A reduced availability of dietary carbohydrates leads to an increased liver production of KBs. The liver cannot utilize KBs because it lacks the mitochondrial enzyme succinyl-CoA: 3-ketoacid (oxoacid) CoA transferase (SCOT) necessary for activation of acetoacetate to acetoacetyl CoA. KBs are utilized by tissues, in particularly by brain. KBs enter the citric acid cycle after being converted to acetyl CoA by hydroxybutyrate dehydrogenase (HBD), succinyl-CoA: 3–CoA transferase (SCOT), and methylacetoacetyl CoA thiolase (MAT). Modified from Owen (2005), Paoli et al. (2014).

The presence of abnormally high levels of KETONES in the blood. These are produced when fats are used as fuel in the absence of carbohydrate or available protein as in DIABETES or starvation. Ketosis is dangerous because high levels make the blood abnormally acid and there is loss of water, sodium and potassium and a major biochemical upset with nausea, vomiting, abdominal pain, confusion, and, if the condition is not rapidly treated, coma and death. Mild ketosis also occurs in cases of excessive morning sickness in pregnancy.

β-hydroxybutyrate and, in some cases, acetoacetate contribute to protection against oxidative stress by decreasing production of mitochondrial reactive oxygen species (mtROS), by increasing expression or protein content of antioxidant enzymes through histone deacetylase (HDAC) inhibition, and by directly scavenging the hydroxyl radical (•OH). Upregulation of antioxidant enzymes through HDAC inhibition includes manganese superoxide dismutase (SOD2), catalase, and metallothionein II and is likely mediated by the transcription factor forkhead box O 3a (FOXO3a).


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). 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 guys!), and then you’ll definitely want to give it a toast to get some texture on.
I made this after watching your video – which made all the difference since I realized I could use a electric mixer. I also measured carefully by weighing the egg whites……and it came out PERFECTLY. I’ve been hungry for a piece of toast with my egg in the morning, smothered in your ccnut oil/mac nut spread and cinnamon. Well, I didn’t wait until morning. Couldn’t resist two pieces toasted with my afternoon tea just now. Thanks so much, Maria.
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This poses a real evolutionary dilemma.  We need an enormous amount of energy just to not die, but the single most important organ in our body (also quite energy hungry in its own right) can’t access the most abundant source of energy in our body (i.e., fat) and is, instead, almost solely dependent on the one macronutrient we can’t store beyond a trivial amount (i.e., glucose). Obviously our species wouldn’t be here today if this were the end of the story. But, to understand how we survived requires one more trip down biochemistry memory lane.  In the figure below (also included and described in the video) I gloss over a pretty important detail.
In the absence of acetyl CoA (several ways this can happen, including substrate shortage, as I’m describing here) we evolved a cool trick.  Our liver can make – out of fat or protein, though we much prefer to use fat so we can spare our protein and prevent severe muscle wasting – something called beta-hydroxybutyrate, one of the 3 ketone bodies I described above.
My loaves always had air pockets and a gummy texture. I made a loaf yesterday and when I was putting it in the oven, the power went out. The dough sat on the counter for 3 – 4 hours until the power came back on and I was able to bake it. The finished loaf cooled in the oven all night (I took it out of the loaf pan) and when I cut into it this morning, the texture was perfect – no gooey middle, no air pocket! Perhaps the secret is to let the dough rest before baking??
I am not a baker so I studied all the comments carefully, ordered the blanched almond flour but not the Robb psyllium powder, used instead a generic (Equate) brand; didn’t weigh anything and don’t have a convection oven. Baked for 60 minutes. This bread fell a little but after complete cooling (2 hours), I sliced this bread down the middle and found it pretty near perfect in consistency. The taste of it is heaven. Small bit of gumminess, so will reduce by 1 oz H2O next time. Thank you for sharing this amazing recipe.
264. Jing E., Emanuelli B., Hirschey M. D., et al. Sirtuin-3 (Sirt3) regulates skeletal muscle metabolism and insulin signaling via altered mitochondrial oxidation and reactive oxygen species production. Proceedings of the National Academy of Sciences. 2011;108(35):14608–14613. doi: 10.1073/pnas.1111308108. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
I finally made this recipe. (I have made many of your others and use them often.) It did fall slighty but I was still able to slice it after it cooled. It was also purple, which is just fine with me. I toasted in the oven this morning and it was nice and crisp. I can’t tell you have happy I was to dip it in my fried egg this morning. Thanks, Maria, for all you do!
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.
So rather than giving one-size-fits-all dietary advice or weaponizing the word “balanced” it might be better if the medical community suggested that there are Individual differences that need to be considered. This might also help those lay folk who have had success with one dietary lifestyle or another also realize that what’s valid for them may not be good advice for others.
One of the foods that people tell us they miss most after going keto is bread. (And cookies or cakes, but you get the idea.) We get it, bread is undeniably comfort food. Growing up, it wasn’t unheard of to eat toast for breakfast, a sandwich for lunch, and maybe even a slice of buttered bread along with dinner. Not only is that ton of carbs, but it’s also a lot of empty calories when we could have been eating real-food alternatives, like this bread made from nutrient-dense ingredients!
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