Maria, I made this bread today – weighed my ingredients carefully and followed instructions. My only adaptation was adding a little liquid Stevia, cinnamon, and raisins right before putting into the bread pan. It raised nicely but fell a little while cooling and is pretty heavy, although tastes great. Any help on what I did wrong? (I’m not sure my water was boiling enough – it was just starting to bubble, not full rolling boil, when I added it. Would that make the difference?)
Prediabetes: When blood glucose (also called blood sugar) levels are higher than normal and not yet high enough to be diagnosed with diabetes. That’s an A1C of 5.7 percent to 6.4 percent (a way to estimate your 3-month average blood sugar reading), a fasting blood glucose level of 100 to 125 mg/dl, or an OGTT (oral glucose tolerance test) two hour blood glucose of 140 to 199 mg/dl.
Though the hunger-reduction phenomenon reported during ketogenic diets is well-known, the underlying molecular and cellular mechanisms remain uncertain. Ketosis has been demonstrated to exert an anorexigenic effect via cholecystokinin (CCK) release while reducing orexigenic signals e.g., via ghrelin. However, ketone bodies (KB) seem to be able to increase food intake through AMP-activated protein kinase (AMPK) phosphorylation, gamma-aminobutyric acid (GABA) and the release and production of adiponectin. The aim of this review is to provide a summary of our current knowledge of the effects of ketogenic diet (KD) on food control in an effort to unify the apparently contradictory data into a coherent picture.
Hello, I’m sure you must roll your eyes at getting yet another post about glitches when making this bread. Unlike the first loaf I made I had four loaves turn out gummy. it still makes reasonable toast but I’d like to avoid this the next time I make the bread. I used your recommended almond flour, and I really ground the psyllium. However in narrowing things down there are two factors that may have contributed to the problem: 1) I mixed up two loaves at a time and I wonder if the dough was too heavy for my mixer and did not combine sufficiently. 2) I may have let a very small amount of yolk fall into the whites. Would either of these caused the gummy texture? Thanks for this amazing website. We purchased all your books and find them a wealth of information. Liz
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
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.
First of all, almond flour bread will never have EXACTLY the same texture as wheat bread because it lacks the gluten. It will be slightly softer. But. Baking with almond flour is never an exact science. If your almond flour is coarser, just add an extra couple of tbsp next time and the bread will be firmer. Or try reducing the amount of water so it dries out more. I would not recommend changing the amount of egg (unless you used extra large eggs). Hope this helps!
PGC-1α coactivates all three known PPAR isoforms (PPARα, PPARδ, and PPARγ) [286]. Although each isoform is expressed in a variety of tissues, PPARα is prominently expressed in the liver, PPARδ in skeletal muscle, the heart, and the pancreas, and PPARγ in adipose [286, 296]. PGC-1α was discovered and named based on its promotion of brown adipose differentiation through coactivation of PPARγ and subsequent induction of mitochondrial biogenesis and UCP1 expression [297]. However, it is the PGC-1α coactivation of PPARα that is responsible for the upregulated transcription of many of the enzymes responsible for increased ketogenesis and fatty acid metabolism in response to a ketogenic diet [120]. Consistent with the role of PGC-1α in inducing mitochondrial biogenesis, it also shifts skeletal muscle fiber composition towards type I [298, 299] and type IIa [299], which are more oxidative. AMPK also contributes to fiber type changes and is required for the transition of highly glycolytic, type IIb fibers to more oxidative, type IIa fibers [276]. Although PGC-1α is primarily known for inducing transcription of nuclear DNA, it may also, in conjunction with SIRT1, induce expression of mtDNA [300].
Thank you for the information. I gain a lot after reading this article. I checked my blood sugar yesterday’s morning I got 323mg. When i checked it this morning the result I got was HI. I was scared initially but thought it wise to recheck again. The second result gave me 111mg. I will check it again today and tomorrow morning to know the results it will give. I use ONETOUCH Ultra Mini machine for the check..
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.
If your blood sugar gets too high, then you may have Ketoacidosis. What happens is that the body does not have enough insulin to use the glucose cells, so it starts to break down fat and muscle for fuel. This causes ketones to enter the bloodstream and causes a pretty bad chemical imbalance. Ketones can also be found in your urine, which is an easy way to test. Signs of Diabetic Ketoacidosis are:
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How can ketosis help reduce your risk various health concerns? It comes down to the benefits of stabilizing your blood sugar and decreasing glucose intake and usage. As glucose enters your blood, your pancreas sends out insulin to pick up the sugar and carry it to your cells so they can use it as energy. However, when your cells have used or stored all the glucose that they can, what remains is converted into glycogen to be stored in the liver and muscles OR converted into triglycerides, the storage form of fat.
The sausage for this keto breakfast sandwich is pretty straight forward.  I used half a pound of store bought breakfast sausage.  I formed it into 2 patties and cooked them in my cast iron skillet.  Cook it on medium-high heat and don’t touch it until it forms a crust.  Try to ignore the splatters all over the stovetop, unless you’re OCD like me and you wipe it away while everything is still cooking.  Then wipe again, and again.
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Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
The handheld devices that are available for home testing (such as FreeStyle by Abbott, or KetoMojo) require a small droplet of blood (obtained by a finger prick with a lancet) to be placed on a testing strip. A new testing strip must be used each time a reading is taken. The machine delivers a numerical blood BHB measurement in the unit milli molar (mM) after ~8 seconds. 
Ketones are a special type of fat that can stimulate the pathways that enhance the growth of new neural networks in the brain. A ketogenic diet is one that is high in fats, and this diet has been a tool of researchers for years, used notably in a 2005 study on Parkinson’s patients finding an improvement in symptoms after just 28 days. The improvements were on par with those made possible via medication and brain surgery. Other research has shown the ketogenic diet to be remarkably effective in treating some forms of epilepsy, and even brain tumors.
Metabolic syndrome is a collection of heart disease risk factors that increase your chance of developing heart disease, stroke, and diabetes. The condition is also known by other names including Syndrome X, insulin resistance syndrome, and dysmetabolic syndrome. According to a national health survey, more than 1 in 5 Americans has metabolic syndrome. The number of people with metabolic syndrome increases with age, affecting more than 40% of people in their 60s and 70s.
Oatmeal is the ultimate morning meal in the winter months—and anytime your soul needs something warm. Ruled.me’s breakfast porridge makes that experience possible on a keto diet. Instead of your usual oats, it’s made with flaxseed meal and coconut flour, and sweetened with erythritol, to keep sugar and carb counts low. (The texture feels something like cream of wheat.)

Hi John, You could possible try a hand mixer in a bowl instead of the food processor, but I haven’t tried it, so can’t vouch for the results. Most likely the bread would not be as tall because the mixer would completely deflate the first half of the egg whites when you add them to the batter. The second half should be folded so that part will be find. If you try with a bowl and hand mixer, let me know how that goes.


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.

Finally, an important consideration is the effect of the ketogenic diet on blood lipids. This is because the levels of various lipids in the blood have been shown to predict the likelihood of cardiovascular disease. Lipids and cholesterol are carried through the blood in biochemical assemblies called ‘lipoproteins,’ because they do not dissolve in water. There are two broad classes of lipoproteins in the blood: high density lipoprotein (HDL) and low density lipoprotein (LDL). HDL is thought of as more ‘healthy’ (H = ‘Healthy’) because it responsible for moving cholesterol and lipids from the peripheral tissues into the liver for metabolism. LDL is demonised as bad cholesterol (L = ‘Lethal’), levels are elevated after a fatty meal and elevated LDL is associated with cholesterol build up in the arteries. 

To think of it another way, if you start with stored energy – glucose or fat, for example, which if burned in calorimeter will give off varying amounts of heat – and you’re willing to convert their carbon, hydrogen, and oxygen molecules into another form with less energy – water and carbon dioxide which, if burned, produce very little heat – it’s a fair trade!  The ETC is simply the vehicle that allows our body to make the switch.
Additional indications of exogenous BHB upregulating antioxidant defense have been observed, although without consideration of HDAC inhibition. In rats, injection of BHB has increased activities of SOD and catalase and prevented the increase in lipid peroxidation and decreases in SOD, catalase, and GSH induced by paraquat injection, all of which were observed in kidney homogenate [104]. Furthermore, BHB also prevented the paraquat-induced decrease in nuclear NFE2L2, indicating involvement of antioxidant signaling [104]. Similarly, BHB treatment has increased FOXO3a, SOD2, and catalase content in cardiomyocytes [105], indicating that BHB may also influence antioxidant defense in the heart. In this study, BHB also prevented the decrease of FOXO3a, SOD2, and catalase content that resulted from H2O2 treatment [105]. Despite the amount of research that has been done on the antiseizure mechanisms of ketogenic diets, the influence of BHB on HDAC inhibition and related antioxidant defense appears to have not yet been investigated in brain tissue. However, BHB appears to inhibit HDAC2 in microvascular and neuronal brain cells [106], and BHB-induced HDAC inhibition is thought to have a role in the antiseizure effects of ketogenic diets [107].
In 2005, the American Heart Association (AHA) in conjunction with the NHLBI also released a scientific statement regarding metabolic syndrome that includes a set of criteria that defines the condition. In order to provide more consistency in both patient care and research, the International Diabetes Federation, NHLBI, AHA, World Heart Federation, and the International Association for the Study of Obesity published a joint statement in 2009 that describes a "harmonized" definition of metabolic syndrome. Waist circumference, with population and country-specific criteria, replaced obesity as a measure of body status.

According to the National Institutes of Health, a mother’s high normal blood sugar levels can put their baby at risk for birth problems. If the mother’s blood sugar levels were high, it is more likely that the baby will have high insulin levels as well at birth. Therefore it is important that during your pregnancy, you are following under the directions of your physician any guidelines which will help you balance your blood sugar levels.


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The trick here is not only to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will converted into glucose in the body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
Hi Christy, It might be a little more difficult, but in theory possible. You’d need to stir the dry ingredients, then use a hand mixer instead of food processor to mix them with the butter. Then, after beating the egg whites separately, you’d need to mix in part of them, trying not to break them down, then fold in the rest once it’s easier to fold.
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].
Hi Amber, Yes, the baking powder and egg whites do help it rise a bit, just not as much as regular bread. It’s hard to say what went wrong, if anything. Everyone’s palate is a little different, so it’s possible you just didn’t like it, or maybe something didn’t go as it should have. It could be that the batter and whites weren’t folded together quite enough?
Moving more . Even if you’ve never exercised before, you can start now and markedly reduce your risks. Even moderate amounts of activity will make a difference with heart markers. Walking is a good starter plan for many people. “I tell my patients to get an activity tracker,” Ndumele says. “Aim for 5,000 steps a day and work up to at least 10,000 steps a day.” Talk to your doctor to get the go-ahead on the types of workouts you want to try.

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!)

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I absolutely LOVE this bread. I make a fresh loaf every 1-2 weeks as needed. It took 3 tries to get it right. I had tried it with pre-ground NOW foods powdered psyllium husk powder and got a gooey, purple version [that still tasted great and toasted fine], and then I must have used a tiny bit too much liquid in another version because it was too dense, but now I precisely weigh everything and grind up my own psyllium husks in my coffee grinder as fine as I can get it and it comes out perfect every time. This is going to sound dramatic, but this bread has changed my life. lol… it’s a go-to for a quick meal if I have nothing else prepared because I can always find something delicious and keto-friendly to either slather on top, or make toast for my eggs, French toast [I can’t REMEMBER the last time I had French toast before I started making this bread!], or a quick little sandwich on the go. Maria – I’ve read almost all of your books and use so many of your recipes and tell everyone that will listen about you. I’ve sent your books to numerous family members, too. Thank you so much for everything you do. I started eating ‘The Maria Way’ last September and have lost that ‘inner carb demon’ that made me hungry all the time. That alone is priceless to me. I feel like I’ve finally been set free! Food has no hold over me anymore, now it’s about all the delicious and healthy food I CAN have and LOVE.

A combination of baking soda, lemon juice, and baking powder eliminates the need for yeast in this bubbly keto bread recipe. With tons of Italian seasonings, olive oil, and flaky salt sprinkled on top, you’ll want to include this loaf with every meal. Each generous slice is 3 net carbs — and to stay more Bulletproof, simply avoid eating garlic and xanthan gum too often.
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