I was well aware of the dearth of mainstream knowledge of NK, and particularly the conflation of NK with diabetic ketoacidosis (DKA), a pathologic state that results from the complete or near absence of insulin, which is what prompted my writing and desire to share my journey. And I was once in the wanker category of folks who spoke with “authority” about ketosis, despite knowing somewhere between zero and nothing on the topic. I remember exactly where I was sitting in a clinic at Johns Hopkins in 2002 during my residency explaining to (admonishing, really) a patient who was on the Atkins diet how harmful it was because of DKA. Not only that, the ketogenic diet could be seen as the antithesis of a “healthy” diet by conventional standards. I could see how this was a difficult proposition for many to acknowledge.


While several national and international organizations use certain criteria to define metabolic syndrome, others, including the American Diabetes Association (ADA), question the value of the specific diagnosis of metabolic syndrome. They point out that the criteria, taken together, are no more useful at predicting the risk of cardiovascular disease or diabetes than the individual criteria considered separately. The science needs to be clearer, suggests the ADA, before metabolic syndrome be considered a definable syndrome.
I so miss bread fresh from the oven (I’m going to be adding the yeast)! You are absolutely correct about beaten egg whites creating air pockets. My family has always made buttermilk pancakes from scratch and we always separate the eggs, beat the whites to soft peaks and fold them in at the last minute. The pancakes rise beautifully! Have you tried this with your keto pancakes?

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).
A hearty breakfast satisfies the soul — that is, unless your syrupy plate of pancakes sends you into a sugar rush and carb coma. If you’re following a ketogenic diet, though, you still have options for keto breakfast recipes. Even if you enjoy a frothy cup of Bulletproof Coffee most days, these dishes are the perfect way to kick off your weekend or change up your morning routine.
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The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
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. . .
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Have breakfast within an hour or two of waking up and then eat a snack or meal every three to six hours after that, says Rebecca Denison, RD, doctor of integrative medicine and diabetes educator at Greater Baltimore Medical Center’s Geckle Diabetes and Nutrition Center. This will add up to three to six total meals and snacks daily. It takes about four to six hours for your body to digest a meal. “You want to eat just a teeny bit before you actually need it so that your body doesn’t have to figure out how to keep your blood sugar stable,” Denison explains.
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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As previously discussed, RET is a prominent source of mtROS and is dependent on a high Δp across the inner mitochondrial membrane. During ATP production, Δp is dissipated as H+ enters the mitochondrial matrix through ATP synthase. Mitochondrial uncoupling also dissipates Δp, but by allowing translocation of H+ into the matrix independent of ATP synthase. Uncoupling is therefore regarded as an antioxidant defense in that it can mitigate mtROS production [122–126]. In fact, only a small dissipation of ΔΨ or ΔpH (components of Δp) is needed for a large decrease in mtROS production [57–60, 127].
Maria I have ALL your books, except your 30 day cleanse, and I have attempted the 7 day weight loss and healing plan, and dairy free I might add, but was so hungry and dizzy on it! My husband pointed out the the “lunch” area, item, says Side. Well I’ve read it 3 times – the front of the book and such, it doesn’t say add food to the “SIDE”…it says use this plan. Also you maybe have said elsewhere, but the math is wrong on the second page for total calories….lastly the intermittent fasting – I thought I read previously in the Metabolism book that you shouldn’t fast more than 3 days at a time, but this book doesn’t mention that. Have you updated your thoughts?
Yes that’s correct. Many on keto diets eat less meals than average so it’s pretty normal to see single means 500+ cal Also keto is a high fat low carb moderate protein diet. You minimize carbs, hit protein goals and eat fat to keep you full. So yes, those are excellent macros. Here is a great resource to learn a ton about keto. Khttps://www.ruled.me/guide-keto-diet/
[…] One of the things I’ve grown to love over the years is fried eggs with runny yolks. They’ve become a regular breakfast for me on the weekends. However, when I do regular low carb high fat meals, I like to have toast to dip into the egg yolks. Psyllium low carb bread seems to be all the rage right now, so I came up with this coconut flour psyllium husk bread that is perfect with my morning eggs. I’m not really sure who started the low carb psyllium bread trend, but one of the first breads I’ve found was Maria Emmerich’s Amazing Bread. […]
In ketogenesis, two acetyl-CoA molecules instead condense to form acetoacetyl-CoA via thiolase. Acetoacetyl-CoA momentarily combines with another acetyl-CoA via HMG-CoA synthase to form hydroxy-β-methylglutaryl-CoA. Hydroxy-β-methylglutaryl-CoA form the ketone body acetoacetate via HMG-CoA lyase. Acetoacetate can then reversibly convert to another ketone body—D-β-hydroxybutyrate—via D-β-hydroxybutyrate dehydrogenase. Alternatively, acetoacetate can spontaneously degrade to a third ketone body (acetone) and carbon dioxide, although the process generates much greater concentrations of acetoacetate and D-β-hydroxybutyrate. When blood glucose levels are low, ketone bodies can be exported from the liver to supply crucial energy to the brain.[28]
In a subsequent series of experiments, glucose metabolism in C. elegans was inhibited by knockdown of the insulin receptor, insulin-like growth factor 1 (IGF-1) receptor, and insulin receptor substrate 1 (IRS-1) [73]. Consistent with the previous study [72], inhibition of glucose metabolism increased mitochondrial respiration concomitant with ROS-dependent increases in lifespan, stress resistance, and antioxidant enzyme activity. However, in this case, detection of ROS was mitochondria-specific, and repeated measures allowed for changes in antioxidant enzyme activities to be evaluated more closely in relation to the timing of changes in mtROS. Compared to controls, inhibition of glucose metabolism resulted in higher mitochondrial O2 consumption at 12 h, higher mtROS production at 24 h, and higher activities of SOD and catalase at 48 h, suggesting a dependence of antioxidant activity on mtROS and a dependence of mtROS on mitochondrial respiration. The most striking result is the lower mtROS at 120 h, indicating that the initial increase in mtROS and subsequent increase in antioxidant enzyme activity ultimately lowered net mtROS production to a level lower than controls, which is the proposed explanation for the more than twofold increase in lifespan. As with the previous study, this demonstration of mitohormesis is further supported by the changes in ROS production, antioxidant enzyme activity, and lifespan having been prevented with antioxidant treatment.
I just made this bread today and MAN, IS IT GOOD!!!! I realized I used salted butter and pink sea salt and maybe that gave it an added boost too. It was super hard for me to try and fold in the almond flour mixture to the egg whites, but now that I watch the video, I see I could have mixed the food processor part more first. I was so scared to collapse my egg whites. I also see your bread was the same size as mine, so I must have done ok. I will say again, WOW it is sooo good! I already ate two pieces with butter, just because. oops! Good thing it was only 1 carb each. =)))) Thank you, thank you!
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.
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By dramatically shifting energy metabolism towards ketogenesis and fatty acid oxidation, ketogenic diets are likely to have a profound effect on mitochondrial function. However, despite the rapidly growing amount of research on ketogenic diets and their effects on various disease states, only a small amount of this research has focused on mitochondrial function or oxidative stress. The well-established increase in fat oxidation induced by a ketogenic diet [7, 8] clearly indicates prominent connection with mitochondrial function and, in turn, oxidative stress and mitohormesis [5, 6, 9]. Therefore, the purpose of this review is to describe the current, but limited, understanding of how ketogenic diets may affect mitochondrial function and resistance to oxidative stress, particularly within the context of extending human healthspan.
In some cases epilepsy cannot be treated successfully using anticonvulsant medications. In some cases where drugs have failed, the ketogenic diet has been widely documented to deliver transformative seizure control, reducing frequency by anywhere between 40-90%43. Whilst the exact mechanisms underlying the beneficial effect of the ketogenic diet are unclear, the hypothesised mechanisms include:
The liver uses triglycerides, cholesterol, and protein to make triglyceride-rich very low-density lipoproteins (VLDL). In the blood, an enzyme removes triglycerides from VLDL to first produce intermediate density lipoproteins (IDL) and then low-density lipoproteins (LDL - the "bad" cholesterol). LDL is not all bad; it is an essential part of lipid metabolism and is necessary for the integrity of cell walls and for sex hormone and steroid production. However, in excess, LDL can oxidize and accumulate, eventually leading to fatty deposits in artery walls and to hardening and scarring of the blood vessels (and to cardiovascular disease and blood clots).
First I tried using coconut flour only. The batter was very thick and pasty and the resulting bread was very firm and dry, like a really dry biscuit. It did, however, keep its shape well and toasted up evenly golden-brown in a skillet with oil. I thought about trying again with more liquid, but that wouldn’t solve its fatal flaw: the strong, overwhelming coconut flavor. Even chicken and sun-dried tomato pesto could barely cover it up.
Hi Maria! I just want to say thank you for this bread recipe! It is awesome! It took me 4 times to get the technique down, but it works with both the Jay Rob psyllium and the bulk I get at my local store (which turns it purple). I watched your video and realized I was doing two things wrong… I was over-mixing and then I was squishing or handling the dough too much. With a little shorter mixing time, like you show on your video, and with light hands “shaping” the dough to fit in the pan, I have met with success! I also picked up the same size pan you use at the grocery store for about $5. This is the only low-carb gluten-free bread my daughter will eat. She loves it! Thanks again!
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).
Scheme of orexigenic and anorexigenic effects of ketosis. The picture is highly schematic. For more details please see the text. AMPK, AMP-activated protein kinase; CCK, cholecystokinin; GABA, gamma-aminobutyric acid; BHB, β-hydroxybutyric acid; FFA, free fatty acids; ROS, reactive oxygen species; NPY, neuropeptide Y; AgRP, agouti gene-related protein.

Insulin inhibits AMPK activity by stimulating protein kinase B (PKB) to phosphorylate the Ser485 residue of the α subunit, thereby inhibiting phosphorylation at Thr172 [222]. One of the most prominent features of nutritional ketosis is that, due to restricted carbohydrate intake, postprandial insulin is dramatically decreased. Furthermore, numerous studies have shown ketogenic or low-carbohydrate diets to decrease fasting insulin [155, 195, 223–225], particularly in the presence of metabolic dysregulation associated with hyperinsulinemia [84, 226–229].


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Populations living further north had much less edible vegetation available for gathering. Thankfully for us, animals that lived in these areas ate the vegetation inedible to us, effectively transforming it into fatty meat we could hunt and enjoy. These people most certainly relied on high levels of fat and protein, thus likely spending most of their time in ketosis.
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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.
I was recently diagnosed with diabetes which I had had uncontrolled for an estimated seven years. I have done a lot of research and while there is a lot of diabetes information available, little was helpful for whatever reasons – too simplistic in nature, didn’t answer hard hitting questions, or didn’t apply forward thinking scenarios. This article is one of the best I have read because it is both clear and concise and givens you all of your essential important information in a single place – something everyone needs. Even after all of my research, I still learned a couple new things reading this article. Excellent reference.
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.
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Try to be patient. Although some people get into ketosis relatively quickly, it can take others a while. Unfortunately, people who are insulin resistant often have a longer journey. Put in a solid month of consistent keto eating, and try to ramp up your physical activity, if possible. Within four weeks, you should definitely be in ketosis and experiencing its benefits.
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It is interesting to note that the KB are capable of producing more energy than glucose due to the changes in mitochondrial ATP production induced by KB (Kashiwaya et al., 1994; Sato et al., 1995; Veech, 2004). During fasting or KD glycaemia, though reduced, remains within physiological levels (Seyfried and Mukherjee, 2005; Paoli et al., 2011). This euglycemic response to extreme conditions comes from two main sources: glucogenic amino acids and glycerol liberated via lysis from triglycerides (Vazquez and Kazi, 1994; Veldhorst et al., 2009). Glucogenic amino acids (neoglucogenesis from amino acids) are more important during the earlier phases of KD, while the glycerol becomes fundamental as the days go by. Thus, the glucose derived from glycerol (released from triglyceride hydrolysis) rises from 16% during a KD to 60% after a few days of complete fasting (Vazquez and Kazi, 1994). According to Bortz (1972) 38% of the new glucose formed from protein and glycerol is derived from glycerol in the lean while 79% in the obese (Bortz et al., 1972). It is important to note that during physiological ketosis (fast or very low calorie ketogenic diets) ketonemia reaches maximum levels of 7–8 mmol/L with no change in blood pH, while in uncontrolled diabetic ketoacidosis blood concentration of KBs can exceed 20 mmol/L with a consequent lowering of blood pH (Robinson and Williamson, 1980; Cahill, 2006) (Table ​(Table11).
Where does nutrition info come from? Nutrition facts are provided as a courtesy, sourced from the USDA Food Database. You can find individual ingredient carb counts we use in the Low Carb & Keto Food List. Carb count excludes sugar alcohols. Net carb count excludes both fiber and sugar alcohols, because these do not affect blood sugar in most people. We try to be accurate, but feel free to make your own calculations.

In both the nutrition literature and public dietary guidelines, nonstarchy vegetables are one of the few dietary components nearly unanimously agreed upon as healthful. Given their health-supporting characteristics and low carbohydrate content, they should be a prominent component of any ketogenic diet. Beyond the primary features of a well-formulated ketogenic diet, such as macronutrient proportions, adequate mineral intake, and appropriate selection of fat sources, which have been discussed more thoroughly elsewhere [34, 35], inclusion of nonstarchy vegetables is an important consideration, given that reports in the literature of adverse effects resulting from ketogenic diets are often associated with extreme implementations that typically lack plant matter. In fact, for this reason, it has recently been recommended to increase the nonstarchy vegetable content of ketogenic diets used to treat epilepsy [38]. Beyond adding variety to the diet, benefits of nonstarchy vegetables that may be particularly relevant to nutritional ketosis include the maintenance of adequate micronutrient status and the presence of prebiotic fiber as substrate for the gut microbiota. In addition to the importance of prebiotic fiber for basic health, the short-chain fatty acids produced by the gut microbiota from this dietary fiber support ketogenesis [39] and metabolic signaling related to mitochondrial function and antioxidant defense [40]. Furthermore, nonstarchy vegetables are a source of the many micronutrients needed to support energy metabolism. As such, there is more to a ketogenic diet than simply restricting carbohydrate. Selection of a variety of nutrient-dense foods is therefore an important component of nutritional ketosis that should be given consideration in any clinical or academic implementation.
Look no further for keto breakfast recipes: This may be the only list you’ll ever need. There’s something for everyone here, including paleo, egg-free, dairy-free, vegetarian, vegan, and Whole30 options. (Only enjoy coffee or tea in the morning? We got you covered there, too.) Best of all? These recipes are all under 10 net carbs per serving — and most are much lower than that.

The reason a starving person can live for 40-60 days is precisely because we can turn fat into ketones and convert ketones into substrate for the Krebs Cycle in the mitochondria of our neurons. In fact, the more fat you have on your body, the longer you can survive.  As an example of this, you may want to read this remarkable case report of a 382 day medically supervised fast (with only water and electrolytes)!  If we had to rely on glucose, we’d die in a few days.  If we could only rely on protein, we’d live a few more days but become completely debilitated with muscle wasting.


First I tried using coconut flour only. The batter was very thick and pasty and the resulting bread was very firm and dry, like a really dry biscuit. It did, however, keep its shape well and toasted up evenly golden-brown in a skillet with oil. I thought about trying again with more liquid, but that wouldn’t solve its fatal flaw: the strong, overwhelming coconut flavor. Even chicken and sun-dried tomato pesto could barely cover it up.
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