Lose a pound. Or four. You don’t need to be supermodel skinny to improve your blood sugar. If you lose 7 percent of your weight, you’ll improve your insulin resistance. That will lower your blood sugar across the board, and dramatically reduce after-meal spikes. How much weight is that, really? Well, it depends on how much you weigh, of course. If you tip the scales at 200 pounds, 7 percent is 14 pounds. You could easily shed that in six months, simply by eating fewer bites per meal. I know we were taught as children to clean our plates, but it’s far better to throw some food away than to eat more than we need to. It’s only wasteful to eat what our bodies don’t need.
4. Tapia P. C. Sublethal mitochondrial stress with an attendant stoichiometric augmentation of reactive oxygen species may precipitate many of the beneficial alterations in cellular physiology produced by caloric restriction, intermittent fasting, exercise and dietary phytonutrients: “Mitohormesis” for health and vitality. Medical Hypotheses. 2006;66(4):832–843. doi: 10.1016/j.mehy.2005.09.009. [PubMed] [CrossRef] [Google Scholar]
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Metabolic syndrome is similarly prevalent in men (24%) and women (22%), after adjusting for age. [28] However, several considerations are unique to women with metabolic syndrome, including pregnancy, use of oral contraceptives, and polycystic ovarian syndrome. [43] Metabolic syndrome and polycystic ovarian syndrome share the common feature of insulin resistance; they therefore share treatment implications as well. [44] Cardiometabolic risk is thought to be elevated in both groups. [45]

Hi Cindy, nut flour breads do not rise as much as wheat breads. Also, I used a small bread tin in the post – if you use a regular size bread pan your bread will end up flatter. What you can try next time is to try to keep the dough nice and fluffy, trying to keep as much air inside as possible (for example, not press it into the pan as much as you can). You could also try to whisk the egg whites until they’re stiff and fold them under last, which will make your dough lighter (=more air). I hope this helps


As described throughout the previous sections, there are many instances of codependencies and feed-forward loops in bioenergetic and antioxidant signal transduction, which supports the well-known potential for metabolic stimuli, such as diet or exercise, to have a profound physiological influence. Given the central role of mitochondria in oxidative phosphorylation and ROS production, the overlap between bioenergetic and antioxidant signaling is not surprising and is possibly an outcome of evolution favoring efficiency. PGC-1α is at the center of this overlapping and complex network of codependencies. The likely role of PGC-1α as a coactivator of FOXO3a indicates a possible dependence of FOXO3a transcriptional activity on PGC-1α [287], indicating FOXO3a as a central mediator as well. Furthermore, FOXO3a induces transcription of PGC-1α [287, 322, 367], and formation and antioxidant transcriptional activity of the PGC-1α-FOXO3a complex are partly dependent on interaction with SIRT1 [325]. In muscle, expression of many of the bioenergetic and antioxidant proteins previously discussed is dependent on PGC-1α [265]. Upstream, activation of PGC-1α is dependent on AMPK [242] and SIRT1 [242, 269] and partly dependent on SIRT3 [270]. Furthermore, activation of SIRT1 is dependent on AMPK [242], which may also be the case for SIRT3. AMPK and PGC-1α are therefore two key factors, with critical supporting roles of the sirtuins, in the signal transduction linking bioenergetics to antioxidant defense. Further supporting the relevance of this linkage to nutritional ketosis, expression of AMPK, SIRT1, FOXO3a, and NFE2L2 is required for extension of lifespan in C. elegans by exogenous BHB [95], and expression of AMPK, p38 MAPK, and NFE2L2 is required for the extension of lifespan, also in C. elegans, by mitohormesis induced through inhibition of glucose metabolism [73]. The induction of AMPK [259, 260], SIRT3 [263, 329], p38 MAPK [310–313], PGC-1α [76, 77, 260, 282, 283], FOXO3a [324, 331, 333], and NFE2L2 [358–360] activity by oxidative stress also makes this signaling highly relevant to mitohormesis [263, 282, 360], especially given that activation of these proteins has been shown to decrease mitochondrial or cellular ROS [76, 263, 282, 289, 323, 332, 334, 356, 359, 367]. Furthermore, mitochondrial biogenesis [346] and the activities of AMPK [259, 260], SIRT3 [329], p38 MAPK [311, 312], PGC-1α [76, 77, 260, 283], FOXO3a [324], and NFE2L2 [368] are increased by H2O2, more specifically associating this signaling with mitohormesis. Given that AMPK and sirtuins are upstream of the majority of this signaling and that AMPK and sirtuin activities are stimulated by both bioenergetic and oxidative stressors, these stressors are likely the primary signals through which nutritional ketosis may induce the mitochondrial and antioxidant adaptations characteristic of mitohormesis (Figure 2).

Eggs and hash browns are the quintessential American breakfast—but carb-loaded potatoes are a definite no-go on the keto diet. Luckily, with a little creativity, you can whip up a delicious low-carb alternative using cauliflower. These hash browns from Keto Connect are made with just cauliflower, shredded cheese, and an egg (plus any seasonings you want), and contain just 3.2 grams of net carbs per serving. They’re the perfect bed for other breakfast ingredients, like eggs, bacon, and avocado, or ground beef, sour cream, and guacamole.


In a separate post, I explained the difference between nutritional ketosis (NK) and diabetic ketoacidosis (DKA). If this distinction is not clear, I’d suggest giving this separate post a quick skim for a refresher.  DKA is a pathologic (i.e., harmful) state that results from the complete or near absence of insulin.  This occurs in the setting of type 1 diabetes or very end-stage type 2 diabetes, and often as the result of a physiologic insult (e.g., an infection) where the patient is not receiving sufficient insulin to bring glucose into his cells.  A person with a normal pancreas, regardless of how long he fasts (including the fellow I reference above who fasted for 382 days!) or how much he restricts carbohydrates, can not enter DKA because even a trace amount of insulin will keep B-OHB levels below about 7 or 8 mM, well below the threshold to develop the pathologic acid-base abnormalities associated with DKA. Let me reiterate, it is physiologically impossible to induce DKA in anyone that does not have T1D or very, very, very late-stage T2D with pancreatic “burnout.”
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The difference between ketosis and ketoacidosis is the level of ketones in the blood. Ketosis is a physiological adaptation to a low carbohydrate environment like fasting or a ketogenic diet. There are situations (such as treatment-resistant epilepsy) where ketosis can be beneficial to health. Ketoacidosis is an acute life-threatening state requiring prompt medical intervention; its most common form is diabetic ketoacidosis where both glucose and ketone levels are significantly elevated.
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Following a low calorie diet: The exact mechanism whereby caloric restriction can slow or prevent cancer is unknown. It may be linked to: decreased blood glucose (less fuel for cancer cells), raised ketones (antiinflammatory, decreased oxidative stress, decreased ability to use glucose) . Animal models have shown that caloric restriction is closely related to tumour incidence and progression94.
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).
Hello Angie, the same happened here. The taste is great except the bread did not rise. It came out flat. Do I have to slice the load in the middle to get it to rise? I replaced the ghee with regular butter but everything else was the same. Also I read on a different site that if the eggs are not room temperature than that would definitely effect the rise of the bread. I took the cold eggs straight out of the fridge to get the egg whites. What do you think?
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Thanks so much for this recipe – it’s a staple. I always have some in the fridge and take it with me to restaurants – no more lettuce buns! I tweaked it a bit using some other keto supplies i had on hand – 1/4 tsp xanthan gum makes it less dense, 1-2 tsp of psyllium husk makes it a bit more bready, and then a spash of avacado or coconut oil to add moister and fat. I will sometimes fold in chedder and jalapenos for added flavor boost. Again, thank you -this recipe has helped me fulfill my need for bread on this diet.
Hi Maria, I love your bread recipes but can’t get over the one thing, the gritty texture you get in one every couple bites due to the psyllium husk, I have tried different brands and all have it. I haven’t tried Jay Robs yet. But have you tried ground up chia seeds instead by any chance? I read somewhere to just add twice the amount of water. Thanks

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.

Insulin (in-suh-lin): A hormone made by the cells in your pancreas. Insulin helps your body store the glucose (sugar) from your meals. If you have diabetes and your pancreas is unable to make enough of this hormone, you may be prescribed medicines to help your liver make more or make your muscles more sensitive to the available insulin. If these medicines are not enough, you may be prescribed insulin shots.
How many calories should I eat a day? A calorie is an amount of energy that a particular food provides. Consuming more calories than needed will result in weight gain, consuming too few will result in weight loss. How many calories a person should eat each day depends on a variety of factors, such as age, size, sex, activity levels, and general health. Read now
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Metabolic syndrome has been shown to be associated with an increased risk of cataract in several observational studies (Table 19.2). Paunksnis et al. reported an association between metabolic syndrome and cataract among middle-aged European men and women.16 In the Blue Mountains Eye Study (BMES), metabolic syndrome was associated with an increased risk of all subtypes of cataract including cortical, nuclear, and posterior subcapsular cataract (PSC) among elderly Australians.17 In a population of Malay adults in Singapore, a significant association between metabolic syndrome and cataract was also found.13 A dose–response relationship was also observed between an increasing number of metabolic syndrome components and cataract. Among the subtypes, cortical cataract showed a positive association with metabolic syndrome.13 Lindblad et al. examined a large, population-based cohort of Swedish women who participated in the Swedish Mammography Cohort and found that a combination of three components of metabolic syndrome, including raised waist circumference, diabetes, and hypertension, increased the risk of cataract extraction by 68% compared to those without any of these components.15 In addition, metabolic syndrome increased the risk of cataract extraction by approximately three-fold among women aged less than 65 years. Galeone et al. found that metabolic syndrome was associated with a two-fold increased risk of cataract extraction in a clinic-based study in Italy.14 Further, a significant linear trend in risk was also reported with an increasing number of metabolic syndrome components.
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Angie, I’m happy to hear you and your hubby enjoyed the taste, but sorry to hear the bread was flat! The egg whites don’t need to be whipped for this recipe, but I’ll try to help you troubleshoot…first I would check to make sure that your baking powder is fresh. Also, did you use the full cup of egg whites? Did you make any ingredient substitutions or adjustments? Did you use a 9 by 5-inch loaf pan? Did you cook it at 350F and is your oven properly calibrated? Did you bake it for the amount of time the recipe calls for? I hope this helps!
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