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.

^ Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F (October 2005). "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement". Circulation. 112 (17): 2735–52. doi:10.1161/CIRCULATIONAHA.105.169404. PMID 16157765.


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Admittedly, I started my journey on this path in 2009, with a deep dive into ketosis in the Spring of 2011, but it seemed so obscure! (For a timeline of what I did, I think I covered it somewhere in this talk…yes I’m too lazy to actually confirm this by skimming through it.) All told I spent approximately 3 years in the strictest state of nutritional ketosis (NK) with one very memorable deviation when I had 6 or 7 full-sized and upsettingly decadent desserts circa September 2013. I believe the diet helped me transition from metabolic syndrome to metabolic health and I certainly thought it could benefit other people. This nutritional state could gain some steam, I thought.
Your bread recipe is the first recipe which turns out like bread! I was so excited. I loved the texture and the smell. Even though i wasn’t using a mixer, it’s still very delicious. Even more delicious when i toast it whenever i wanna have a slice. Can’t wait to try the rest of your recipes. Thanks Katrin. p/s: i didn’t have xanthan gum, so i replaced with arabica gum.
Even though intracellular metabolism and activation of the ATP-sensitive K+ channels appear to be necessary for some signaling effects of FAs, a great amount of the FA responses in the ventromedial hypothalamic neurons are mediated by interactions with fatty acid translocase (FAT)/CD36. Translocase is a FA transporter/receptor that activates downstream signaling even in the absence of intracellular metabolism (Moulle et al., 2014).
Sounds weird? Yeah I thought so too! Ok let me explain. When at room temperature I’m fairly certain you’ll all agree it tastes like a lovely corn (free) bread. Dense, but soft and lightly crumbly (and I’m fairly certain that with a cornbread extract some good stuff will happen). But then when you warm it up, it goes softer again and reminds me of a lovely sweet bun.

More specific to mitochondrial function, treatment with BHB + ACA (1 mM each) has decreased O2•− production in isolated rat neuronal mitochondria following glutamate exposure [109]. This occurred in conjunction with decreased NADH levels, suggesting that ketones may additionally decrease mtROS production by enhancing electron transport along the mtETC after NADH oxidation and, in turn, decreasing mitochondrial Δp and associated O2•− production. The observed decrease in mitochondrial O2•− production occurred independently of glutathione [109], but in isolated and stunned hearts from guinea pigs, treatment with 5 mM ACA increased GSH and the NADPH/NADP+ ratio [110], suggesting that glutathione may be involved to some extent.


Consistent with the mechanisms described above, changes in AMPK in response to a ketogenic or low-carbohydrate diet have been reported in several studies. In rodents, a ketogenic diet (Bio-Serv F3666) has increased AMPK activity in skeletal muscle [150] and AMPK phosphorylation in the liver [230], and a low-carbohydrate diet (18.5% of energy) supplemented with ketone esters (6% w/v) increased AMPK content in brown adipose [149]. In humans, a nonketogenic low-carbohydrate diet (% energy: 50 fat, 30 carbohydrate, and 20 protein) has increased AMPK phosphorylation in skeletal muscle [231].
Unfortunately I did not care for this recipe. I’ve been cooking snow I was 8yrs old and cook everything from scratch but I always make a recipe and follow it to a T the first time..based on that..this was like eating scrambled eggs..the taste was very very eggy! Texture was like scrambled eggs too on the inside.. Also very very salty!! I’m wondering if taking out the yolk and eliminating half the salt could make this better. I’m bummed because I really wanted to like it. 
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!!
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
Ketosis could benefit patients with PD, as ketones provide an alternative energy source to the brain and also have antiinflammatory effects. Several research groups have shown that the ketogenic diet can have manifold beneficial effects in animal models of PD: alleviating motor symptoms, reducing inflammation, decreasing neuronal loss 61 ,62. Also, an in vitro model of PD (neurons in culture treated with a drug called MPTP) was used to demonstrate that addition of 4 mM of BHB was protective against neurodegeneration52. An early study of the ketogenic diet in PD patients reported very promising results: patients improved their clinical PD ‘score,’ as classified by factors including tremor, balance and mood 63. Whilst there are promising results, further clinical studies are required to demonstrate if the ketogenic diet or exogenous ketones (either alone or in combination) are a tolerable and efficacious intervention for PD.            
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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.  
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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This savory frittata recipe by Ketogasm is loaded with nutrients to power your day.It’s hearty and filling, without taking you past your carb limit. Each serving has 333 calories, 26 grams of fat, 20 grams of protein, and only 1 net gram of carbs. This bloggers uses spinach, mushroom and uncured sausage, but feel free to play around with your veggies or swap sausage for chicken or steak.
“Individuals vary in their blood ketone levels (i.e., beta-hydroxybutyrate – aka BOHB) over the course of a day and from day to day. This can be due to variations in dietary carbohydrate and protein from meal to meal and from day to day…Additional factors that increase blood BOHB are endurance exercise and also after consuming fats containing medium chain triglycerides (MCT) such as butter, coconut oil, or purified MCT oil. In contrast, there is often a steep drop in BOHB after high intensity exercise, the mechanism for which has yet to be proven. This post-sprint drop in BOHB tends to be temporary (lasting for an hour or two), which means that it’s cause is very different from the days-long drop in blood BOHB that one sees after a large carb meal.”
I want you to start drinking. A lot. Of water. (Sorry for the letdown.) In fact, I want you to drink only water. Never, ever, ever drink a calorie. Stick with water, and drink a lot of it. It’s good for you, and like an early salad, water can help keep hunger at bay. I’d also like you to avoid diet sodas, at least on a regular basis. Though they don’t have any calories, diet sodas cause folks who drink a lot of them to have a harder time losing weight. No one is sure why.
The ketogenic diet can compromise high intensity sprint performance: High intensity exercise performance is heavily reliant on the ability to produce energy via anaerobic respiration (glycolysis), which requires carbohydrate as a substrate. Following a ketogenic diet causes a decrease in the amount/activity of the enzymes in the glycolysis pathway that decreases the rate that the pathway can proceed24. This could explain the decrease in anaerobic sprint performance consistently seen with athletes following a ketogenic diet 25 ,23. 
While several national and international organizations use certain criteria to define metabolic syndrome, others, including the American Diabetes Association (ADA), question the value of the specific diagnosis of metabolic syndrome. They point out that the criteria, taken together, are no more useful at predicting the risk of cardiovascular disease or diabetes than the individual criteria considered separately. The science needs to be clearer, suggests the ADA, before metabolic syndrome be considered a definable syndrome.
Typically jam-packed with fruit and sugar, your average smoothie bowl isn’t a keto-friendly way to start the day. This chia smoothie bowl by Fat for Weight Loss, though, uses ingredients like coconut cream, avocado, chia seeds, and desiccated coconut for healthy fats, along with blueberries, erythritol, and a little vanilla for that smoothie bowl sweetness. At six grams of net carbs per serving, this sweet, creamy breakfast bowl is a great option when you’re craving something sweet. Top with whatever seeds your heart desires, coconut, and low-sugar fruit, like strawberries.
This “lazy” keto bread recipe is anything but boring: Crumbling the butter directly into the dough creates moist and tender biscuits for all your sweet and savory recipes. Plus, this recipe takes 30 minutes from start to finish and keeps each biscuit macro-friendly at 3 net carbs. Stay more Bulletproof and use the sour cream and whey protein swaps suggested in the recipe, plus avoid eating flaxseed too often.
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This bread does have quite a few ingredients, but you’ll find that most are staple paleo and keto pantry ingredients. In the list below you’ll find details on several ingredients and possible subs. But if possible, please do try and make this recipe without any subs. As out of the 18 permutations we tried, this one really was terrific and the absolute best.
Having adequate blood levels of vitamin D may reduce the risk of insulin resistance in people who are obese. There is some evidence that a certain blood level of vitamin D is needed for normal glucose metabolism in women who are overweight and obese (but not diabetic), but it is not clear whether any further benefit is gained with higher blood levels.
Some investigators feel that mitochondrial dysfunction and compromised brain glucose metabolism may play a role in the development of autism. As autism is sometimes accompanied by seizures such as those seen in epilepsy (which could be improved by the ketogenic diet), the diet has been trialled in a small number of case studies. These cases have shown that the ketogenic diet can lead to improvements in the childhood autism rating scale score 78 ,79, however dietary adherence may prove even more of a challenge with these children, decreasing the viability of the ketogenic diet as an intervention.   
L-glutamine, an amino acid needed in large amounts by your body, has been shown to help build lean muscle by suppressing insulin levels and stabilizing blood sugar. One study found that supplementing with L-Glutamine for six weeks improved body composition in patients with type 2 diabetes. L-glutamine has also been shown to help heal a leaky gut, which is important for digestive health and immunity. In addition to supplements, you can find L-glutamine in foods such as bone broth, grass-fed beef, cottage cheese, spirulina, asparagus, broccoli rabe, salmon, and turkey.
Instead of a complicated keto bread recipe, this breakfast sandwich from Hey Keto Mama gets creative and simple by using spicy pork sausage patties in place of an English muffin or bagel. An egg plus a sriracha and cheese mixture are sandwiched in between, along with any veggies of choice (a slice of tomato and spinach would fit right in). To lighten it up, swap in turkey sausage patties and use just egg whites instead of the whole egg.
Recent studies indicate that mood disorders such as depression and anxiety can be linked to a range of physical changes in the brain, such as inflammation or change in gene expression71. Early results from animal studies have shown that ketosis could improve mood disorders, although the mechanism is still unclear. Rats fed exogenous ketones for several weeks showed reduced anxiety behaviours72. Similarly, endogenous and exogenous BHB alleviated depressive behaviour in mice subjected to stress73. This was found to be linked to altered epigenetic markers (modifications to DNA that affect the degree of gene expression) and an increased amount of brain derived neurotrophic factor (BDNF) in the brain. At this time, there are no trials investigating the effects of ketosis in human patients with mood disorders. 
Insulin resistance also may increase your risk for metabolic syndrome. Insulin resistance is a condition in which the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used for energy. Insulin resistance can lead to high blood sugar levels, and it’s closely linked to overweight and obesity. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.
For those, like myself, wanting a low-carb real bread I would recommend a proper low-carb yeast bread recipe with vital wheat gluten (the vast majority of people have zero gluten sensitivity, so the gluten-free fad is at best a waste and at worst a scam). Such breads have approx 1.5-2 grams more net carbs per 40g slice (5-6 grams total net carbs) than this recipe and I think it’s worth it.
My bread came out a teeny bit “eggy”…which wasn’t bad, I still enjoyed it. Maybe some egg yolk made it in the batter??? Anyway, the slight egginess made me think of French toast. So with the last few pieces, that’s what I made. I mixed an egg, heavy cream, and a little vanilla to coat the bread…used browned butter to sub for syrup…then topped off with Swerve confectioners sugar. It was delicious!
The situation for Type II diabetics is different because some insulin production remains and some cells of the body can still respond to insulin. It is worth noting that insulin sensitivity can be different between the different tissues of the body such as liver, adipose tissue and muscle. A small amount of insulin release can help to prevent development of DKA unless the body is totally insulin resistant. Insulin resistance is a term used to indicate that for a given amount of insulin, the cells of the body are less responsive and take up less glucose. This means that blood glucose levels remain higher for longer when insulin resistant Type II diabetics eat a carbohydrate rich meal. Over time, the pancreas secretes more insulin to compensate for reduced insulin sensitivity, which can damage the insulin producing (beta) cells. Furthermore, having high blood glucose can lead to a number of side effects:
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)
Fill half your plate with non-starchy vegetables. Split the other half in two between protein and whole-food carbs such as brown rice, quinoa, beans, legumes, or ancient grains such as amaranth, millet, or farro. These complex carbohydrates have more fiber and nutrients than processed carbs such as white rice, bread, and pasta, and the fiber helps control blood sugar levels.

Last point of background: Everything I’ve just presented is based on data from starving subjects.  If one restricts carbohydrate intake, typically to less than about 20-50 gm/day (dependent on timing and carbohydrate composition), and maintains modest but not high protein intake (because protein is gluconeogenic – i.e., protein in excess will be converted to glycogen by the liver), one can induce a state referred to as “nutritional ketosis” with similar physiology to what I’ve just presented without resorting to starvation.  Why you’d do this is something I will discuss later.

Scheme of orexigenic and anorexigenic effects of ketosis. The picture is highly schematic. For more details please see the text. AMPK, AMP-activated protein kinase; CCK, cholecystokinin; GABA, gamma-aminobutyric acid; BHB, β-hydroxybutyric acid; FFA, free fatty acids; ROS, reactive oxygen species; NPY, neuropeptide Y; AgRP, agouti gene-related protein.
One side effect of ketosis that some people experience is the keto rash. It is rare but can be very irritating. The keto rash occurs in the armpits, chest, and back. These areas are red and itching. There are several theories about the causes of the rash. Because it is found in regions where sweat accumulates, the most plausible explanation is that acetone in the sweat irritates the skin. [7].
This bread does have quite a few ingredients, but you’ll find that most are staple paleo and keto pantry ingredients. In the list below you’ll find details on several ingredients and possible subs. But if possible, please do try and make this recipe without any subs. As out of the 18 permutations we tried, this one really was terrific and the absolute best.

[Guideline] Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120(16):1640-5. [Medline].
All of the factors associated with metabolic syndrome are interrelated. Obesity and lack of exercise tend to lead to insulin resistance. Insulin resistance has a negative effect on lipid production, increasing VLDL (very low-density lipoprotein), LDL (low-density lipoprotein – the "bad" cholesterol), and triglyceride levels in the blood and decreasing HDL (high-density lipoprotein – the "good" cholesterol). This can lead to fatty plaque deposits in the arteries which, over time, can lead to cardiovascular disease and strokes. Insulin resistance also leads to increased insulin and glucose levels in the blood. Excess insulin increases sodium retention by the kidneys, which increases blood pressure and can lead to hypertension. Chronically elevated glucose levels in turn damage blood vessels and organs, such as the kidneys. 
Ketogenic diets (around 50 grams of carbs per day) are extremely effective for getting lean because you reset the body’s enzymatic machinery to use fat as its primary fuel source in the absence of carbs. I see three problems with your diet that are certainly causing your fat-loss plateau—too much protein, not enough good fat, and residual carbohydrates.
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.

You've probably heard of the keto diet, the trendy weight loss plan that advocates for cutting down carbs and upping your fat intake. (That means no to pastries and pasta, and yes to meat, eggs, and heart-healthy oils.) If your morning routine of the past involved bagels, toast, or oatmeal, trying to come up with keto breakfast ideas can feel like a rude awakening. With so many carb-heavy a.m. foods, it's arguably the hardest meal to find ketogenic diet-approved substitutes for — especially when you're staring right in the face of a donut on your morning coffee run.


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.

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Because metabolic syndrome and insulin resistance are closely tied, many healthcare providers believe that insulin resistance may be a cause of metabolic syndrome. But they have not found a direct link between the two conditions. Others believe that hormone changes caused by chronic stress lead to abdominal obesity, insulin resistance, and higher blood lipids (triglycerides and cholesterol).

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
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.  
Carbohydrates need to be consistent. You don’t want to eat all of your daily carb count in one meal. That will cause your blood sugar to spike, and then drop during the other meals. Giving your body a steady amount of carbohydrates will provide a stable amount of energy. It will also help your body make enough insulin to keep your blood sugar at a healthy number.
The fact that the diagnostic criteria for metabolic syndrome vary between ethnic populations is testimony to significant nuances in the manifestation of metabolic syndrome in these groups. The original metabolic syndrome criteria were derived in mostly Caucasian populations, and some have argued for modification of individual criteria for specific ethnic subgroups, as has been done with waist circumference for patients of Asian origin. [39]
Loaded with protein-packed ground beef, sharp cheddar, veggies, and everyone's favorite taco add-ons (salsa and sour cream, anyone?), this skillet from Peace, Love, and Low Carb is like eating nachos for breakfast — minus the chips. The best part: It can be meal prepped ahead of time for a week's worth of breakfasts. (Just leave the toppings off and add them after you've heated up a serving in the morning.) Who says tacos only belong on Tuesdays?
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I followed the recipe to a tee, used all recommended ingredients. I’ve attempted making it twice, the first time I didn’t have a food processor and that was a complete fail. The second time, today, I bought a food processor and attempted it again. The egg whites were fluffy but never got to stiff peaks… maybe my eggs were too cold? Anyway, I baked for 30 mins, and it wasn’t even golden brown on the top so I didn’t put the foil on time and cooked it another 20 mins. I just pulled it out about 20 mins ago and it is golden brown. However, it is a very moist almost like a banana bread texture. I just popped it back in the oven hoping it will “dry up”. Any recommendations? Do I need to cook for and hour ?

Notably, it can take several months to become fully ‘keto-adapted’ and performance can decline in the short term as these adaptations occur. It is also likely that individual responses to the diet vary. These factors make design and interpretation of sports science studies challenging and leave the door open for continued disagreement between scientists on each side of the debate. If you want to find out what each side has to say, we would recommend reading the comprehensive reviews by Louise Burke (who dislikes the use of the ketogenic diet)27 and Volek and Phinney (who promote the use of ketogenic diet)28. 
The Caerphilly Heart Disease Study followed 2,375 male subjects over 20 years and suggested the daily intake of a pint (~568 ml) of milk or equivalent dairy products more than halved the risk of metabolic syndrome.[51] Some subsequent studies support the authors' findings, while others dispute them.[52] A systematic review of four randomized controlled trials found that a paleolithic nutritional pattern improved three of five measurable components of the metabolic syndrome in participants with at least one of the components.[53]
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.

I tried this bread and on my first shot, it came out amazing and I didn’t even have a scale to weigh the measurements properly! I just used measuring cups. I ground up my psyllium husk (for all you Canadians, I used ‘Source of Life’ brand from my local health food store, product of BC) to a fine powder using my mini-food processor. Today I’m trying it out again but to my dismay I had only 2 cups of almond flour left so I decided to experiment and add 1/2 cup of coconut flour to the almond flour. I probably should have tweaked the other ingredients but I wasn’t sure how so I used the same amount of everything else. I know normally you have to double the eggs but I’m using both almond and coconut so we’ll see. It’s in the oven now. . .


Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120 (16):1640-5.

Formation of O2•− at complexes I and III primarily occurs in the mitochondrial matrix, but some of the O2•− produced at complex III is produced in the intermembrane space [63]. Within the matrix, O2•− is rapidly dismutated into hydrogen peroxide (H2O2) by manganese superoxide dismutase (SOD2) [41, 53]. Some O2•− may escape into the mitochondrial intermembrane space [64] and cytosol [65], where copper/zinc superoxide dismutase (SOD1) can dismutate it into H2O2 [41]. The large majority of mitochondrial H2O2 is removed by peroxiredoxin (Prx) 3, followed by much smaller contributions from Prx5 and glutathione peroxidases (GPx) 1 and 4 [66]. GPx also removes other peroxides, including lipid hydroperoxides [41]. Catalase is another antioxidant enzyme capable of removing H2O2 but is primarily located in peroxisomes and is therefore unlikely to directly remove mitochondrial H2O2 [41, 66]. However, H2O2 can be transported out of mitochondria [67], and it is possible that the majority of mitochondrial H2O2 is removed in the cytosol. Since Prxs and GPxs rely on NADPH for recycling of their cofactors (thioredoxins and glutathione, resp.) [41], and since NADH is required for recycling of NADPH [68], activity of these enzymes would decrease availability of NADH for oxidative phosphorylation. Therefore, transport of H2O2 out of mitochondria for removal in the cytosol may be a more likely defense mechanism [67], implying a more important role of catalase and other antioxidant enzymes outside of mitochondria. Despite the lower reactivity of H2O2, it is still reactive and can oxidize metal ions, particularly iron, to form the hydroxyl radical (•OH), which readily damages DNA, lipids, and proteins [41]. •OH is scavenged by metallothioneins I and II [69, 70] and glutatathione [71], indicating that these antioxidant proteins may be important defenses against byproducts of unaddressed mtROS. Other important antioxidant enzymes include glutamate-cysteine ligase (GCL), which is the rate-limiting step in glutathione synthesis, and glutathione reductase (GSR) and thioredoxin reductase (TRXR), which recycle glutathione and thioredoxin, respectively, to their reduced forms [41].


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.
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Ana, We like using a combination of almond flour and coconut flour for this bread to achieve the best flavor and texture. We haven’t tried this bread using only coconut flour, but it may work. Coconut flour absorbs liquid differently, so you’ll want to use about 1/4 the amount of coconut flour as almond flour (since the recipe calls for 2 cups almond flour, that would be 1/2 cup coconut flour in addition to the 3/4 cup coconut flour that the recipe already calls for). However, the flavor and texture of this bread will likely be different with that substitution. Please let us know how it goes if you give it a try!
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