Usually, there are no immediate physical symptoms. Medical problems associated with the metabolic syndrome develop over time. If you are unsure if you have metabolic syndrome, see your healthcare provider. He or she will be able to make the diagnosis by obtaining the necessary tests, including blood pressure, lipid profile (triglycerides and HDL), and blood glucose.

Hi Maria! Just wanted to say I love this recipe and I found a way to make similar single servings quickly that look like english muffins! I just use a greased ramekin and combine 2 tbsp almond flour, 2 tsp psyllium husk (or 1 tsp powder), pinch of salt and baking powder. Then stir in 2 tbsp + 2 tsp egg whites, 2 tbsp water, 1 tsp olive oil and 1/8 tsp apple cider vinegar. Microwave for 1 min then flip out onto a plate and microwave for another 30 sec. Toast and top with whatever you’d like! 🙂
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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.

Additional research has raised the possibility that metabolic syndrome adversely affects neurocognitive performance. [70] In particular, metabolic syndrome has been blamed for accelerated cognitive aging. [71] Patients with mental illnesses also face increased cardiometabolic risk due at least in part to socioeconomic factors such as greater poverty and poorer access to medical care. [72, 73]
Rick, Yes, I would try baking it longer if it’s coming out gummy. If it’s starting to brown too much outside, but the inside doesn’t seem to be fully cooked, you could cover it with foil to prevent over-browning. Another trick I sometimes use is to leave the bread in the oven to cool once it’s done baking (sometimes covering the loaf with foil to prevent over-browning). I hope these tips help!
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
Another aspect of mitochondrial function influenced by ketones is the mitochondrial permeability transition pore (mPTP). Prolonged opening of the mPTP is one of the mechanisms through which mtROS can induce cellular injury and promote disease [114]. In neurons isolated from rat brain slices, treatment with BHB + ACA has decreased the mtROS production, mPTP opening, and cell death induced by H2O2 [115]. This protective effect was duplicated with catalase, even in conjunction with diamide-induced opening of the mPTP, indicating that the protective effect of BHB and ACA is at least partly due to defense against ROS [115]. In a mouse model of epilepsy, this decrease in mPTP opening was found to be induced exclusively by BHB, and in a manner dependent on the cyclophilin D subunit of the mPTP [116]. BHB in combination with ACA also appears to promote opening of mitochondrial ATP-sensitive K+ (mtKATP) channels [117], which in heart mitochondria is known to protect against Ca+ overload [118] and dissipate membrane potential (ΔΨ) [119]. Since high ΔΨ promotes mtROS production, dissipation of ΔΨ through mtKATP channels may partly explain the potential for ketones to decrease mtROS production. However, opening of mtKATP channels by pinacidil decreases mitochondrial ATP production [119], which is consistent with dissipation of ΔΨ and suggests a compromise between ATP and mtROS production.
Hi Anita, I double checked my carton egg whites. 3/4 cup of egg whites is equivalent to 4 large whole eggs, not 4 large egg whites. Mine has a chart for converting whole eggs, and the conversion for egg whites only is below the chart. It says 2 tablespoons of liquid egg whites are equivalent to the egg white of 1 whole egg. So, 12 large egg whites would be 24 tablespoons, or 1 1/2 cups as written in the recipe. Hope this helps!
It is still unclear what is the very first step that occurs in a normal cell becoming cancerous. Two theories that explain the development of cancer are the ‘somatic mutation’ theory, and the ‘metabolic theory.’ The somatic mutation theory states that the first event in cancer is a gene mutation due to environmental damage or a mistake in the DNA replication and repair processes. This gene mutation initiates a cascade of events that subsequently leads to tumour growth. Popular opinion favoured the somatic mutation theory for many years, leading to a large body of research describing the different genetic mutations of cancer cells, and ambitious projects to sequence the ‘Cancer Genome.’ From the compelling simplicity of the somatic mutation theory, an increasingly complicated picture has emerged as more than 100 oncogenes and 30 tumor suppressor genes have been identified, leading researchers to look for alternative explanations. 
You’ll recall, from the point I made above, that my brain requires about 400 to 500 kcal of glucose per day (100 to 120 gm).  You’ll also recall (from the video, above) that I can store about 100 to 120 gm of glucose in my liver.  While I can store much more in my muscles, (on the order of about 300 to 350 gm), because muscles lack the enzyme glucose-6-phosphatase, glucose stored in muscle as glycogen is unable to re-enter the bloodstream and is meant for the muscle and the muscle alone to use.  In other words, muscle glycogen is a stranded asset of glucose in the body to be used only by the muscle.

While tender, chocolatey donuts are perfect on their own, this keto breakfast recipe amps them up with a rich and sweet glaze. Pair with coffee and tea, or enjoy as dessert (if you can wait that long). At just over 2 net carbs per donut, they’re basically guilt-free. For more Bulletproof donuts, use grass-fed butter and mold-free coffee, plus full-fat coconut milk instead of heavy cream in the glaze.
I just made this today. If I lived in London and could hug you, I would! You have NO idea how many recipes I’ve tried for almond flour bread and they never come out right or taste very good. This recipe is amazing! Since I can’t use psyllium due to an allergy to it, I used ground flax seed meal instead. OMG, this bread is delicious! I used the small loaf pan like you did and it came out perfect. It rose above the pan and is a perfect loaf. I let it completely cool, cut it with a bread knife and it did NOT fall apart, something so many of these type of breads do. AND it does NOT taste eggy which has been another problem I’ve dealt with. The loaf is so pretty! I can’t wait to experiment with different spices or herbs in this bread. Another plus for me is that since the slices are smaller than regular bread, it helps with calorie control when putting things on it for a sandwich. I have a strong wheat intolerance and don’t do well with grains in general so I’m always looking for alternative recipes. Thank you from the bottom of my heart. You just made my day!!!!

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!
The use of lifestyle interventions to treat and prevent chronic disease is attractive because of their potential to lower medical costs and produce more robust and holistic improvements in health. Ketogenic diets have been studied sporadically for more than 100 years, but over the last 15 years, a growing number of researchers have contributed to what is now a critical mass of discoveries that link the process of keto-adaptation to a broad range of health benefits [10–33]. Early clinical research focused on the use of “extreme” versions of ketogenic diets to treat seizures, but recent research indicates that benefits related to the management of epilepsy, weight loss, metabolic syndrome, and type 2 diabetes can be achieved with an approach that is less restrictive in carbohydrate and protein, and therefore more satisfying, sustainable, and feasible for the general population. A “well-formulated” ketogenic diet is generally characterized by a total carbohydrate intake of less than 50 g/d and a moderate protein intake of approximately 1.5 g/d per kg of reference weight [34]. This typically increases circulating β-hydroxybutyrate (BHB) and acetoacetate (ACA) from concentrations that are typically less than 0.3 mM into the range of nutritional ketosis, which for BHB, we define as 0.5–3 mM [35]. This range is below the typical 5–10 mM range for BHB that occurs during prolonged fasting, and well below concentrations characteristic of ketoacidosis [34, 35]. From the perspective of meeting energy demands, the reduced carbohydrate and moderate protein intakes necessarily make ketogenic diets high in fat. Despite this contradiction with mainstream dietary guidelines, ketogenic diets may be beneficial for many health conditions, particularly the previously mentioned conditions related to mitochondrial impairment, which includes obesity [10, 11], diabetes [12–14], cardiovascular disease [15–17], cancer [15, 18–26], neurodegenerative diseases [19, 20, 27–30], and even aging [31–33, 36, 37].
Many neurological conditions share a common feature of impaired brain energy metabolism. It isn’t always clear if this impairment is the cause or the effect of the disease, but nonetheless, interventions that even partially restore or improve brain energy metabolism could help to prevent, slow or even reverse some conditions of the brain. Because ketones can: 1) get into the brain; 2) undergo metabolism by a distinct pathway that bypasses glucose metabolism, providing ketones by either following a ketogenic diet or by taking exogenous ketones could impact the natural course of some neurological conditions. 

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
The 2 major issues that will lead to a flat loaf is not whipping the egg whites and gently folding them in OR using almond meal instead of a finely ground almond flour. If you've tried everything and they don't seem to be working for you, the next best option will be to make a larger recipe. Try making 1.5x this recipe (it's easy to do using the servings slide bar) and you'll have a much larger loaf.