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].

Acetoacetate diester did not improve performance37: a different ketone ester to that used by Cox et al (an acetoacetate diester) decreased cycling performance by 2% given before a 50’ cycling race. Reasons for the difference in findings could be: this ketone ester drink was given along with a can of diet cola 30 mins before exercise and caused GI upset in many athletes. Delivering acetoacetate causes the muscle cells to become more ‘oxidised,’ which is a less favourable state for ATP production. Risk of some gastrointestinal upset with all ketone supplements. The dose, tonicity, time taken before competition and overall volume of a ketone drink will affect how easy it is to tolerate. Many athletes take ketone supplements without side effects, however there are differences between individuals, so practice with ketone supplements in training is advisable to ensure they don’t experience any GI side effects in competition. Geoff Woo discussed this study in a blog post.
The reason a starving person can live for 40-60 days is precisely because we can turn fat into ketones and convert ketones into substrate for the Krebs Cycle in the mitochondria of our neurons. In fact, the more fat you have on your body, the longer you can survive.  As an example of this, you may want to read this remarkable case report of a 382 day medically supervised fast (with only water and electrolytes)!  If we had to rely on glucose, we’d die in a few days.  If we could only rely on protein, we’d live a few more days but become completely debilitated with muscle wasting.

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For those with gummy results, don’t throw away the bread. I found toasting it in oven on 425 works better than toaster and makes the bread edible if your loaf did come out gummy. Also, by accident, I left a piece in oven and preheated oven later for something else I was making and found my extremely crispy toasted bread which made a GREAT baguette! Now I’m making a bunch like this to eat with different creamed cheese spreads! The only real success I’ve had making this bread is in sub or roll form, otherwise, I too experienced some dense/gummy results, moreso, using the coconut flour recipe though.

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.


Well… it turned out beautifully. It rose evenly, it was light, fluffy and baked through. It tasted very good, both plain and toasted with butter. I truthfully do not know if I would add the butter the next time I make a loaf because I was so pleased with this version. I will likely reduce the erythritol to 1 tablespoon or less for a more subtle sweetness in the future. This recipe has so many flavour possibilities and I look forward to trying out all of my ideas using this excellent base. It is also good to know that it can be made without the additional fat component. Don’t get me wrong, I am keto and a committed high fat enthusiast but slathering some fat on top of the bread… butter, pâté, nut butter… will work just fine for me.
In controlled studies on exercise-trained humans and animals, ketogenic diets have been shown to increase fat oxidation [8, 167] and expression or activity of carnitine palmitoyltransferase [167, 168] and β-HAD [168, 172], demonstrating that nutritional ketosis induces adaptation beyond exercise. Similarly, in a study comparing the independent and combined effects of exercise and a ketogenic diet on rats, the combination resulted in greater β-HAD and citrate synthase activities in skeletal muscle and higher maximal O2 consumption than either intervention alone, further indicating the potential for exercise to magnify adaptations induced by nutritional ketosis [156].
I just made this bread and although mine looks more dense than yours, it is good. I was going to make it again using a little less water to see if I can get more rise, but then I read your comment about you not eating this bread because your keto bread is more weight loss friendly. So I shouldn’t eat this since I’m trying to lose weight? I’ve been keto-adapted for over a year, but I’ve only lost 62 pounds:( Thank you for your recipes and all of the research you do! Don’t think I could stick with this way of eating without being able to cook delicious food!
^ Klein MS, Buttchereit N, Miemczyk SP, Immervoll AK, Louis C, Wiedemann S, Junge W, Thaller G, Oefner PJ, Gronwald W (February 2012). "NMR metabolomic analysis of dairy cows reveals milk glycerophosphocholine to phosphocholine ratio as prognostic biomarker for risk of ketosis". Journal of Proteome Research. 11 (2): 1373–81. doi:10.1021/pr201017n. PMID 22098372.
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In controlled studies on exercise-trained humans and animals, ketogenic diets have been shown to increase fat oxidation [8, 167] and expression or activity of carnitine palmitoyltransferase [167, 168] and β-HAD [168, 172], demonstrating that nutritional ketosis induces adaptation beyond exercise. Similarly, in a study comparing the independent and combined effects of exercise and a ketogenic diet on rats, the combination resulted in greater β-HAD and citrate synthase activities in skeletal muscle and higher maximal O2 consumption than either intervention alone, further indicating the potential for exercise to magnify adaptations induced by nutritional ketosis [156].

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?
The yeast in this low carb and keto bread ensures a wonderful texture and taste. Now, how much your bread will rise (and fall!) post-bake depends quite a bit on your altitude. But note that you still won’t get that gummy and wet texture here of most low carb breads. Plus, as mentioned, we’re baking at over 7,000 feet (Mexico City here!!), so if we can make this keto sandwich bread work so can you.
Practically speaking, because it takes several days to raise blood ketone levels by following the ketogenic diet it has been virtually impossible to study the effects of ketosis on brain injury in humans. It is also complicated by the difficulty in quantifying the extent of the damage without repeated imaging and there is a lack of reliable biomarkers for concussion. Furthermore, concussions can’t be ‘administered’ to humans experimentally, making it impossible to study in a controlled setting. Therefore much of the proof of concept research looking a ketosis for concussion has been done in animals. Nevertheless, the results are promising: rats who were given a ketogenic diet or ketone precursors before67 and after68 a controlled concussive injury have were found to have improved brain energy metabolism, and improved cognitive and motor function post injury. Also, giving exogenous ketones as an injection post-injury protected the brain against glutamate induced excitotoxicity69 and alleviated the decrease in brain ATP that occurs due to the depression of glucose metabolism70. Therefore, as scientists’ ability to quantify concussion in humans improves, ketosis could be an interesting intervention to attempt to reduce the harmful after-effects.  
As previously discussed, RET is a prominent source of mtROS and is dependent on a high Δp across the inner mitochondrial membrane. During ATP production, Δp is dissipated as H+ enters the mitochondrial matrix through ATP synthase. Mitochondrial uncoupling also dissipates Δp, but by allowing translocation of H+ into the matrix independent of ATP synthase. Uncoupling is therefore regarded as an antioxidant defense in that it can mitigate mtROS production [122–126]. In fact, only a small dissipation of ΔΨ or ΔpH (components of Δp) is needed for a large decrease in mtROS production [57–60, 127].
High blood sugar levels, or hyperglycemia, is a condition in which glucose concentrations in the blood are too high. This condition is commonly found in individuals who have diabetes and is caused when the body does not produce enough of or is resistant to the effects of the hormone insulin. When high blood sugar is left untreated, it can lead to organ and tissue damage, coma and death. Monitoring your blood sugar levels is a good way to address high sugar immediately and there are several ways to lower sugar levels in the blood.
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.

I made it tonight and use a mini loaf pan. It came out delicious. I used the http://www.tasteofhome.com/article/how-to-cut-down-recipes/ link to adjust the recipe measurements using the one third column. I used 2 egg whites. The slices will be small but it was delicious with melted butter. Keto bread recipes and I have tried quite a few have not turned out well for me. I do not like to waste expensive ingredients that is why I will usually do a small amount first. This recipe has been the exception. It is good simple and delicious. I will make it again using the recipe as written. Note: I whipped the egg whites for 10 minutes to get the right consistency. I hope this helps and thank You Maya for finally for me making a bread that tastes great and is easy to make.


Made this bread this morning Will use a little less water next time as along the bottom of the loaf about ½ an inch deep was a bit doughy & it did sink in the middle was also a darker colour than the one in the picture but is so yummy Have sliced it into peices & put 2 slices into bags in the freezer for when I have toast for breakfast Going to make another loaf tomorrow as my husband thought it was great So pleased to have finally found a bread recipe I can enjoy Thank u so much Really enjoy browsing on here
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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.
Brittany, Thank you so much for leaving a comment! Without being there in the kitchen with you, it’s difficult to say what the issue was; however, I can definitely help you troubleshoot…did you cook it for the full amount of time the recipe calls for, and did you cover the top with foil for the last 15 minutes? If so, there might be an issue with your oven’s calibration (you can get an inexpensive oven thermometer to check this). Another tip is to let your eggs come to room temperature first. Another factor is the altitude at which you’re baking; if you’re at high altitude, you might need to slightly adjust the oven temperature and bake time. The other thing to remember is that there will usually be a little bit of fall to most keto breads (in fact, every keto bread we’ve ever made) because keto flours lack gluten and are naturally quite dense; however, you can see in the photos, we still got a good rise on this loaf. I hope these tips help!
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