced by ketones is the mitochondrial permeability transition pore (mPTP). Prolonged opening of the mPTP is one of the mechanisms through which mtROS can induce cellular injury and promote disease [114]. In neurons isolated from rat brain slices, treatment with BHB + ACA has decreased the mtROS production, mPTP opening, and cell death induced by H2O2 [115]. This protective effect was duplicated with catalase, even in conjunction with diamide-induced opening of the mPTP, indicating that the protective effect of BHB and ACA is at least partly due to defense against ROS [115]. In a mouse model of epilepsy, this decrease in mPTP opening was found to be induced exclusively by BHB, and in a manner dependent on the cyclophilin D subunit of the mPTP [116]. BHB in combination with ACA also appears to promote opening of mitochondrial ATP-sensitive K+ (mtKATP) channels [117], which in heart mitochondria is known to protect against Ca+ overload [118] and dissipate membrane potential (ΔΨ) [119]. Since high ΔΨ promotes mtROS production, dissipation of ΔΨ through mtKATP channels may partly explain the potential for ketones to decrease mtROS production. However, opening of mtKATP channels by pinacidil decreases mitochondrial ATP production [119], which is consistent with dissipation of ΔΨ and suggests a compromise between ATP and mtROS production.

This is now my go to for lo-carb bread recipe. It is SO EASY! I made it last weekend, Instead of Xanthan gum I used konjac root powder, it worked just fine, my baking time was more like 50 minutes and I did cover the top loosely with foil for the first 15 minutes so the top wouldn’t brown so quickly (maybe why my cooking time was so long?) I also added a pinch of Bakers yeast (brewers yeast is NOT gluten free) just for flavor and stevia 3/4 T. This bread makes really good grilled cheese or avocado toast! Very yummy! Thanks for this recipe!
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 this bread. As a pregnant type 1 diabetic, I was looking for something to toast. I’ve tried multiple different recipes from other sites, and the bread is always so crumbly that you can never spread anything on it. This one is AMAZING! I may have to experiment with more water so that it comes out less dense, but soooo happy to prevent blood sugar spikes with future sandwiches. I can even foresee being able to have traditional burgers again (not just wrapped in lettuce). My husband bakes his own “normal” bread, and now I get bread too and its even easier to make than his 🙂
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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].

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.
Moreover, in the above study of Sumithran et al. (2013), ketosis maintains post-prandial secretion of CCK as previously demonstrated by other researchers (Chearskul et al., 2008). Note that the orexigenic effect of BHB is blocked by transection of the common hepatic branch of the vagus nerve (Langhans et al., 1985). The hepatic branch contains fibers from the proximal small intestine, stomach and pancreas, and is sensitive to CCK (Horn and Friedman, 2004); ghrelin signals to brain are also transmitted via vagus nerve (Habara et al., 2014). Thus, the effects of ketosis on these two appetite-related hormones could be one of the many factors related to the effects of such nutritional regimen on food control.
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Although convincing, the bulk of evidence in relation to the inhibitory effects of ketosis on appetite is still anecdotal. Preliminary scientific reports seem to support this phenomenon, and the evidence shows that KD is more effective, at least in the short/medium-term, on fat loss (Paoli, 2014). It was demonstrated that diet-induced weight loss leads to changes in energy expenditure and in appetite-regulating hormones that facilitate weight regain and the return to initial energy homeostasis (Sumithran et al., 2011). This response to alteration of energy balance nullifies the success of many dietary approaches. It is well-known that the long-term success of a nutritional approach is defined by the amount of weight regain and is the main problem regarding the so-called weight cycling or “yo-yo” effect (Jeffery, 1996). A recent study by our group has demonstrated that a brief ketogenic period, if followed by a longer period of correct Mediterranean diet could avoid this yo-yo effect (Paoli et al., 2013). During the ketogenic period subjects reported less hunger, confirming previous studies (Nickols-Richardson et al., 2005; Johnston et al., 2006; Johnstone et al., 2008) on hunger-suppression effect of ketogenic diet. Despite these clinical findings, the mechanisms of action of ketosis on appetite reduction are still not completely understood. Clinical results are suggestive of both direct and indirect (via modifications of hunger-related hormones concentration) actions of KBs on appetite (Sumithran et al., 2013).
Conversely, the term “ketone bodies” refers to 3 very specific molecules: acetone, acetoacetone (or acetoacetic acid), and beta-hydroxybutyrate (or beta-hydroxybutyric acid), shown below, of which only 2 are technically ketones.  (The reason beta-hydroxybutyrate, or B-OHB, is not technically a ketone is that the carbon double-bonded to the oxygen is bonded to an –OH group on one side, technically making B-OHB a carboxylic acid for anyone keeping score.)

Kids who have a family history of heart disease or diabetes are at greater risk for metabolic syndrome. But, as with many things in life, the lifestyle habits a child adopts can push things in one direction or another. So kids who are active, fit, and eat a lot of fruits and vegetables may drastically decrease their chances of developing metabolic syndrome — even if a close relative already has it.
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.

In less time than it takes to order delivery, you can have this keto bread base ready to enjoy — plus, it requires no baking! A quick dough made from almond and coconut flours, xanthan gum, and egg, then sizzles in your skillet before taking on your favorite toppings. To keep this 2-carb pizza crust more Bulletproof, avoid eating xanthan gum too often.
Pizza for breakfast? You betchya! This recipe by All Day I Dream About Food slashes carbs by subbing in cauliflower for the standard wheat flour crust, and racks up plenty of fats and protein with toppings like cheese, sausage, eggs, and avocado. It’s as gooey and crispy as your favorite pizza pie, but costs you a slim 5.43 grams of net carbs a serving. Perfect for relaxing weekend mornings or keto-friendly brunch.

Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
Low blood sugars can be caused by not eating enough, or by trying to lower your sugar too quickly. A blood sugar under 60 is considered dangerous. It can lead to confusion or loss of consciousness, which can be deadly. It is important to have a snack with you at all times in case this happens to you. If it does happen, think about what you did or didn’t do that lead to the low number. If it happens often, start writing things down to help you track what the cause is so that you can avoid it.
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].
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.
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Populations living further north had much less edible vegetation available for gathering. Thankfully for us, animals that lived in these areas ate the vegetation inedible to us, effectively transforming it into fatty meat we could hunt and enjoy. These people most certainly relied on high levels of fat and protein, thus likely spending most of their time in ketosis.
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.
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In addition to the seaweed and glycogen carbohydrates mentioned above, the Inuit can access many plant sources. The stomach contents of caribou contain a large quantity of partially digested lichens and plants, which the Inuit once considered a delicacy. They also harvested reindeer moss and other lichens directly. The extended daylight of the arctic summer led to a profusion of plant life, and they harvested plant parts including berries, roots and stems, as well as mushrooms. They preserved some gathered plant life to eat during winter, often by dipping it in seal fat.[71]
In regard to the practicality of BHB signaling, many of the outcomes described above, including HDAC inhibition, were achieved with BHB concentrations within the range of 0.6–2 mM [37, 103, 105, 108, 109, 111, 112, 116], which is well within the physiological range of nutritional ketosis for humans and even suggests potential benefit at low to moderate levels.
Not so anymore. Thanks to the rising obesity epidemic in young people, kids and teens are getting these conditions — and they're getting them earlier than ever before. Some estimates say that nearly 1 in 10 teens — and over a third of obese teens — have metabolic syndrome. And a study of 375 second- and third-graders found that 5% had metabolic syndrome and 45% had one or two risk factors for it.
Ketone salts did not improve performance 35 ,36. There are two recent published studies of ketone salts on athletes.. Performance was compared between ketone salts vs. carbohydrate in a 4 minute cycling time trial and a 150 kJ ( ~10 mins) cycling time trial. In the 4 minute trial there was no change in performance, and in the 150 kJ test, performance was decreased by 7%. Reasons for the difference in findings could be: Lower levels of blood BHB levels (which peaked at 0.6 mM and 0.8 mM in these studies) meaning far less BHB was present than in the ketone ester study. The ketone salt was given without carbohydrate and so there was no additive effect of ketones + carbohydrate as seen in the ketone ester study. The tests used were short and highly reliant on anaerobic (glycolytic) metabolism, therefore ketones did not offer an advantage. 
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
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The ARC exerts opposing actions on food intake responding not only to leptin and insulin, but also to gut hormones (the most studied are ghrelin and, recently, PYY). The neurophysiological pathways suggest that feeding is regulated by a feedback loop, where the hypothalamus provides the long-term regulatory input to the NTS, which acts as a setpoint (Williams et al., 2001).
Schele E., Grahnemo L., Anesten F., Hallen A., Backhed F., Jansson J. O. (2013). The gut microbiota reduces leptin sensitivity and the expression of the obesity-suppressing neuropeptides proglucagon (Gcg) and brain-derived neurotrophic factor (Bdnf) in the central nervous system. Endocrinology 154, 3643–3651. 10.1210/en.2012-2151 [PubMed] [CrossRef] [Google Scholar]
We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again.
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Alcoholic ketoacidosis (AKA) presents infrequently, but can occur with acute alcohol intoxication, most often following a binge in alcoholics with acute or chronic liver or pancreatic disorders. Alcoholic ketoacidosis occurs more frequently following methanol or ethylene glycol intoxication than following intoxication with uncontaminated ethanol.[11]
The clinical relevance of nutritional ketosis to mitochondrial function is further indicated by promotion of ketogenic diets for treatment of mitochondrial disorders [19, 20, 26, 30, 247, 403]. The most prominent example is the study of mitochondrial adaptations as a mechanism for the well-known antiseizure effect of ketogenic diets [19, 29, 33, 162, 247, 403–405]. As previously discussed, the dramatic shift in energy metabolism and subsequent increase in circulating ketones induced by a ketogenic diet can enhance mitochondrial function and endogenous antioxidant defense. The primary mechanism behind these adaptations appears to be the increased demand for fat oxidation resulting from carbohydrate restriction. However, ketones themselves have important metabolic and signaling effects that enhance mitochondrial function and endogenous antioxidant defense, implying that a well-formulated ketogenic diet should have greater benefit than a nonketogenic low-carbohydrate diet. Regardless of the mechanism(s), the potential outcomes imply protection against chronic disease through improved mitochondrial function and, in turn, decreased potential for oxidative stress and subsequent pathology. However, further research is needed to better understand how nutritional ketosis influences mitochondrial function across different tissues and how these influences relate to human disease. Future research should also focus on further differentiation of the effects of carbohydrate restriction from the direct effects of ketones.

First of all, thanks for the recipe. I tried it yesterday with coconut flour and egg whites, and I failed miserably. It rose 5 or 6 times in volume and then collapsed like the world economy. Also, it was very moist on the inside. I’ll try the almond flour version with half the baking powder and full eggs this time, but I’m having trouble wrapping my head around measurements. If 1 and 1/2 cup of almond flour is 5oz, how can 1/2 cup of coconut flour be 2.5oz (equalling 7.5oz for 1 and 1/2 cup)? If anything, almond flour is more dense, not less.


I was a Corpsman (not a corpse-man as some recent somewhat fanatical president would say), and I can tell you many stories of Marines and Sailors who maintained restrictive diets (aka picky eaters). Most obvious was lack of sustaining energy (hypoglycemia) at mile 15 (with 80lbs of gear including a 6.5lb rifle and 200 rnds of ammo, etc.) and depletion of essential vitamins, electrolyte imbalance. They were always the first to collapse and have to hear me scold “see I told you so.” An IV of D5W usually does the trick (D is for dextrose, OMG!)
Lower HbA1c: HbA1c is an abbreviation for ‘glycosylated hemoglobin.’ Hemoglobin is a protein inside red blood cells, this means it is always exposed to the substances that circulate in the blood (i.e glucose). When glucose levels are high, glucose can bind to hemoglobin (i.e it becomes glycoyslated). As red blood cells survive inside the body for 100-120 days, the amount of glyosylated hemoglobin is a good indicator of long term glucose control. The healthy limit for HbA1C is below 5.7% (Source: WebMD). 
You should always be in touch with your doctor about your disease and any changes you make or problems that you notice. Having that line of open communication is key to gaining knowledge and insight into what can make your life and your health better. Try the things mentioned in this article, but if they don’t help, then talk to your physician about what else is available for you.

Have you heard all the buzz about the keto diet and want to know more? Did a friend tell you they’re “in ketosis” and you got interested? Here’s everything you need to know about ketogenic diets and being in ketosis for fat loss, brain function, satiety, and performance. Editor’s Note: This article is being updated … Continue reading The Keto Diet: Next Big Thing or Dangerous Fad?
You should always be in touch with your doctor about your disease and any changes you make or problems that you notice. Having that line of open communication is key to gaining knowledge and insight into what can make your life and your health better. Try the things mentioned in this article, but if they don’t help, then talk to your physician about what else is available for you.
Insulin is the medication that will bring blood glucose down the fastest. Someone who uses mealtime insulin can take correction doses to lower blood glucose. This requires a thorough understanding of when to inject, how often to give correction doses, and how much insulin to use. You will need to work with your doctor or diabetes educator to learn how to do this.
Patterns can be great because they help you figure out what is causing undesirable blood sugar values. A good way to track of it is to keep a journal of all of the food you eat, activities you do and your blood sugar levels for 1 week. During this week, check your sugar before and after you eat, as well as in between meals. Also document any insulin that you give yourself.
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.
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Hey there… I’m new to keto, so I’m hoping my questions don’t come across as really stupid. Your bread looks great, and if I can get bread again, then that’s simply awesome. The pictures remind me of banana bread. Is there a way of adding this flavor without going insanely overboard on the carbs? And without that artificial banana taste? Also, would this recipe work as muffins? Thanks, Kelly
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