Increased reliance on mitochondrial respiration will increase the flow of electrons through the mtETC and, in turn, increase the potential for mtROS formation. Although oxidative stress is traditionally viewed as harmful, a modest increase in ROS is now established as a signaling stimulus that induces hormetic adaptation [3]. In regard to mitohormesis and mtROS, such adaptation is largely centered around antioxidant defense [4–6], making mitohormesis an attractive target for the prevention and treatment of chronic disease.
Metabolic syndrome is quite common. Approximately 32% of the population in the U.S. has metabolic syndrome, and about 85% of those with type 2 diabetes have metabolic syndrome. Around 25% of adults in Europe and Latin America are estimated to have the condition, and rates are rising in developing East Asian countries. Within the US, Mexican Americans have the highest prevalence of metabolic syndrome. The prevalence of metabolic syndrome increases with age, and about 40% of people over 60 are affected.
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High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
Metabolic syndrome (MetS) is the commonly observed clustering of obesity, hypertension, dyslipidemia, and insulin resistance. The components of MetS occur together more often than expected by chance and display significant heritability. Investigations into monogenic diseases that model features of the common MetS have uncovered responsible genes. Genome-wide association studies (GWAS) of the components of the MetS have been enormously successful. Meta-analysis of public GWAS data and risk-score analysis are revealing the role of common single-nucleotide polymorphism genotypes in MetS pathophysiology. A pleotropic polygenic architecture underlies MetS, making it a fascinating complex trait. Research will continue to uncover how metabolic pathways interact to form the MetS and its subsequent risk for atherosclerosis and diabetes.

Back in the really old days (like in the Paleolithic), life had some challenges. Like saber-tooth tigers. What happened when your ancient ancestors encountered a saber-tooth cat? I imagine they threw their hands up in the air, screamed, and ran like hell. To assist in the running like hell, their bodies would dump sugar into their blood for extra energy. To this day, our bodies still do that. The problem is that the modern saber-tooth tiger is the overdue electric bill, the dropped cell phone call, the dinnertime telemarketer, and the annoying neighbor. You can’t run away from any of these tigers. The extra sugar just sits in your body. But you can learn to defeat this ancient biological fight-or-flight response by learning how to relax. You’ll need to make time for you. It might be a warm bubble bath in the evening, a good book at lunch, aromatherapy candles, or even kickboxing. Take that, saber-tooth tiger. Bam!
Since then, it’s safe to say I dove down the rabbit hole. The more I learned, the more I grew tired of reading so much misinformation on the topic. While there are more thoughtful people and articles on the subject of ketosis these days (e.g., here’s a thoughtful video on ketosis and ketogenic diets from one of my most important ketosis mentors, Steve Phinney, a co-founder of Virta Health1Disclosure: I’m an investor in, and advisor to, Virta Health.), there are still pieces like the one Vox published this month, that doesn’t exactly do the topic justice.

Ketolysis is the process of breaking down ketones to ultimately provide energy through the Krebs Cycle and mitochondrial oxidative (using oxygen) phosphorylation. Ketone bodies are broken down in the mitochondria of virtually all tissues in the body. The liver is a notable exception, being unable to utilise ketones as a fuel because liver cells lack acetyl-CoA thiolase, a key enzyme in the ketone oxidative pathway. BHB enters the mitochondria of the cell through a monocarboxylate transporter, undergoes conversion to acetoacetate by BHB dehydrogenase and then addition of a CoA group from succinyl-CoA by 3-oxo-acid transferase. The resulting acetoacetyl-CoA acts a substrate for the formation of two molecules of acetyl-CoA in a reaction catalysed by acetyl-CoA thiolase. Acetyl-CoA is then available to condense with oxaloacetate and enter the Krebs cycle.
Has anyone tried this using a substitute for the eggs/egg whites? My husband seems to be sensitive to eggs (not sure which part, to be honest) and we’ve been making most recipes using agar agar as a substitute (for either whites or whole eggs) but this only works if the egg is a binder. I’m guessing that they are a leavening agent in the bread (please correct me if I’m wrong!) and I don’t know if agar would work in this recipe. I do have VersaWhip 600 – anyone ever tried that in a bread recipe?
All I can say is WOW! I am a week in on this Keto way of eating and came across this simple recipe. Gotta admit, I didn’t think I would like it…I LOVE IT! So easy to make…took me 20 minutes total! It was light, moist and delicious. I used one small loaf pan, doubled the ingredients and made the regular one and the cheese mix in. Can’t wait to share the rest with my co-workers…we are doing this together. Will be back to check for other recipes. Thank you!
Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). Ketones can also be consumed in exogenous ketone foods and supplements.

I absolutely LOVE this bread. I make a fresh loaf every 1-2 weeks as needed. It took 3 tries to get it right. I had tried it with pre-ground NOW foods powdered psyllium husk powder and got a gooey, purple version [that still tasted great and toasted fine], and then I must have used a tiny bit too much liquid in another version because it was too dense, but now I precisely weigh everything and grind up my own psyllium husks in my coffee grinder as fine as I can get it and it comes out perfect every time. This is going to sound dramatic, but this bread has changed my life. lol… it’s a go-to for a quick meal if I have nothing else prepared because I can always find something delicious and keto-friendly to either slather on top, or make toast for my eggs, French toast [I can’t REMEMBER the last time I had French toast before I started making this bread!], or a quick little sandwich on the go. Maria – I’ve read almost all of your books and use so many of your recipes and tell everyone that will listen about you. I’ve sent your books to numerous family members, too. Thank you so much for everything you do. I started eating ‘The Maria Way’ last September and have lost that ‘inner carb demon’ that made me hungry all the time. That alone is priceless to me. I feel like I’ve finally been set free! Food has no hold over me anymore, now it’s about all the delicious and healthy food I CAN have and LOVE.
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].

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Eating mindfully. A child who learns to see food as fuel and not emotional compensation can start to make better choices at mealtime — for example, selecting complex carbs instead of simple carbs (whole-grain instead of white bread, brown rice instead of white); getting more fiber with beans, fruits, and vegetables; choosing "healthy" fats like olive oil and nuts; and avoiding too many empty calories from soda and sweets.

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The key sign of metabolic syndrome is central obesity, also known as visceral, male-pattern or apple-shaped adiposity. It is characterized by adipose tissue accumulation predominantly around the waist and trunk.[5] Other signs of metabolic syndrome include high blood pressure, decreased fasting serum HDL cholesterol, elevated fasting serum triglyceride level, impaired fasting glucose, insulin resistance, or prediabetes. Associated conditions include hyperuricemia; fatty liver (especially in concurrent obesity) progressing to nonalcoholic fatty liver disease; polycystic ovarian syndrome in women and erectile dysfunction in men; and acanthosis nigricans.
Metabolic syndrome between pregnancies increases the risk of recurrent preeclampsia, according to a retrospective cohort study of 197 women who had preeclampsia during their first pregnancy. Of the 197 women, 40 (20%) had metabolic syndrome between pregnancies. Of these 40 women, 18 (45%) had preeclampsia during their second pregnancy, compared with 27 (17%) of the 157 women without metabolic syndrome between pregnancies. The risk of recurrent preeclampsia increased with the number of components of the metabolic syndrome present. [68, 69]
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?
Eating whole grains has been shown to cause blood sugar levels to rise more slowly after a meal and reduce the risk of type 2 diabetes. The fiber in whole grains slows the digestion of carbs, reducing the demand for insulin. Whole grains also contain antioxidants and anti-inflammatory nutrients that may also play a role in helping prevent diabetes.
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:
Most people who have metabolic syndrome already have a closely related condition called insulin resistance, which is when the body stops responding to insulin (a hormone produced in the pancreas). After the food we eat is converted into a type of sugar called glucose, insulin is what enables the glucose to enter the body’s cells and be used as energy. For someone who is insulin resistant, however, the glucose builds up in the blood, setting the stage for damage.
Hi Eva, That’s awesome that you are helping your son this way. I haven’t tried this with other tools, but you could probably use either the blender or the food processor. The key is to pulse in step 5, not just constantly blend, so that the whites don’t fully break down. Other than that, it should be pretty similar. As for the yolks, if you don’t want to make creme brulee, I usually just put a couple extras into an omelet (or breakfast casserole, or any other dish requiring cooked eggs) mixed with whole eggs.

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.
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.
Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold . According to the American Heart Association, 47 million Americans have it. That's almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age.

Nice and firm. Baked it on the recommended temp, added 6 or 7 minutes. Pressed the middle and it was great. I let it cool. What was nice about it was obviously it’s low carb bread…hurray for that, but it cut well. Got 18 slices easily about 1/2 inch thick without breakage. Most importantly, it wasn’t greasy, or almond tasting overload, just delicious.
For a diagnosis of metabolic syndrome, a child must have at least three of the four risk factors. The most common risk factors in teens are hypertension and abnormal cholesterol. Even when just one risk factor is present, a doctor will likely check for the others. This is especially true if a child is overweight, has a family member with type 2 diabetes, or has acanthosis nigricans.

Sounds weird? Yeah I thought so too! Ok let me explain. When at room temperature I’m fairly certain you’ll all agree it tastes like a lovely corn (free) bread. Dense, but soft and lightly crumbly (and I’m fairly certain that with a cornbread extract some good stuff will happen). But then when you warm it up, it goes softer again and reminds me of a lovely sweet bun.
The difference between ketosis and ketoacidosis is the level of ketones in the blood. Ketosis is a physiological adaptation to a low carbohydrate environment like fasting or a ketogenic diet. There are situations (such as treatment-resistant epilepsy) where ketosis can be beneficial to health. Ketoacidosis is an acute life-threatening state requiring prompt medical intervention; its most common form is diabetic ketoacidosis where both glucose and ketone levels are significantly elevated.
tips for making this bread with coconut flour and those getting purple results! i made half the recipe and made the following changes: 3/4 cups of water, 1 teaspoon baking powder, 1/2 teaspoon baking soda. my bread which previously came out purple and with very dense patches came up much fluffier and with more bread like ‘holes’ and also had the colour of normal brown bread! i baked it in a small loaf and the bread rose a lot but the top half was basically a tunnel. the rest of it is good ‘bread’ though! 🙂
Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.
I had the same problem. Everything blended beautifully, rose in oven, then fell. Toothpick came out clean after 45 min of baking. I let it cool and then cut into it this morning and it has raw spots throughout the loaf. I am so disappointed because I killed a dozen eggs to make it and really don’t want to do it again. I wonder if the oven needs to be warmer and the cooking time needs to be increased?
Research on cinnamon’s blood sugar-stabilizing powers is a little mixed, and it may not be a wonder spice. But if you’re adding it to an already healthy diet, it may have a subtle benefit. Some studies suggest that cinnamon lowers blood sugar by increasing insulin sensitivity, or making insulin more efficient at moving glucose into cells. Try sprinkling it onto oatmeal or into low-sugar smoothies. Bonus: It tastes delicious!
This was my first time baking anything EVER and it turned out perfectly! I do find that the bread does taste a tad “eggy” but it’s soft and a perfect replacement for sandwich bread. I can finally have grilled cheese sandwiches again!! Next time around, I’ll double the recipe because the bread was smaller than expected. Thanks for this amazing recipe!
Concussion (a mild form of TBI), is defined as a short term impairment of brain function caused by impact. Symptoms include dizziness, confusion and headache. When the brain suffers a concussive impact this triggers an acute cascade of cellular events that can eventually cause chronic problems. Firstly, immediately after impact there are changes to the concentrations of ions and neurotransmitters in and outside of the neurones. For example, the cells release potassium and glutamate (excitatory neurotransmitter); this can cause neuronal damage instantly64. The disruption to the equilibrium of substances within the brain must be corrected, which requires the action of the ATP dependant ion pumps in the cell membranes. In order to produce enough ATP the brain has a transient period of high glucose metabolism (within 30 minutes of impact), which is followed by a period of glucose metabolic depression that can last anywhere from 5 days to several months, depending on severity65. In this time the brain is starved of energy when it is unable to metabolise glucose, which can cause long term damage. Severe or repeated impacts can lead to development of conditions such as chronic traumatic encephalopathy (CTE). 

Typically jam-packed with fruit and sugar, your average smoothie bowl isn’t a keto-friendly way to start the day. This chia smoothie bowl by Fat for Weight Loss, though, uses ingredients like coconut cream, avocado, chia seeds, and desiccated coconut for healthy fats, along with blueberries, erythritol, and a little vanilla for that smoothie bowl sweetness. At six grams of net carbs per serving, this sweet, creamy breakfast bowl is a great option when you’re craving something sweet. Top with whatever seeds your heart desires, coconut, and low-sugar fruit, like strawberries.
Ketogenic diet could improve body composition: For some sports (such as gymnastics, cycling and some fighting sports), power to weight ratio is a key determinant of performance. Because the ketogenic diet has been associated with fat loss accompanied by lean muscle maintenance (or gain), it could thereby improve the power to weight ratio 21 ,22 and performance. 
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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 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?
Hi Maria, glad you like the bread! Good question about the olive oil – on the one hand using the same amount as butter would mean you stick with the same wet/dry ratio, on the other had olive oil doesn’t firm up at room temperature, but butter and coconut oil do. Therefore, I’d try using a bit less olive oil than butter, maybe 40g instead of 60g. You could also get hold of refined coconut oil, which does not have the coconut taste, for example this one.
Insulin resistance. Insulin is a hormone that helps your body use glucose -- a simple sugar made from the food you eat -- as energy. In people with insulin resistance, the insulin doesn't work as well, so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
Conversely, the term “ketone bodies” refers to 3 very specific molecules: acetone, acetoacetone (or acetoacetic acid), and beta-hydroxybutyrate (or beta-hydroxybutyric acid), shown below, of which only 2 are technically ketones.  (The reason beta-hydroxybutyrate, or B-OHB, is not technically a ketone is that the carbon double-bonded to the oxygen is bonded to an –OH group on one side, technically making B-OHB a carboxylic acid for anyone keeping score.)
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.

Too much fat at the waist . Although obesity in general raises your risk of metabolic syndrome, excess belly fat (being “apple-shaped”) is the riskiest kind of fat, defined as more than 40 inches around the waist for men, or more than 35 inches for women. Ask your doctor about different measurements for your ethnicity, Ndumele says. “Individuals of Asian descent are thought to have an increased risk at a lower threshold of belly fat, for example.”
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.
Maria and Craig: I made this recipe (into kaiser roll shapes) on Sunday night for the first time. I just ate my first sandwich (pork roast and mayo, yummy) on it and almost wept with happiness. It is SO good. The texture is PERFECT. It was easy and quick to make. And I can actually see my way to a GF lifestyle…sandwiches have been my bugaboo all along. Thank you, thank you for all your hard work and wonderful recipes!
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! 
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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