Metabolic syndrome is a risk factor for neurological disorders.[38] Metabolomic studies suggest an excess of organic acids, impaired lipid oxidation byproducts, essential fatty acids and essential amino acids in the blood serum of affected patients.[medical citation needed] However, it is not entirely clear whether the accumulation of essential fatty acids and amino acids is the result of excessive ingestion or excess production by gut microbiota.[medical citation needed]
Clinical results suggest both direct and indirect actions of ketones via modifications of various hunger-related hormones concentrations. While it’s not completely clear how ketosis reduces appetite, studies have found that ketosis is effective at lowering food intake and regulating appetite by altering levels of the hunger hormones including cholecystokinin (CCK) and ghrelin. At the same, ketone bodies seem to affect the hypothalamus region in the brain, positively impact leptin signals, and avoid slowing down the metabolism like most other diets do. (5)
More definitive evidence that metabolic syndrome per se predisposes to coronary heart disease and cerebrovascular disease has been reported. Thus a twofold to fourfold increase in subsequent cardiovascular events has been described in men and women with metabolic syndrome (modified WHO criteria) even in the absence of type 2 diabetes or impaired glucose tolerance.234-236 Qualitatively, similar results have been obtained when metabolic syndrome was defined by ATP III criteria237,238 (Fig. 43-9). In a compilation of multiple studies, the presence of metabolic syndrome had a greater impact on the risk for developing diabetes (fivefold) than ASCVD (twofold).22,182,199 In addition, where studied, the rate of cardiovascular events was higher in patients who had diabetes and metabolic syndrome than in individuals with only metabolic syndrome.22,239

I used the coconut flour, Now whole psyllium husks (ground by me), and whole eggs…this bread is exactly what I have been looking for, for such a long time. Yes a bit dense with the whole eggs but super-tasty nonetheless. I know if doing egg whites would make a bit lighter. Mine did not turn purple either, and I didn’t order a special pan, just used a regular loaf pan. Also, used coconut vinegar instead as all I had on hand and subbed perfectly. Thank you Thank you for a terrific recipe!

The notion that metabolic syndrome, or its surrogate markers hyperinsulinemia and insulin resistance, antedate and contribute to the pathogenesis of coronary heart disease, diabetes, and at least some cases of hypertension was proposed many years ago.21,35 Coronary heart disease in the setting of metabolic syndrome can to a great extent be attributed to dyslipidemia (increased dense LDL cholesterol, diminished HDL cholesterol, and hypertriglyceridemia)231 as well as to elevations in blood pressure and blood glucose and the presence of a procoagulant, proinflammatory state.22,228 In addition, some studies suggest that hyperinsulinemia and insulin resistance, as well as hyperglycemia, may be independent risk factors.51 Whether elevated FFA levels or a dysregulation of intracellular fatty acid metabolism contribute to atherosclerosis by directly altering the function of endothelium (see the section entitled “Vascular Endothelial Cells and Atherogenesis”) or other cells in the vascular wall remains to be determined. Relevant to this discussion, low levels of adiponectin are associated with an increased risk for coronary heart disease in humans,155 whereas, as noted earlier, overexpression of adiponectin or its globular subunit diminishes the severity of atherosclerosis in ApoE–/– mice.232,233

Yolks are great. Make a healthified custard, or a custard ice cream (Maria has recipies for both). I’m a diabetic and I got that way eating “real” food, not manufatured food. I baked. All from scratch, all homemade. But that meant traditional sugar and wheat flour. I had developed a number of reduced carb recipies on my own, but Maria’s recipies go all the way with better success than I would have guessed possible. (I still yearn for a good, two-day rise wheat and yeast bread — But I know allow myself this only once a quarter. It is not good for you.) I’m excited to try this. So far my favorite has been her psyllium powder/egg/boiling water version pizza crust. A homemade pizza made with this tastes as good as any pizza.
Hello, I’m sure you must roll your eyes at getting yet another post about glitches when making this bread. Unlike the first loaf I made I had four loaves turn out gummy. it still makes reasonable toast but I’d like to avoid this the next time I make the bread. I used your recommended almond flour, and I really ground the psyllium. However in narrowing things down there are two factors that may have contributed to the problem: 1) I mixed up two loaves at a time and I wonder if the dough was too heavy for my mixer and did not combine sufficiently. 2) I may have let a very small amount of yolk fall into the whites. Would either of these caused the gummy texture? Thanks for this amazing website. We purchased all your books and find them a wealth of information. Liz
143. Echtay K. S., Winkler E., Frischmuth K., Klingenberg M. Uncoupling proteins 2 and 3 are highly active H+ transporters and highly nucleotide sensitive when activated by coenzyme Q (ubiquinone) Proceedings of the National Academy of Sciences. 2001;98(4):1416–1421. doi: 10.1073/pnas.98.4.1416. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

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Thank you for the terrific recipe. I must admit that this really turned out to be “oopsie bread” for me. Due to the expensive nature of the recipe (organic eggs, almond flour, grass fed butter) I really attempted to follow the recipe perfectly instead of going with my usual improvisational style. I also do not have a food processor however that did not impede anything… a hand mixer and a deft hand did the trick. I did add the optional xanthum gum and erythritol but not the cream of tartar. The batter filled my silicone loaf pan to the top, I smoothed it out and popped it into the oven. Then, to my horror, I saw the little pot of melted butter still on the stovetop. There was nothing to be done except cross my fingers and hope for the best.
Proof the yeast. This involves mixing dry active yeast with water that’s just warm to touch (between 105-110°F to be precise) and maple syrup or honey for 7 minutes until foamy. And before you scream sugar (!!) remember that the yeast will feed on such sugar to emit carbon dioxide, so it doesn’t affect the carb count at all. And yes, this is a scientific fact.
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I found your recipes and was eager to try them! This morning I made the almond and coconut flour bread, blueberry muffin and the pancakes for family breakfast. They were all delicious!! I was amazed at how moist they were. However, even thought the bread was light, it did not achieve the height shown with the recipe. I need advice on how to achieve a higher loaf. My family was delighted at the healthier version of our Sunday morning breakfast. Thank you, Maya, for the time and effort spent in perfecting and sharing your recipes.
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Further indicating that ketones influence mtROS production through alteration of electron transport, treatment of rat hippocampal slices with BHB + ACA (1 mM each) prevented the increase in mtROS and mitigated the decrease in ATP production that otherwise result from inhibition of mtETC complex I with rotenone [111]. In mitochondria isolated from the brains of mice injected with BHB, although inhibition of complex I with rotenone and 1-methyl-4-phenylpyridinium increased rather than decreased mtROS production, the BHB treatment prevented the decrease in O2 consumption caused by inhibition of complex I, and this occurred independently of uncoupling [112]. Consistent with the results from hippocampal brain slices, the BHB treatment also mitigated the decrease in ATP production caused by complex I inhibition [112]. These effects were prevented by inhibition of complex II with 3-nitropropionic acid or malonate, indicating that BHB primarily influences mitochondrial respiration at complex II [112], which is consistent with ketolysis increasing formation of succinate and FADH2. However, in mutated cells prone to complex I disassembly and an associated severe decrease in complex I activity, treatment with BHB + ACA (5 mM each) increased both the assembly and activity of complex I [113], indicating that ketones somehow promote repair of complex I damage and may therefore influence mitochondrial respiration at more than one site.

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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.

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. . .
I found your recipes and was eager to try them! This morning I made the almond and coconut flour bread, blueberry muffin and the pancakes for family breakfast. They were all delicious!! I was amazed at how moist they were. However, even thought the bread was light, it did not achieve the height shown with the recipe. I need advice on how to achieve a higher loaf. My family was delighted at the healthier version of our Sunday morning breakfast. Thank you, Maya, for the time and effort spent in perfecting and sharing your recipes.
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Being in optimal ketosis for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are NOT part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.
82. Schwarz J. M., Neese R. A., Turner S., Dare D., Hellerstein M. K. Short-term alterations in carbohydrate energy intake in humans. Striking effects on hepatic glucose production, de novo lipogenesis, lipolysis, and whole-body fuel selection. Journal of Clinical Investigation. 1995;96(6):2735–2743. doi: 10.1172/jci118342. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Schele E., Grahnemo L., Anesten F., Hallen A., Backhed F., Jansson J. O. (2013). The gut microbiota reduces leptin sensitivity and the expression of the obesity-suppressing neuropeptides proglucagon (Gcg) and brain-derived neurotrophic factor (Bdnf) in the central nervous system. Endocrinology 154, 3643–3651. 10.1210/en.2012-2151 [PubMed] [CrossRef] [Google Scholar]
But comprehensive transcriptional profiling of glucose-sensing neurons is challenging, as glucokinase (Gck) and other key proteins that transduce glucose signals are expressed at low levels. Glucose also exerts a hormonal-like action on neurons; electrophysiological recordings demonstrated, for example, that hypoglycemia activates growth hormone-releasing hormone (GHRH) neurons, suggesting a mechanistic link between low blood glucose levels and growth hormone release (Stanley et al., 2013).
It looks and smells beautiful when baking. The bottom of my loaves is heavy and dense. The top rises and makes an air pocket. As a result, it’s just not really pleasant to eat with it being so dense and solid even though it tastes good. The few good pieces at the very ends were yummy. I really don’t know what to do. Almond flour is expensive to be going through it like this. 🙁

Moreover, in the above study of Sumithran et al. (2013), ketosis maintains post-prandial secretion of CCK as previously demonstrated by other researchers (Chearskul et al., 2008). Note that the orexigenic effect of BHB is blocked by transection of the common hepatic branch of the vagus nerve (Langhans et al., 1985). The hepatic branch contains fibers from the proximal small intestine, stomach and pancreas, and is sensitive to CCK (Horn and Friedman, 2004); ghrelin signals to brain are also transmitted via vagus nerve (Habara et al., 2014). Thus, the effects of ketosis on these two appetite-related hormones could be one of the many factors related to the effects of such nutritional regimen on food control.
I am so frustrated. I have made the rolls a dozen times and they vary in results but always come out acceptable. I truly enjoy them. However, no matter what I do I cannot get the darn loaf to work! I am specific with ingredients, I have tried leaving the loaf in the oven to cool, I have tried taking it out. I make sure the water is at a rolling boil. I tried different sized pans…just doesn’t work. The only difference I can think of is the loaf pan. I am wondering if I were to just form the dough into a loaf without the restriction of a pan, would it come out better? It wouldn’t be as pretty but it might work.
Ketone esters (BHB-BD) lowers glycogen use30. During exercise, the muscle breaks down stored carbohydrate (glycogen) to provide a fuel for the working muscle. When a ketone ester drink was taken pre-workout, the muscle used far less glycogen compared to when the pre-workout drink contained carbohydrate. The high levels of blood ketones meant that the muscle used ketones as a fuel before needing to use glycogen. Reducing reliance on muscle glycogen could improve performance and decrease the time for muscle glycogen to fully recover between exercise bouts.
KBs can cross the BBB but not in a homogenous manner. For example, past experiments have demonstrated that BHB utilization is different in various brain areas (Hawkins and Biebuyck, 1979). Areas without BBB, hypothalamic regions and the lower cortical layers have a higher BHB metabolism compared to the lower one of the basal ganglia (Hawkins and Biebuyck, 1979). Also the metabolic meaning of the three KBs is different: while the main KB produced in the liver is AcAc, the primary circulating ketone is BHB. The third one, acetone, is produced by spontaneous decarboxylation of AcAc, and it is the cause of the classic “fruity breath.” Acetone does not have any metabolic functions, but it can be used as a clinical diagnostic marker. BHB acid is not, strictly speaking, a KB because the ketone moiety has been reduced to a hydroxyl group. Under normal conditions the production of free AcAc is negligible and this compound, transported via the blood stream, is easily metabolized by various tissues including skeletal muscles and the heart. In conditions of overproduction, AcAc accumulates above normal levels and a part is converted to the other two KBs. The presence of KBs in the blood and their elimination via urine causes ketonemia and ketonuria. Apart from being the fundamental energy supply for CNS, glucose is necessary for the replenishment of the quota of oxaloacetate, since this intermediate of the tricarboxylic acid cycle (TCA) is labile at body temperature and cannot be accumulated in the mitochondrial matrix. Hence it is necessary to refurnish the TCA with oxaloacetate via the anaplerotic cycle that derives it from glucose through ATP dependent carboxylation of pyruvic acid by pyruvate carboxylase (Jitrapakdee et al., 2006). This pathway is the only way to create oxaloacetate in mammals. Once produced by the liver, KBs are used by tissues as a source of energy (Fukao et al., 2004; Veech, 2004; McCue, 2010): initially BHB is converted back to AcAc that is subsequently transformed into Acetoacetyl-CoA that undergoes a reaction producing two molecules of Acetyl-CoA to be used in the Krebs cycle (Figure ​(Figure22).
People with type 1 diabetes do not produce enough insulin, so their bodies are unable to regulate ketones, which can lead to a dangerous environment. Always consult with your doctor if you have diabetes before changing your diet, and look out for warning signs of ketoacidosis including: excessive thirst, increased urination, nausea, vomiting, abdominal pain, shortness of breath, weakness, fatigue and confusion.
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I think next time I will either use less psyllium or less egg. I had to halve the recipe and I used a bit more egg and water by accident. Next time I’ll try it with coconut flour since I think as a very “dry” flour it works best with flours/meals that are very “wet” like flax meal and psyllium. They cancel each other out in the end it seems. I’ll also bake it a bit longer because the crust is yummy!

^ 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.
Angie, I’m happy to hear you and your hubby enjoyed the taste, but sorry to hear the bread was flat! The egg whites don’t need to be whipped for this recipe, but I’ll try to help you troubleshoot…first I would check to make sure that your baking powder is fresh. Also, did you use the full cup of egg whites? Did you make any ingredient substitutions or adjustments? Did you use a 9 by 5-inch loaf pan? Did you cook it at 350F and is your oven properly calibrated? Did you bake it for the amount of time the recipe calls for? I hope this helps!