There is one exception to exercising with diabetes. If your blood sugar is too high (such as over 240) and you are spilling ketones into your urine, then exercise is only going to increase your blood sugar. You can buy a dipstick urine test to check for ketones, but the best thing to do would be to talk to your doctor about what is safe for you to do.
I just tried this for the first time and it didn’t turn out :(, it is very gummy and dense. I used Now Healthy Foods Psyllium Husk Powder, I measure out 10 TBSP and then weighed it, it went way over 90 grams on my scale so I kept using less and less until I got to what I thought was 90 grams. This powder is very fine. I looked for Jay Robb psyllium husk powder but the only thing on his website is psyllium seed husks? No powder? I see on your “store” you’re promoting “Frontier” psyllium husk powder, should we use that instead?

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AMPK and sirtuins are the interface between the metabolic stimuli of nutritional ketosis and the downstream signaling that influences expression of proteins related to bioenergetics and antioxidant defense. Some of the primary downstream signaling molecules involved include PGC-1α, FOXO3a, nuclear respiratory factors 1 and 2 (NRF-1 and NRF-2), mitochondrial transcription factor A (TFAM), and NFE2L2.
Glucose. Usually a fasting glucose test is performed but, in some cases, a healthcare practitioner may also order a post prandial glucose (after a meal) or a GTT (glucose tolerance test – several glucose tests that are taken before and at timed intervals after a glucose challenge). The goal of glucose testing is to determine whether a person has diabetes or a decreased ability to process glucose (impaired glucose tolerance), which can eventually result in diabetes.
Note that urine measurements may not reflect blood concentrations. Urine concentrations are lower with greater hydration, and after adaptation to a ketogenic diet the amount lost in the urine may drop while the metabolism remains ketotic. Most urine strips only measure acetoacetate, while when ketosis is more severe the predominant ketone body is β-hydroxybutyrate.[36] Unlike glucose, ketones are excreted into urine at any blood level. Ketoacidosis is a metabolic derangement that cannot occur in a healthy individual who can produce insulin, and should not be confused with physiologic ketosis.
I’m so glad you love it, Tanya! Yes, $17 sounds like a lot for xanthan gum. I use this one here. Swerve is sweeter than erythritol, so you’d need less of it – I have a conversion chart here. You’re absolutely right about the xanthan gum and texture – it will make the bread more chewy. It will still be more of a “light and fluffy” bread, but definitely less muffin-like with the xanthan gum. I haven’t tried add-ins yet – let me know how it goes if you try!
Another mechanism that could be involved in food-regulation during KD is the gamma aminobutyric acid (GABA) and glutamate regulation. Wu et al. demonstrated that GABAergic signaling from the NPY/AgRP neurons to the parabrachial nucleus (located in the dorsolateral part of the pons) is involved in many regulatory sensory stimuli including taste and gastric distension, regulate feeding behavior. GABA signaling seems to prevent animals from anorexia when AgRP neurons were destroyed (Wu et al., 2009). These findings are yet another contradictory aspect of KDs and food behavior; ketosis should increase the availability of glutamate (via diminution of transamination of glutamate to aspartate) and therefore increase GABA and glutamine levels; moreover, in ketosis, the brain imports a huge amount of acetate and converts it through glia into glutamine (an important precursor of GABA) (Yudkoff et al., 2008). The result of these mechanisms, together with the increased mitochondrial metabolism and flux through the TCA cycle, is an increased synthesis of glutamine and a “buffering” of glutamate. These results are not consistent with the well-documented anorexigenic effect of KDs, and therefore the GABA hypothesis cannot be taken into account despite the mild euphoria often reported during a KD that is probably due to the action of BHB (Brown, 2007) and can help to reduce appetite.
Although resting skeletal muscle is less metabolically active than the heart, kidneys, brain, or liver, it rivals even the brain in being the body's most metabolically demanding tissue when considered relative to total tissue mass [369]. Physical activity can greatly increase this demand, making exercise a practical and powerful way to induce bioenergetic adaptations.

The only issue with keto, is really that I’m afraid that it might be hard to up my calories to a maintenance weight now that I’ve gotten a taste preference for the rich assortment of foods with no carbs in them. I’m satisfied with less calories than I will need after my excess fat is burned off… but , maybe I bet my body will send more hunger signs once there isn’t anymore body fat in the cupboard to use instead of what goes down my throat.
I made this bread today and love it! The only problem I have is that the bread is very moist on the inside. The crust is perfect. I baked it at 350 for 70 mins and the bottom of the bread was a little moist as well as the inside. I measured all of my ingredients as your instructions say. Please help. This is the best bread I’ve made in the 2 years we have been eating wheat free.
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].
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Ketogenesis is the pathway that forms ketone bodies from fatty acids. Starvation (specifically low levels of blood insulin and glucose) triggers ketogenesis in the liver cells’ mitochondria. Two molecules of acetyl-CoA from the breakdown of fatty acids are condensed via acetyl-CoA transferase to form acetoacetyl-CoA; a third is added to form 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) in a reaction catalysed by HMG-CoA synthase. HMG-CoA lyase then splits this to re-generate acetyl-CoA and form one molecule of AcAc. Beta-hydroxybutyrate (BHB) is formed from reduction of AcAc by BHB-dehydrogenase enzyme, and acetone results from spontaneous, non-enzymatic decarboxylation of AcAc. Acetone is a volatile molecule which is primarily excreted in the breath, although some evidence suggests that a small amount can be metabolised and oxidised4.
A high proportion of energy from ketone oxidation is transferred to the electron transport chain at the start (as NADH+), in comparison to the energy from fat, where a high proportion is transferred ‘downstream’ (as FADH). This means that, even though there is a high amount of ‘potential energy’ in a fat molecule, less of this can be transferred to ATP.   
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.
Metabolic syndrome is a clustering of cardiovascular risk factors that leads to an increased risk for premature cardiovascular disease and increased susceptibility of developing type 2 diabetes mellitus. The syndrome represents a collection of multiple derangements that include elevated blood pressure, impaired glucose tolerance or insulin resistance, atherogenic dyslipidemia (i.e., high triglycerides, low high‐density lipoprotein [HDL] cholesterol, and small low‐density lipoprotein [LDL] particles), proinflammatory and prothrombotic properties, and obesity, with a particular contribution of abdominal obesity. There are two definitions for adults: World Health Organization, 1998 and the National Cholesterol Education Panel (NCEP), Third Adult Treatment Panel, 2001.
Absolutely wonderful recipe! Recently switched to KETO diet for my diabetes since the recommended diet wasn’t working (without loads of insulin, etc.) and hubby recently deemed pre-diabetic. My poor mother, who is a 71-year-old diabetic carb-o-holic, has been a very unhappy camper with the changes, until today. She had a delicious hamburger (using your recipe made in a wider dish) and jicama fries. She actually FINISHED her meal with a smile! Maybe now she won’t kill me in my sleep for tossing all the bread/carbs. 😉 Thanks!

Add yeast and maple syrup (to feed the yeast, see notes) to a large bowl. Heat up water to 105-110°F, and if you don't have a thermometer it should only feel lightly warm to touch. Pour water over yeast mixture, cover bowl with a kitchen towel and allow to rest for 7 minutes. The mixture should be bubbly, if it isn't start again (too cold water won't activate the yeast and too hot will kill it). 
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I’m just starting a new low carb diet and I love your channel. You have so many great and easy recipes but I will definitely be trying this bread out. I love burgers, and was sad I won’t be able to have a bun anymore. I tried a different recipe before and it just tasted like eggs. This looks like it will work much better for me. I may try and make a few batches all at once in the oven and then freeze it for later. Rock on! \m/
I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
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:
If for any reason you get a fail…a spongy loaf , or one with a buble don’t throw it away. Cut off the top bubble and cut into squares or triangles then taost for great pita like chips…cube the bottom sprinkle on some spices and toast or rebake for croutons…I have had my successes and failures wih this loaf but the ingredients are too expensive to waste…another idea would be to toast the bottom after you slice the top off and then add butter, garlic and cheese for a good garlic bread.
I was so excited about making this bread. I recently cut all grains out of my life and I’m also in the process of going gluten free because i have a lot of digestive issues. I followed the recipe precisely. Checked the temp before taking it out of oven. It looked amazing nice and golden brown. I cut into it and i couldn’t wait for that first bite. I was so disappointed it has an odd flavor I just couldnt stomach and it was very salty to me. I tried a few tiny bites with different condiments and couldn’t eat it. After reading some comments, I see it is supposed to be unsalted butter. I used salted, but why did it seem to have a bitter sour taste to it?

I just tried this recipe in my kitchen. OMG thank you so so much for this wonderful idea! The only thing I think I will try next time is to add just a dash or so of salt to the mug before microwaving (although it already tastes great!). I think it will be fun to experiment with adding some different seasonings or herbs to the batter before baking it, too, just for variety.


Metabolic syndrome is quite common. Approximately 32% of the population in the U.S. has metabolic syndrome, and about 85% of those with type 2 diabetes have metabolic syndrome. Around 25% of adults in Europe and Latin America are estimated to have the condition, and rates are rising in developing East Asian countries. Within the US, Mexican Americans have the highest prevalence of metabolic syndrome. The prevalence of metabolic syndrome increases with age, and about 40% of people over 60 are affected.
For those whose bread keeps sinking or falling, make sure your baking powder is fresh. It does expire and usually a sunken baked good is evidence of it. I think it only lasts about half a year to a year. I made some strawberry muffins with almond flour last year and they were such a pretty pink but all of them caved in in the middle. 🙁 Bad baking powder.

Nutrition: What is it and why is it important? Nutrition is the supply of materials that organisms and cells require to live. Humans need seven major types of nutrients to function. A nutritionist studies nutrients, how the body uses them, and the relationship between a person’s diet and their health. Here, learn more about nutrients and what a nutritionist does. Read now
Ketosis is a sensitive state so as soon as you increase your carb intake above your carb tolerance, you’re out! You probably don’t want to continuously weigh and count your food for the rest of your life. So even if you stick to the approved list of ketogenic food, there is no guarantee that you will be in ketosis without interruption. That’s OK. Now if you’re in ketosis to manage cancer or epilepsy, that’s a different story obviously.
As for the bacon, I lay it out in my biggest iron skillet and bake it in the oven while the eggs are in the Instant Pot, the timing works out almost perfectly.  If you’ve got a busy week at work or are going through finals week as a student (or teacher) make these bad boys the Sunday before and roll them into 10 balls rather than 8 and have 2 for breakfast all week long, rather than skipping breakfast and subjecting yourself to UIF (Unintentional Intermittent Fasting).
This is the advice that people with type 2 diabetes received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when they start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.
Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.  The Merck Manual was first published in 1899 as a service to the community.  The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America.  Learn more about our commitment to Global Medical Knowledge.

This breakfast casserole by I Breathe I’m Hungry packs all of the delicious flavors of a Monte Cristo sandwich (a ham and cheese sandwich dipped in French toast batter, fried, and served with syrup) without the carbs. The recipe layers cream cheese keto pancakes, Canadian bacon, and cheese, and is served warm with sugar-free syrup. Sounds like ooey-gooey perfection, doesn’t it? One serving provides 32 grams of protein and just 4.5 grams of net carbs.


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I had the same problem. Everything blended beautifully, rose in oven, then fell. Toothpick came out clean after 45 min of baking. I let it cool and then cut into it this morning and it has raw spots throughout the loaf. I am so disappointed because I killed a dozen eggs to make it and really don’t want to do it again. I wonder if the oven needs to be warmer and the cooking time needs to be increased?
I made this over the weekend. I weighed all of my ingredients and it looked beautiful when it came out of the oven. I baked it for the 75 minutes. It fell after it cooled and when I cut it open, it was purple and a little gummy even after 75 minutes of baking time. After toasting the slices, it tasted very good and I even served it to company. The kids all thought it was cool that the bread was purple. Should I reduce the water? If so, by how much? I will try and get Jay Robb psyllium husk powder in the future. I used Vitacost brand and it tasted fine but, it is not always easy to get people to try purple bread. Thanks for the recipe. We will be making purple bread until we run out of the psyllium husk powder we have.
When your carb intake is that low, your body can't burn glucose (a.k.a the sugar from carbs) for energy like it normally would. So instead, it burns fat for energy, a process that then releases ketones as a byproduct, says Eric Klett, M.D. an endocrinologist and associate professor of medicine and nutrition at the University of North Carolina at Chapel Hill. (This process explains why people on the keto diet see such crazy weight-loss results.)
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Recurrent migraines are highly prevalent and sometimes debilitating. They manifest as throbbing, one-sided headaches and can also involve visual disturbances (aura). Many of the processes involved in migraine are shared with those implicated in epilepsy, especially an abnormally high glutamate (excitatory) activity. In fact, medical professionals sometimes prescribe anti seizure medications that block glutamate activity to migraine patients. The ketogenic diet has been associated with improved migraine control both anecdotally and in a small number of case studies 74 ,75 ,76 ,77. Researchers are currently undertaking further investigations to confirm if the ketogenic diet or exogenous ketones are viable and effective treatment options for migraine patients.  
Most people who have metabolic syndrome have insulin resistance. The body makes insulin to move glucose (sugar) into cells for use as energy. Obesity, commonly found in people with metabolic syndrome, makes it more difficult for cells in the body to respond to insulin. If the body can’t make enough insulin to override the resistance, the blood sugar level increases, causing type 2 diabetes. Metabolic syndrome may be a start of the development of type 2 diabetes.

Eat more fruits and vegetables. According to the 2015-2020 Dietary Guidelines, a person on a 2,000-calorie-per-day diet should eat 2.5 cups of vegetables and 2 cups of fruit a day. This amount will vary depending on how many calories you need. Be sure to choose a variety of fruits and vegetables. Different fruits and vegetables have different amounts and types of nutrients.
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.
For a given quantity of fuel, the maximum amount of work that can be obtained from that fuel in a closed system is called ‘the Gibbs free energy’ (G). This takes into account the inherent ‘heat’ (combustion enthalpy (H)) and a property called entropy (a measure of tendency towards ‘disorder’ (S). The change in Gibbs free energy (∆G) is related to the change in combustion enthalpy (∆H), change in entropy (∆S) and the temperature (T):
In our keto bread recipe, we use a combination of coconut and almond flours so neither is overpowering. We also use a touch of psyllium husk powder to help achieve the right texture. A little bit of beef gelatin acts as a binder and adds bread-like “chew” to the final result. Our recipe only contains egg whites, which add structure and act as a natural leavening agent, but without the eggy flavor that the yolks would add.
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