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.
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).
So I made my own coconut-flour from flaked coconut(according to a recipe I found on line). Psyllium Husk i managed to find only in whole husks form so I grind it up to a powder in a blender. I understand now it sounds like a recipe for disaster but I don’t have another choice (getting the ingredients from the internet will take about 2 weeks and until then it is all I have).
It just needed a bit more structure, so for trial number three I split the difference, using half coconut flour and half almond flour. There’s a reason they say the third time’s a charm. This was the perfect blend. The bread was moist but firm enough to hold its shape, and it didn’t taste like coconut. After that, I began experimenting: hazelnut flour worked great, and cheese and scallions added great flavor.

The goal of the ketogenic diet is to keep you in this fat-burning metabolic state of ketosis. This is achieved by following a very low-carbohydrate, high-fat diet that includes only moderate amounts of protein. Foods like bread, cereal, processed snacks and sugary drinks are therefore off the table, while fattier foods like butter, grass-fed beef, fish and also non-starchy veggies take center stage, providing the majority of daily calories (as much as 70–80 percent).
Another process also happens during ketosis that helps keep your body energized, and it’s called gluconeogenesis. This occurs when glycerol (created during beta-oxidation) get’s converted into glucose that your body can use for energy. Protein in your diet can also be converted to glucose in small amounts. So as you can see, essentially your body is able to create its own source of necessary glucose without getting it from carbohydrate foods. The human body is very efficient, and it knows just how to convert other macronutrients (protein and fat) into useable molecules that can be dispersed throughout the body as needed.
Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show specific very-low-carb diets help people with metabolic syndrome, insulin resistance, and type 2 diabetes. Researchers are also studying the effects of these diets on acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.

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.
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.

One hypothesised contributor to neuronal death is insufficient energy production, secondary to impaired mitochondrial function. However, it is unclear if this is in fact a cause or effect of PD. Whatever the case may be, patients with PD have been shown to have impaired mitochondrial energy production in the brain59 and lower brain glucose utilisation60. Another factor may be neuro-inflammation, which is also common in PD, and is thought to lead to further accumulation of Lewy Bodies and neuronal death.


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.   
^ Bechtel PJ (2 December 2012). Muscle as Food. Elsevier Science. pp. 171–. ISBN 978-0-323-13953-3. Retrieved 19 May 2014. Freezing does stop the postmortem metabolism but only at about −18ºC and lower temperatures. Above −18ºC increasing temperatures of storage cause an increasing rate of ATP breakdown and glycolysis that is higher in the comminuted meat than in the intact tissue (Fisher et al., 1980b). If the ATP concentration in the frozen tissue falls below ~ 1 µmol/g no contraction or rigor can occur because they are prevented by the rigid matrix of ice.
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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Finally, exogenous ketones have been shown to decrease the levels of triglycerides and free fatty acids in the blood after one drink 107 ,106 ,11. There is also early data showing that ketone ester consumption decreases cholesterol biosynthesis in rodents, an effect which appeared to be conserved in humans114. It is unclear at this stage what the long term effects of exogenous ketone consumption on blood lipids and cholesterol would be, but this is an area of promising research. 
Hi Jen, It sounds like it needed to bake for longer – this is why it sunk and was still moist. The timing varies by ovens and even different pans. I hope you’ll try it again and just keep it in there for longer. You can cover the top if it starts to brown too much. For the one you made, depending on how moist it was in the middle, you may be able to salvage it somewhat by pan frying the slices.
While I do not really miss bread I do occasionally like a grilled cheese. I think this will also work well as a hamburger bun this Summer. It is a bit salty even when using unsalted butter, so I might cut that back a bit. It made a great grilled cheese though. I made mine in a small rectangular pan then cut it in half and grilled it in my cast iron pan with cheddar. Wonderful!
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This is now my go to for lo-carb bread recipe. It is SO EASY! I made it last weekend, Instead of Xanthan gum I used konjac root powder, it worked just fine, my baking time was more like 50 minutes and I did cover the top loosely with foil for the first 15 minutes so the top wouldn’t brown so quickly (maybe why my cooking time was so long?) I also added a pinch of Bakers yeast (brewers yeast is NOT gluten free) just for flavor and stevia 3/4 T. This bread makes really good grilled cheese or avocado toast! Very yummy! Thanks for this recipe!
Although convincing, the bulk of evidence in relation to the inhibitory effects of ketosis on appetite is still anecdotal. Preliminary scientific reports seem to support this phenomenon, and the evidence shows that KD is more effective, at least in the short/medium-term, on fat loss (Paoli, 2014). It was demonstrated that diet-induced weight loss leads to changes in energy expenditure and in appetite-regulating hormones that facilitate weight regain and the return to initial energy homeostasis (Sumithran et al., 2011). This response to alteration of energy balance nullifies the success of many dietary approaches. It is well-known that the long-term success of a nutritional approach is defined by the amount of weight regain and is the main problem regarding the so-called weight cycling or “yo-yo” effect (Jeffery, 1996). A recent study by our group has demonstrated that a brief ketogenic period, if followed by a longer period of correct Mediterranean diet could avoid this yo-yo effect (Paoli et al., 2013). During the ketogenic period subjects reported less hunger, confirming previous studies (Nickols-Richardson et al., 2005; Johnston et al., 2006; Johnstone et al., 2008) on hunger-suppression effect of ketogenic diet. Despite these clinical findings, the mechanisms of action of ketosis on appetite reduction are still not completely understood. Clinical results are suggestive of both direct and indirect (via modifications of hunger-related hormones concentration) actions of KBs on appetite (Sumithran et al., 2013).
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Did you hear the news? I have a new cookbook out called Keto Instant Pot Recipes book! But this is not just any Instant Pot cookbook. This keto cookbook has a ton recipes with BOTH Instant Pot directions AND slow cooker directions! I also started an Instagram account on my favorite Keto Instant Pot Recipes and giveaways called @KetoInstantPotRecipes! 
Insulin is the medication that will bring blood glucose down the fastest. Someone who uses mealtime insulin can take correction doses to lower blood glucose. This requires a thorough understanding of when to inject, how often to give correction doses, and how much insulin to use. You will need to work with your doctor or diabetes educator to learn how to do this.
Hi Melissa, Are you beating the whole eggs? It needs to be egg whites only. Whole eggs will never form peaks. Adding a little cream of tartar helps, as well as making sure you start with a very clean bowl (preferably not plastic if you’re having issues). Having the egg whites at room temperature can be a little easier, too, though I usually don’t need to. Hope this answers your question!
These Keto Breakfast Fat Bombs are a true lifesaver for frantic (Monday) mornings.  Personally, when I wake up in the morning after my alarm clock gives out a warning I don’t think I’ll ever make it on time.  By the time I grab my books and give myself a look, I’m at the corner just in time to see the bus fly by…wait no, scratch that…that’s Zach Morris, not me. Either way, I’m sure we’ve all had those mornings where we were saved by the bell, so let these little bacon covered bites of heavenly deliciousness make your mornings more calm*, I guess you could say you’re saved by the (fat) bomb.

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You should always be in touch with your doctor about your disease and any changes you make or problems that you notice. Having that line of open communication is key to gaining knowledge and insight into what can make your life and your health better. Try the things mentioned in this article, but if they don’t help, then talk to your physician about what else is available for you.
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We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again.
Bioenergetic and oxidative stressors may be largely responsible for inducing many of the beneficial adaptations to exercise, and for this reason, exercise research provides much of the basis for mitohormesis [4–6]. As previously discussed, an increase in fat oxidation appears to be a prerequisite for increasing mtROS and, in turn, inducing mitohormesis. Given that ketogenic diets prominently increase fat oxidation during submaximal exercise [8, 88, 214–216, 218, 219, 376–381], the combination of the two interventions may induce mitohormetic adaptations to a greater extent. Furthermore, much of the signaling that is relevant to mitohormesis, and likely induced by nutritional ketosis, is also induced by exercise, further suggesting the possibility of an additive or even synergistic effect. Demonstrating this, exercise or muscle contraction increases activity, activation, or expression of AMPK [209–211, 275, 284, 382–386], SIRT1 [384–389], SIRT3 [272, 390, 391], NFE2L2 [358, 360, 392], p38 MAPK [284, 305, 313–315, 393–395], PGC-1α [275–279, 284, 305, 314, 385–389, 396–400], NRF-1 [358], and TFAM [358, 388, 389]. Exercise also increases expression or activity of antioxidant enzymes [313, 358, 360, 396, 397, 401], uncoupling proteins [94], and bioenergetic proteins involved in oxidative phosphorylation [396, 397, 400] and the citric acid cycle [396], all of which appear to be at least partly mediated by ROS-induced activity of p38 MAPK [284, 310, 313, 314], PGC-1α [284, 310, 397, 401], TFAM [310, 314, 358, 397], NRF-1 [310, 358, 397], NRF-2 [358, 360], and NFE2L2 [358].

If you divide the dough in 3 you'll cook the bread for 90 seconds on high, but if you cook it all together you'll want to do 150 seconds (2 1/2 minutes). Time can vary a lot in microwaves, but to give you an idea mine is 1000 watts. Either way, it'll come out looking pale and spongy (and not very appetizing at all tbh!). But worry not, just wait for it to cool down until just lightly warm (it continues to cook as it cools guys!). Then you'll definitely want to give it a good toast to get some texture on (non negotiable guys!). 


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Hey Maria, I am baking my third loaf of your amazing bread. I’ve been having trouble with it rising and keeping risen, but it is still delicious. This time it has risen to new heights and I’m hoping it stay high. I don’t usually make comments because I almost always make changes to recipes. I added onion powder, garlic powder and caraway seeds. It bothers me when people give recipes poor ratings after they have changed them. Anyway, the reason for my comment is to thank you and tell you how brilliant, amazing and stupendous you are. Using psyllium is genius. I have been making various low carb breads for years, some that I invented, others not. Anyway, nothing I have made has ever come close to the taste or texture of yours. Thank you, thank you, thank you.
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.
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The root cause of most cases of metabolic syndrome can be traced back to poor eating habits and a sedentary lifestyle. In some cases, a diagnosis of metabolic syndrome has also been assigned to those already diagnosed with hypertension or with poorly controlled diabetes. There also seems to be an association with non-alcoholic fatty liver disease, polycystic ovarian disease, and some cancers. A few cases are thought to be linked to genetic factors.
Many questions about the role of such an important intermediate of lipid metabolism remains unanswered, e.g., the role of BHB in food control. For example, whether or not BHB could act as a satiety signal in the brain, considering its role in energy supply to CNS. We have to consider that the effects of KBs on hunger reduction can only be seen after many days following fasting or KD initiation (Paoli et al., 2010); this is consistent with the abovementioned threshold of brain utilization of KB as an energy source, i.e., 4 mmol/L (Veech, 2004), which is close to the Km for the monocarboxylate transporter (Leino et al., 2001). During the first days of fasting or KD there is a rise of BHB and adiponectin concentrations (Halberg et al., 2005). One of the putative causes of hunger in starved humans may be due—together with other causes—to adiponectin. When adiponectin binds to its receptor AdipoR1, AMP-activated protein kinase (AMPK) is phosphorylated in the ARC of the hypothalamus (Valassi et al., 2008). The increase of AMPK activity in the hypothalamus may increase food intake and hepatic glucose output in mice while the decrease seems to reduce food intake (Zhang et al., 2009). KDs can also act similarly to a caloric restriction on AMPK (Newman and Verdin, 2014). Interestingly, AMPK seems to have opposing actions on the liver, muscle tissues and the brain: in liver and muscle AMPK activation increases FA oxidation by decreasing malonyl-CoA concentrations (Malonyl-CoA is the first intermediate in the lipogenic pathway and is also an inhibitor of carnitine palmitoyltransferase-1 (CPT-1). CPT-1 activity can be limiting for FA oxidation), through the inactivation of the acetyl-CoA carboxylase 1 (ACC1). AMPK can also increase the activity of malonyl-CoA decarboxylase (MCD), which enhances the decrease of malonyl-CoA levels.

Hey there… I’m new to keto, so I’m hoping my questions don’t come across as really stupid. Your bread looks great, and if I can get bread again, then that’s simply awesome. The pictures remind me of banana bread. Is there a way of adding this flavor without going insanely overboard on the carbs? And without that artificial banana taste? Also, would this recipe work as muffins? Thanks, Kelly


Adiponectin increases AMPK activity in skeletal muscle [188, 189] and the liver [189] by promoting Thr172 phosphorylation, likely in response to an increase in the AMP to ATP ratio [189]. Similarly, α-adrenergic signaling increases AMPK activity in skeletal [190] and cardiac muscle [191], and β-adrenergic signaling increases AMPK activity in adipose [192, 193], all through promotion of Thr172 phosphorylation. While activation through β-adrenergic signaling appears to involve the AMP to ATP ratio [192], α-adrenergic signaling appears to work independently of AMP and ATP [190]. Increases in adiponectin have been observed during ketogenic or low-carbohydrate diets, although primarily in obese individuals [194–196]. BHB induces adiponectin secretion in adipocytes [197], indicating that the level of nutritional ketosis may be an important determinant of the extent to which ketogenic diets influence AMPK activity through adiponectin. In regard to catecholamines, epinephrine increases during fasting, and this appears to be dependent on carbohydrate restriction [198], implying that epinephrine is likely to be elevated during nutritional ketosis. Consistent with this, dietary carbohydrate restriction increases catecholamines at rest [155, 199] and in response to exercise [155, 199–202]. This may be, at least in part, a result of glycogen depletion [200, 203], suggesting both direct and indirect effects of glycogen on AMPK activity. The potential for nutritional ketosis to increase catecholamines is further supported by the dependency of the antiseizure effects of ketogenic diets on norepinephrine [204].
Luckily, DKA has some pretty glaring signs, so someone experiencing it can get help ASAP—symptoms include rapid and heavy breathing, having to pee a lot, and thirst that can’t be quenched, says Klett. As things progress, they’ll also “get confused, become delirious, and eventually have cardiovascular collapse because the blood pH gets so low,” and their organs will stop functioning properly. So again, treatment is necessary.
In regard to the practicality of BHB signaling, many of the outcomes described above, including HDAC inhibition, were achieved with BHB concentrations within the range of 0.6–2 mM [37, 103, 105, 108, 109, 111, 112, 116], which is well within the physiological range of nutritional ketosis for humans and even suggests potential benefit at low to moderate levels.
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
Brain glucose and KB uptake was investigated in rats subjected to mild experimental ketonemia induced by 2 weeks on the KD or by 48 h fasting. To test this, researchers developed a carbon-11 labeled AcAc (11)C-AcAc for PET use. They found in rats that after 10 days of KD (11)C-AcAc brain uptake increased up to 8-fold, an increase comparable to those measured after 48 h of fasting (Pifferi et al., 2008).
.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.
309. Lemieux K., Konrad D., Klip A., Marette A. The AMP-activated protein kinase activator AICAR does not induce GLUT4 translocation to transverse tubules but stimulates glucose uptake and p38 mitogen-activated protein kinases alpha and beta in skeletal muscle. FASEB Journal. 2003;17(12):1658–1665. doi: 10.1096/fj.02-1125com. [PubMed] [CrossRef] [Google Scholar]

Anyone with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height), and to incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle. With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed, and the risk for cardiovascular complications can be substantially improved.

In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
309. Lemieux K., Konrad D., Klip A., Marette A. The AMP-activated protein kinase activator AICAR does not induce GLUT4 translocation to transverse tubules but stimulates glucose uptake and p38 mitogen-activated protein kinases alpha and beta in skeletal muscle. FASEB Journal. 2003;17(12):1658–1665. doi: 10.1096/fj.02-1125com. [PubMed] [CrossRef] [Google Scholar]
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].
I am so impressed by your bread recipes. Have spent the last two days just baking away and they taste absolutely great! What a joy to finally find something this tasty and healthy. I noticed in your previous post that we could expect to read about “What I eat” from you next. We’re staying tuned and waiting with great curiosity. Will pass on to our libraries about your books, for sure.
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This is the best keto bread I have ever made! By far! My bread was a little flat, but I think my baking powder needs to be replaced. I did make two substitutions with this recipe. I replaced egg whites with whole eggs, and ghee with coconut oil. Everything else, I already had on hand. I will definitely make this again and play with it a little. Really delicious bread.
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