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Benefits of Ketogenic Diet For Management of Type Two Diabetes: A Review was published in the Journal of Obesity and Eating Disorders and asserts that the ketogenic diet can be used to manage numerous health issues, specifically Type II Diabetes.

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Keywords

Ketogenic diet; Diabetes; Cardiology; Nephrology

Introduction

According to the latest data by the World Health Organization, approximately 366 million people will have diabetes by the year 2030 [ 1]. Several studies have shown a strong association between being overweight and the risk of developing diabetes. In fact, according to the US center for Disease control and Prevention, 85% of the diabetic patients are overweight and 55% are obese [ 2]. For weight loss, it became well known that the energy intake should be decreased and the energy expenditure should be increased. Several interventions have been proposed for decreasing energy intake such as bariatric surgeries, pharmacological usage, and decreasing caloric intake while enhancing energy expenditure to achieve weight loss [ 3]. Yet, recent studies showed that most of the obesity interventions tend to fail in the long term, especially those that have previously focused on reducing dietary fat [ 4]. However, recently, several studies have showed the benefits of ketogenic diet in overweight diabetic population [ 2- 14]. This review will discuss the physiological foundation of ketogenic diet and their effects on patients with type 2 diabetes.

Discussion
Physiological aspect of ketogenic diet
Ketogenic diet is a diet that is very low in carbohydrates which results in high circulation of ketone bodies in the body. Usually after 3 days of fasting, or having a dietary intake of carbohydrates less than 20 grams per day, fat oxidation through Krebs cycles will be stopped due to the lack of production of oxaloacetate since glucose is needed with pyruvate carboxylase for the carboxylation of pyruvic acid through ATP to produce oxaloacetate [ 4].

Moreover, the central nervous system requires glucose as an energy source and thus following a ketogenic diet will cause the need for an alternative energy source which is derived from the overproduction of acetyl-CoA namely ketone bodies. Ketone bodies are made up of acetoacetate, B-hydroxybutric acid and acetone. This whole process occurs in the matrix of liver and is called ketogenesis. Under normal diet, the concentration of ketones bodies is less than 0.3 mmol/l and ketone bodies will not be used as an energy source by the central nervous system until this concentration reaches 4 mmol/l, similar to the glucose concentration. At that point, ketone bodies are then used as a source of energy by the all tissues. Specifically, B-hydroxybutric acid is transformed into acetoacetyl-coA which is then transformed into two molecules of actely-coA which are used in Krebs cycle. The maximum ketone bodies concentration in individuals following the ketogenic diet will reach to 8 mmol/l [ 4].

However, it is important to note that glucose is also formed from two sources: glycogenic amino acids and glycerol. In fact, after few days of complete fasting, glycerol can produce around 60% of the body glucose [ 4].
Benefits of ketogenic diet with type 2 diabetes
Several studies have shown the benefits of ketogenic diet for patients with type two diabetes, such as weight loss, reducing hbaA1c, reversing nephrology, cardiac benefits, improvement of lipid profile and even have potential effect on reversing diabetic neuropathy and retinopathy [ 5].
Weight loss
Achieving weight loss is one of the earliest strategies used for the management of type two diabetes and the prevention of diabetic complications. Moreover, there is a positive correlation between ketogenic diet and weight loss. In fact, according to the study done by Sahama et al., which compared the efficacy of ketogenic diet and that of low fat diet, it showed that the ketogenic diet are 3 times more effective in weight loss than the low fat diet [ 6]. One of the reasons for such weight loss is the excessive fatty acid metabolism in the presence of ketone bodies. Another possible reason for weight loss using ketogenic diet might be the hunger-reduction caused by the hypothalamus, yet the main mechanism is still elusive since ketone bodies have shown to act both anorexigenically and orexigenically. Therefore, more studies should be conducted to determine the mechanism of ketone bodies regarding satiety and appetite reduction.

An observational study done by Leonetti et al., showed that very low carbohydrate ketogenic diet (VLCKD) was effective and safe in morbidly obese patient with or without T2DM scheduled for laparoscopic bariatric surgery. Introducing VLCKD immediately prior to bariatric surgery showed temporary but significant pre-operative weight loss that is helpful in reducing the perioperative risk and difficulties associated with anaesthesia and surgery without the possible disadvantages of carbohydrate withdrawal in close proximity of surgery [ 7].
Reduction of Hba1c levels
Reduction of the HbA1c levels is one of the main guideline for the management of T2D. Having constantly low levels of hba1c, would decrease the risk of developing diabetic complications. The benefits of carbohydrates restriction in diabetes are immediate and well documented but the concern is about the long term safety and efficacy. These benefits can be achieved even in the absence of weight loss [ 8].

Histologic studies presented in an experimental study done on rats by Khalifa et al. supported the view that VLCKD has a significant beneficial effect in improving the diabetic state by stabilizing hyperglycemia that could result in improved B-cell function [ 9].

According to the study done by Talib et al., the effectiveness of ketogenic diet was more significant than that of a low calorie intake diet on the glycosylated hemoglobin. This effect on HbA1c levels is possibly due to the ability of ketone bodies to decrease the glucose metabolism. However, the mechanism of the reduction of glucose metabolism by ketone bodies is still debatable [ 10].

A review done by Feinman et al., presented many points of evidence to support the use of VLCKD as the first approach in treating T2DM and are effective as an adjunct to pharmacologic therapy in T1DM [ 8].
Reversing nephropathy
Nephropathy is one of the complications that occur with people with uncontrolled diabetes. A study that was done by Poplawski et al., on rats, showed that ketogenic diet reverses diabetic nephropathyby raising blood levels of of 3-betahydroxybutric acid(3-OHB) which subsequently reduce glucose metabolism in at least some tissues including kidneys. Within one week of administration of ketogenic diet to rat, blood glucose got normalized. Remarkably, within 2 months, albumin/creatinine ratio was back to normal and diabetic nephropathy was completely reversed. This reversal in functional nephropathy was associated with robust normalization of expression of genes induced by oxidative and other forms of stress [ 5]. According to the study done by Talib et al., on human, the ketogenic diet showed decrease in creatinine level compared to the low calorie intake levels which showed increase in creatinine level [ 10]. Furthermore, it was well established that ketones can be used as an alternative energy-efficient fuel. In fact, according to study Little JR et al., in which B-hydroxybutric acid infusion were done in dogs, the utilization of ketone accounted for more than 50% of QO2. Therefore, ketogenic diet might have benefit renal functions [ 11].
Cardiac benefits
Several studies showed the increased risk of cardiovascular disease in diabetic patients. Myocardial dysfunction in diabetes is due to the combination of diabetic cardiomayopathy, myocardial ischemia, and hypertension. There are several factors that cause diabetic cardiomypathy such as: autonomic dysfunction, interstitial fibrosis, increase in oxidative stress, mitochondrial dysfunction and myocardial stiffness due to persistent hyperglycemia with glycation of interstitial protein. Generally, 95% of the myocardial energy is derived from mitochondrial oxidative metabolism. During fasting and settings of insulin resistance, free fatty acids are the dominant myocardial fuel for oxidative metabolism. An increased reliance on free fatty acid for myocardial fuel at the level of left ventricular function would results in decreased cardiac efficiency and increase propensity for heart failure. However, when serum ketone levels increases, ketone bodies will be a main contributor to myocardial energy metabolism According to a study done on rat heart model, addition of ketone bodies lead to increased cardiac work efficiency by 25%. Moreover, according to proteomic analysis in mouse models of heart failure done by Aubert et al, and according to metabolomics analysis of end-stage of heart failure in human done by Bedi et al., ketone bodies are the major fuel in failing heart [ 12, 13]. IN EMPA-REG study that was done to show the benefits of sodium-glucose cotransporter 2(SGLT2) inhibitor on CV and all-cause mortality and hospitalization for heart failure, a failing myocardium may have the ability to use ketone bodies. In conclusion, increase in ketone bodies would lead to increase in cardiac work efficiency, increase in myocardial contractility and thus decrease the incidence and progression of heart failure [ 14].
Lipid profile
One of the main complication of T2D is cardiovascular disease. Dyslipidemia is considered one of the risk factors of cardiovascular disease. However, several studies showed improvement of lipid profile through ketogenic diet intake. In fact, according to the study done by Talib et al., ketogenic diet showed a significant decrease and low density lipoprotein level, triglyceride and increase in high density lipoprotein levels [ 10]. Moreover, according to the study done by Sahama et al., ketogenic diet produces a greater reduction of the triglyceride levels when compared to low fat diet [ 6].
Disadvantages of ketogenic diet
Although this review presented the fact that the pathologies caused by diabetes can be reversed by a simple dietary manipulation. Yet, attention should be driven to the possible disadvantages of this type of diet specially when applied for long duration. First, the ketogenic diet could be too extreme for chronic use in adult patients since it may produce unwanted iatrogenic effects. Patients with T2DM on oral hypoglycemic agents who were put on ketogenic diet were at increased risk of developing hypoglycemia, so reducing the dose of the hypoglycemic agents should be considered [ 8].

For those scheduled for bariatric surgery who were put on low carbohydrate ketogenic diet,an increased metabolic side effects were more compared to those who were not put on such a diet due to the fact that in the perioperative period there is an increased catabolic state and increased oxidative stress that may have a negative effect on the surgical outcome [ 7].

Conclusion

In conclusion, Ketogenic diet has several benefits on the management of type two diabetes. These benefits include the reduction of HbA1c level, weight loss, and improvement of lipid profile, cardiac benefits, reversibility of nephropathy and even possible effect on reversing diabetic neuropathy and retinopathy.

Future studies should be conducted on a large population of patients to fully understand the mechanism of action between ketone bodies and the above benefits as well as the possible long-term disadvantages of applying such a diet regimen.

References

1. Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 27: 1047-1053.

2. Campbell RK (2009) Type 2 diabetes: where we are today: an overview of disease burden, current treatments, and treatment strategies. J Am Pharm Assoc 49: S3-S9.

3. Thompson WG, Cook DA, Clark MM, Bardia A, Levine JA (2007) Treatment of obesity. Mayo Clin Proc 82: 93-101

4. Paoli A (2014) Ketogenic diet for obesity: friend or foe? Int J Environ Res Public Health 11: 2092-2107.

5. Poplawski MM, Mastaitis JW, Isoda F, Grosjean F, Zheng F, et al. (2011) Reversal of diabetic nephropathy by a ketogenic diet. PloS One 6: e18604.

6. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, et al. (2003) A low-carbohydrate as compared with a low-fat diet in sever obesity. N Engl J Med 348: 2074-2081.

7. Leonetti F, Campanile F, Coccia F, Capoccia D, Alessandroni L, et al. (2015) Very Low- Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. OBES SURG 25: 64-71.

8. Feinman R, Bernstein R, Westman E, Pogozelski WK, Astrup A, et al. (2015) Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition 31: 1-13.

9. Al-khalifa A, Mathew T, Al-Zaid, Mathew E, Dashti HM, et al. (2009) Therapeutic role of low-carbohydrate ketogenic diet in diabetes. Nutrition 25: 1177-1185.

10. Hussain TA, Mathew Tc, Dashti AA, Asfar S, Al-Zaid N, et al. (2012) Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition 28: 1016-1021.

11. LittleJR, SpitzerJJ (1971) Uptake of ketone bodies by dog kidney in vivo. Am J Physiol 221: 679-683.

12. Aubert G, Martin OJ, Horton JL, Lai L, Vega RB, et al. (2016) The Failing Heart Relies on Ketone Bodies as a Fuel. Cirrculation 23: 698-705.

13. Bedi KC, Snyder NW, Brandimarto J, Aziz M, Mesaros C, et al. (2016) Evidence for Intramyocardial Disruption of Lipid Metabolism and Increased Myocardial Ketone Utilization in Advanced Human Heart Failure. Circulation 23: 706-716.

14. Mudaliar S, Alloju S, Henry R (2016) Can a Shift in Fuel Energetics Explain the Beneficial Cardiorenal Outcomes in the EMPA-REG OUTCOME Study? A Unifying Hypothesis. Diabetes Care 39: 1115-1122

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Benefits of Ketogenic Diet for Management of Type Two Diabetes: A Review

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Keywords Ketogenic diet; Diabetes; Cardiology; Nephrology Introduction According to the latest data by the World Health Organization, approximately 366 million people will have diabetes by the year 2030 [ 1]. Several studies have shown a strong association between being overweight and the risk of developing diabetes.

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The Ketogenic Diet and Sport: A Possible Marriage? was published in American College of Sports Medicine and focuses on the effects that a ketogenic lifestyle can have on one's strength/power performance

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The ketogenic diet (KD) is used widely as a weight loss strategy and, more rarely, as therapy for some diseases. In many sports, weight control is often necessary (boxing, weightlifting, wrestling, etc.), but the KD usually is not considered. Our hypothesis is that KD might be used to achieve fat loss without affecting strength/power performance negatively.

Evidence suggests that ketogenic diets can be used by athletes as a weight loss strategy without impairing strength performance, but more research is needed.

¹Department of Biomedical Sciences, University of Padova, Padova; and ²Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy; and ³ Biomedical Engineering Laboratory, Institute of Communication and Computer Systems, National Technical University of Athens, Athens, Greece

Address for correspondence: Antonio Paoli, M.D., Department of Biomedical Sciences, University of Padova, Via Marzolo 3, 35131 Padova, Italy (E-mail: antonio.paoli@unipd.it).

Accepted for publication: January 27, 2015.

Associate Editor: Barry Braun, Ph.D., FACSM

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The Ketogenic Diet and Sport: A Possible Marriage? : Exercise and Sport Sciences Reviews

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The ketogenic diet (KD) is used widely as a weight loss strategy and, more rarely, as therapy for some diseases. In many sports, weight control is often necessary (boxing, weightlifting, wrestling, etc.), but the KD usually is not considered. Our hypothesis is that KD might be used to achieve fat loss without affecting strength/power performance negatively.

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This Today article explains why the ketogenic diet may not work for some and the heath effects that could come from it.

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You may be hearing a lot about the ketogenic diet as a way to slim down while noshing on butter and heavy cream. This way of eating is suddenly hot among venture capitalists in Silicon Valley, who believe it will help them live longer and healthier, CNBC reports.

Some praise the high-fat/ultra low-carb plan for helping them to lose weight and have energy all day long. Other advocates say it finally helped them to get control of their body.

How does it work and could it help you?

We asked Bonnie Taub-Dix, a registered dietitian nutritionist and author of "Read It Before You Eat It"; and Keri Glassman, nutritionist, registered dietitian and TODAY Tastemaker.

To start with, both said they would never advise the ketogenic diet for weight loss.

"Cutting out carbs is usually an invitation to overeat them at another point," Taub-Dix said. "For a diet where you're looking to lose weight, look good and feel good... I would not recommend a diet like this."

"For safe and effective weight loss, the carb reduction is too extreme," Glassman added.

RELATED: Read inspiring stories of ordinary people slimming down in TODAY's My Weight-Loss Journey

Here's what you need to know:

What is the ketogenic diet?

It's a diet fine-tuned in the 1920s to help treat epilepsy. It does help to control seizures in some children, but it's not recommended for adults "mostly because the restricted food choices make it hard to follow," the Epilepsy Foundation says.

The diet has just recently begun to be touted as a weight loss plan, Glassman noted. She described it as eating "mostly fat with a teeny bit of protein and carbs."

How does it work?

Your body normally relies on carbohydrates for energy. It breaks them down into glucose, which is your main source of fuel.

If that's not available when you stop eating carbs, your body turns to fat for energy in a process called ketosis. Fat becomes your fuel.

RELATED: Why fat in your diet is good for weight loss

What can you eat?

In a word: fat. Lots and lots of fat.

The desired ratio in the ketogenic diet is consuming 3 or 4 grams of fat for every 1 gram of carbohydrate and protein, which amounts to getting about 75-80 percent of your daily calories from fat.

You can eat foods like butter, heavy whipping cream, mayonnaise, and oils, the Epilepsy Foundation notes.

"It's putting butter on your butter," Taub-Dix said. A sample daily menu might include eggs with olive oil and avocado on the side for breakfast; leafy greens, salmon, nuts and olive oil for lunch; and steak, greens, vegetables and oil for dinner, Glassman added.

It's all about that fat to carbs/protein ratio, so even though you're not really counting calories, the meals have to be planned very carefully to adhere to the strict formula.

What must you avoid?

Carbs. That means all breads, pastas, grains, sweets and more. You have to be extremely careful because even toothpaste may contain sugar, the Epilepsy Foundation warns.

The ketogenic diet restricts the intake of carbs to as low as 2-4 percent of calories. As a point of reference, a standard diet provides about 45-55 percent of calories from carbs, Glassman said.

RELATED: How much salt, fat and carbs a day are OK?

Would someone lose weight?

Yes, you can lose weight on the ketogenic diet. One reason is that the body burns fat for fuel. Another is that you can't eat many of your favorite foods, like crusty bread, potato chips or sugar-laden pastries. Plus, all that fat keeps you full, so you may just skip your usual 3 p.m. snack because you're not hungry.

But the nutritionists were adamant that if you want to slim down, this is not the way to go.

"Generally, whenever you do something like this, it's extreme. Most extreme things, you lose weight, but that doesn't mean it's good... that doesn't mean it's healthy," Glassman cautioned.

"It's not really sustainable, nor is it good for you," Taub-Dix added. "In most cases, you're just dying to have a cracker so the weight gain is usually pretty quick as well."

RELATED: 13 foods a nutritionist always keeps in her fridge

What about the effect on the body?

Since this diet doesn't provide all the essential nutrients, you'd need to take supplements and multi-vitamins, Taub-Dix said. You'd also need to make sure your digestive system works properly because the diet is very low in fiber.

Bottom line

The ketogenic diet is a very restrictive plan that most people can't stick with and shouldn't try for weight loss, the nutritionists said. People with heart disease or diabetes should especially stay away, Taub-Dix warned.

There is one healthy takeaway, though: In general, reducing carbs and incorporating more healthy fats, like nuts and avocados and certain oils, in your diet - without going to extremes - is a good idea for most of us, both Glassman and Taub-Dix said.

"I'm a big believer in having a lot of healthy fat in your diet, and many people skimp too much on healthy fats," Glassman said.

"If you're eating a more well-balanced diet - eating carbohydrates that are high in fiber, whole grains, and combining it with fats, you feel good, too," Taub-Dix noted.

Follow A. Pawlowski on Facebook, Instagram and Twitter.

This story was originally published in December 2016.

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What is the ketogenic diet and will it help you lose weight?

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You may be hearing a lot about the ketogenic diet as a way to slim down while noshing on butter and heavy cream. This way of eating is suddenly hot among venture capitalists in Silicon Valley, who believe it will help them live longer and healthier, CNBC reports.

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This USA TODAY article talks about the diet in relation to celebrities.

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Have you noticed how high-key people are being about the ketogenic diet?

The high-fat, low-carb diet has recently caught the interest of celebrities, and made its way to their social media feeds. Tim Tebow subscribes. Kourtney Kardashian wrote about how she detoxes in a state of ketosis on her app. Marie Claire UK linked the food program to Megan Fox, Adriana Lima and Mick Jagger, and Business Insider says you can also count Halle Berry as a fan.

And A-listers aren't the only ones taking note. Searches for "keto" have quadrupled on Google in the last year, according to Google Trends. And Pinterest consumer PR manager Lara Levin says more than 69 million keto recipes have been saved since 2014.

"It's low carb but high fat so that your body will break down the fat as the primary fuel source," says Dr. Eric Kossoff, director of the Child Neurology Residency Program at Johns Hopkins. "If you keep carbohydrates low enough, that's what the body has to do."

Dr. Kossoff says those on a classic keto diet are "eating a lot of butter, and mayonnaise and oils and whipping cream. They're eating lots of different fats, not just avocados and nuts and things like that."

The classic keto diet has been associated with epilepsy treatment since the 1920s, according to Dr. Kossoff.

"It's a very well-established, very mainstream therapy for epilepsy in today's society," he says. "Your body will create ketones, and either the ketones, or keeping your carbohydrates low, or probably something even more than that helps suppress seizures in people who have epilepsy."

So, why the high-interest for celebs and non-epileptics?

"When in a state of metabolic ketosis, the body will shed pounds rapidly," says celebrity nutritionist Philip Goglia, PhD, who calls Christian Bale, Khloé Kardashian Kim Kardashian and Kanye West clients. He says the plan is "used for temporary but quick weight loss."

He also feels people are loosely using the term "keto" for Atkins. "It's just so funny because people take (Dr. Robert Atkins') brand and then re-brand it and call it something different and then add a slightly different slant to it," says Dr. Goglia.

Dr. Kossoff has also witnessed people being liberal with the keto label.

"I have friends and neighbors who say, 'Hey, I'm on your diet.' I'm like, 'What are you talking about? You have epilepsy?'" he shares."Most of the time when I hear what they're doing, they're not. They're on much more of a stricter Atkins diet where they're pushing fats and that's probably healthy - you just gotta be careful."

Debating whether you should shun the forthcoming smorgasbord of carb-heavy holiday treats to give it a whirl? Like Dr. Kossoff, Dr. Goglia has concerns. He warns against diving in without taking family history and one's health into account.

"Just because Paul, your buddy, lost 15 pounds on a ketogenic food protocol, it doesn't make sense that you just jump on it and start it without taking a look at a lipid profile for example and looking at your heart health history," Dr. Goglia explains.

CLOSE

He says though a food program might help you lose weight, what determines if it is a sustainable diet depends on how well your body uses fats, proteins and carbs.

For example, Dr. Goglia says, "Khloé is very fat and protein efficient" while "Kim has a dual structure where she utilizes fat, proteins and carbs in a balanced way."

More: Kim Kardashian finally confirms she's expecting a third child with Kanye West

CLOSE

Certified Registered Dietitian Lisa DeFazio also issues a warning about the keto diet. She says she would not counsel a client on the food program as "there are too many health problems that can occur."

"It sounds good but the problem is it's an abnormal way for the body to function," DeFazio says. "It's like putting fruit juice in your gas tank of your car and trying to make your car run off of fruit juice instead of gasoline."

She mentions possible gnarly side effects, including kidney stones, fatty blood, dehydration and constipation.

Dr. Kossoff stresses the diet is "a real medical therapy."

"It is not holistic or organic or alternative," he insists.

DeFazio also doubts the sustainability of the diet someone who isn't dependent on it for medical reasons. "It's something that people do when they gain some weight and then they want to do that for a few weeks," she explains. "Then the holidays come, or then they go to a wedding, or then you just get burnt out on it because you want a slice of bread."

More: Blac Chyna sues Rob Kardashian and his 'vindictive' family

More: Kim K looks just like Cher, Aaliyah, Madonna in her stunning Halloween costumes

Read or Share this story: https://usat.ly/2Anc0C7

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What is the keto diet? Kardashian nutritionist, experts weigh in on the celeb food fad

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Have you noticed how high-key people are being about the ketogenic diet? The high-fat, low-carb diet has recently caught the interest of celebrities, and made its way to their social media feeds. Tim Tebow subscribes. Kourtney Kardashian wrote about how she detoxes in a state of ketosis on her app.

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This Gazette article speaks of a couple who turned to the ketogenic diet in hope of improving health and later began a community program to improve the health of those around them.

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When Mary and Joshua Haun began their relationship in 2013, they were together more than 160 pounds heavier than they are now.

The couple, who were married in October 2017, has been committed to the Ketogenic diet for more than a year and said they have inspired numerous friends, co-workers and acquaintances to follow suit.

"It must be close to 800 pounds lost now," Mary, 47, of Cedar Rapids, said about those they've helped.

Although Mary and Joshua's journey with the Ketogenic lifestyle can seem impressive when looking at the numbers, weight loss was never the main focus for the couple.

"I'm adopted so I really don't know my family's medical history," Mary said after explaining her experience with hormonal issues, inflammation and brain fog among other symptoms.

"The brain fog scared me," she said. "I knew I had to do something."

After countless doctor's visits and blood tests, Mary still had no idea what could be causing all her symptoms. So she decided to take things into her own hands and try several different elimination diets.

It took some time but Mary eventually found keto. The high-fat, adequate-protein, low-carb diet seemed accessible at the time. She just needed to get Joshua, 38, who has family history with diabetes and lost both his parents to diabetic complications, onboard.

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"We never wanted to talk about our weight. We were just dating then and it was a touchy subject," Mary said. "But I explained to Josh that the diet is basically meats, cheeses and vegetables grown above ground and he said 'OK, let's do it.'"

They started their new lifestyle on Aug. 13, 2016.

"I remember the exact date because I remember being like, 'oh God,'" Joshua said.

A ketogenic diet's main purpose is to force the body to burn fat as fuel rather than carbohydrates, called ketosis, and it is reached by cutting out carbohydrates and eating more fats.

Joshua and Mary combined their new diet with mild, yet frequent, exercise and intermittent fasting.

Before long, Joshua and Mary were fully committed to their new lifestyle. Their results began to show and their community began to take notice.

"Josh became a celebrity," Mary said. "We couldn't get out of church until like an hour after it ended."

Joshua, who has lost more than 120 pounds, and Mary, who lost more than 40, wanted a better way to spread the word about their new lifestyle, rather than explaining their success to every person who asked. So, the couple decided to host a workshop at their church, Unity Center of Cedar Rapids, 3791 Blairs Ferry Rd. NE, in April 2017.

Around 20 people came to the workshop, according to Mary. After seeing the interest of the community, the Hauns decided to host ketogenic-friendly potlucks and began teaching cooking classes at Natural Grocers, 931 Blairs Ferry Rd. NE.

"The potlucks are more than sharing recipes. We also share our successes, our struggles ..." Mary said. "It's a community of people (who) are there for support."

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Now the couple has begun hosting regular events and hopes to further develop a ketogenic program through their company, Living Prayer Ministries.

Since beginning their journey, the couple said they have helped several people reduce or eliminate their need for diabetic, blood pressure and anxiety medication. Showing people a path to health, not just weight loss, has always been the main goal of the community, Mary said.

"We are always saying that we want people to truly be the best versions of themselves," she said. "The greatest gift that we can receive is just to see people living their purpose, feeling the best they can and inspiring others."

Joshua said he hopes those who come to their events realize the power of their minds, as he did.

"I didn't realize how much I valued being fat. I valued having those layers of protection so that I could stay invisible," he said. "Most people aren't ready to analyze themselves like that ... When they do, they're able to change what needs to be changed."

"This isn't a 'fad diet' that you'll stop once you reach an arbitrary goal. We want to show people that they can be healthy and live a long and enjoyable life with this lifestyle."

l Comments: (319) 398-8287; alexandra.olsen@thegazette.com

Check it out

Living Prayer Ministries is holding three upcoming events:

l Cooking Demo: Keto quick breads, 4:30 to 6 p.m. Saturday at Natural Grocers, 931 Blairs Ferry Rd. NE, Cedar Rapids; free

l Community Potluck, 5:30 to 7 p.m. Jan. 20 at Unity Center of Cedar Rapids, 3791 Blairs Ferry Rd. NE, Cedar Rapids; free

l Ketogenic Living Clinic, 4 to 9 p.m. Jan. 27 at Awaken Vitality Holistic Healing, 777 11th St, Marion; $50

l For more information, visit Livingprayerministries.org

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Cedar Rapids couple turn to keto diet for health reasons, embrace new religious mission

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When Mary and Joshua Haun began their relationship in 2013, they were together more than 160 pounds heavier than they are now. The couple, who were married in October 2017, has been committed to the Ketogenic diet for more than a year and said they have inspired numerous friends, co-workers and acquaintances to follow suit.

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This is a reddit page that allows users to share their personal experience and ask the community questions. The home page for this reddit page also gets into defining what the ketogenic lifestyle is.

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r/keto - IMMENSELY Euphoric Experience on Keto!

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r/keto: The Ketogenic Diet is a low carb, high fat method of eating. And /r/keto is place to share thoughts, ideas, benefits, and experiences around eating within a Ketogenic Diet. Helping people with diabetes, epilepsy autoimmune disorders, acid reflux, inflammation, hormonal imbalances, and a number of other issues, every day.

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This Good Housekeeping article describes the ketogenic lifestyle as a fad diet.

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While some low-carb diets allow for the carbohydrates found in plant-based foods, others restrict them almost entirely - namely, the ultra-trendy ketogenic diet.

When I first heard that the next weight-loss "trend" was the ketogenic diet, I laughed out loud. "Absolutely not - no way! That's IMPOSSIBLE!" I was caught saying one year ago.

That's because my first intro to this seemingly new plan was when I worked in a hospital, where ketogenic diets were specifically used as a medical nutrition therapy for pediatric patients with seizure disorders, for whom medication was no longer effective. In other words: It was used as an absolute last resort for families who felt otherwise hopeless in the face of a neurological disease, and under strict medical supervision.

Indeed, there's plenty of research to support ketogenic diets in the treatment of some devastating neurological conditions. But can it really help the average Joe or Joanne lose weight?

How the Keto Diet Works

The diet aims to induce ketosis, a metabolic process in which we use fat for energy instead of the body's preferred source, sugar. Fans of the low-calorie, high-fat, extremely low-carb plan tout having more energy, lower appetite, and pretty immediate weight loss - all while chowing down on bacon, heavy cream, and butter. In regimented keto diets, only 10% of total calories per day (about a measly 20 grams!) come from carbs, 20% from protein, and a whopping 70% from fats.

Since our bodies preferentially use carbs for energy, cutting them means we have to use something else to keep organs functioning. Our bodies then turn to the glucose stored in our muscles as glycogen for fuel.

What else happens when we break down muscle glycogen? We lose water weight! Our muscles store about 3 grams of water for every gram of glycogen, meaning we can lose quite a bit of weight right away when we tap into glycogen stores for fuel. That's why someone who loses weight in "just one week!" from a low-carb plan is likely losing water weight, not necessarily real weight that stays off over time.

What's more, studies that have examined the efficacy of the ketogenic diet for weight loss have a few questionable similarities. First, they use the keto diet in conjunction with an extremely low-calorie plan (under 1,000 per day!), which makes it difficult to determine what caused the actual weight loss. Second, they all question the long-term impact on your heart of eating mostly saturated fat, not to mention how hard (and boring) it is to eat mainly coconut oil and butter for months on end.

The Keto Diet's Undeserving Rise to Fame

So why is social media blowing up with all things #keto, all the time? Well, most of us eat too many carbs to begin with. About half of our calories should come from carbs, according to the USDA Dietary Guidelines for Americans. That's about 250 grams per day for a 2,000 calorie diet. When you consider all of the grain-based foods and sneaky sources of added sugar, it's easy eat a lot more than the recommended amount.

Contrary to what social media hashtags would have you believe, there's not much to suggest that it will improve . athletic performance Keto also ranked dead-last (down with another joy-stealer, the Whole 30 Diet) on the U.S. News and World Report's Best Diets list. The lack of research on long-term outcomes, hard-to-follow regimen, and potential health hazards all alarmed the panel of experts.

Science simply doesn't support the notion that keto diets keep weight off in the long run, unlike the evidence-backed Mediterranean-style plans. Ketogenic eating may actually increase your risk for kidney and liver problems, plus osteoporosis.

Why the Keto Diet Will Probably Backfire on You

Since carb-filled foods contain the highest amount of water and dietary fiber, it's crucial to consider both the immediate side effects (constipation) and future ones (increased risk of GI cancers and decreased immune function) of cutting them out.

Besides constipation, crabbiness, and making it difficult for others to make plans with you, keto may lead to other health concerns too. Since research has yet to follow participants for more than a year, it's difficult to say with certainty that other problems (like an increase in LDL "bad" cholesterol) won't arise as well.

But the real reason why keto plans fail most of us is that they're not sustainable for the long term. Holidays, vacations, work functions ... there's likely at least one scenario in which you'll find yourself eating higher-carb foods. And the same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage.

The Bottom Line

Any diet that's as extreme as keto - to the point where it's often implemented under the supervision of an entire medical team - won't translate into everyday life. And when it backfires (as it always does), the shame and feelings of inadequacy hit us even harder when we've put so much darn work into it.

It's for that last reason alone that I don't recommend the keto diet. It can be so downright discouraging when we "fall off the wagon" that it seems completely pointless to eat healthier at all.

Keto diets rely on an extreme technique to (temporarily) move the scale down a few pounds , and basically eliminates all joy associated with eating real food and living life. Since restriction for life is downright impossible: Cut back on ultra-processed, high-carb foods like sugary beverages and tons of refined grains, and fill up on more nutritious carb choices, like veggies, fruit, legumes, low-fat dairy, and 100% whole grains to maximize long-term weight loss, health, and happiness.

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Ketogenic Diets Are B.S. for Weight Loss - Here's Why

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While some low-carb diets allow for the carbohydrates found in plant-based foods, others restrict them almost entirely - namely, the ultra-trendy ketogenic diet. When I first heard that the next weight-loss "trend" was the ketogenic diet, I laughed out loud. "Absolutely not - no way! That's IMPOSSIBLE!"

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This video describes Kristi's experience with the ketogenic diet

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HOW I LOST 40 LBS IN 12 WEEKS! | RawBeautyKristi

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Get a free 30-day trial today by signing up at http://www.audible.com/rawbeauty This video is sponsored by Audible, thank you so so much for partnering with me on this video! Hey guys!! Today I am bring you the EVER long awaited WEIGHT LOSS VIDEO!

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This blog is run by Carolyn Ketchum. The blog provides recipes and general information on the ketogenic lifestyle.

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All Day I Dream About Food | Low Carb Keto Recipes for Everyday Living

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A low carb keto food blog with the best recipes for your healthy diet.

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Blogs/ Personal Experiences with the Keto Lifestyle

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Blogs/ Personal Experiences with the Keto Lifestyle

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Ketogenic Food Pyramid image breaks diet up into 5% Carbohydrates, 25% Protein, and 70% Fat.

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This blog is run by Craig Clarke. The blog provides recipes, information on what a ketogenic diet is and what it can do for one's body, and general recommendations for starting a ketogenic diet.

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This website is run by the self-published, research-oriented author Craig Clarke, and it will show you how to finally take control of your health and weight.

You'll learn exactly how to cook, eat, and live to lose the weight you want, get more energy, and feel better than you ever have before...without having to sacrifice tons of time, the foods you know and love, or risking personal injury.

Ruled.me is all about learning how to make the right changes in your lifestyle so that you can take your body to its maximum level.

In most cases, these changes are very easy to make and will be incredibly powerful.

Thousands of others have already changed their lives by following the simple and effective principles taught on this site and applying a bit of willpower. Now you can too!

Who is Craig Clarke?

Before I continue, let me introduce myself. My name is Craig Clarke, and I've struggled with my weight for almost my entire life.

Through dedication and research, I've been able to completely turn around my body and help hundreds of thousands of people lose weight, gain energy, and get healthy.

Even though I'm only in my twenties, my love for all things science has taught me a great deal that I'm able to pass on the all my readers.

We all know that health starts in the kitchen. My passion for cooking and my fast growing passion for photography will help you do that in a delicious, easy, beautiful and affordable way.

I post on the website serveral times a week, so make sure you come back to check it out!

What is ?

Ruled.Me is my blog, and also a forum and community for people that are interested in learning and living a Ketogenic lifestyle. Ruled.me is where I attempt to enlighten and entertain readers with my articles, recipes, and books.

Take your time to look around, learn new things about the ketogenic diet, and find inspiration in the kitchen to make your weight loss story a successful one.

If you want to read more about the website and what my purpose is, go to our About Us >

What is a Ketogenic Lifestyle

The Keto Diet, or ketogenic diet, is a diet that's been around for well over 100 years. This is a diet that's very well known for being low-carb, where the body is forced into a state called ketosis and essentially uses fat as the primary fuel source.

Medically, it has been used to treat a myriad of disease and ailments including Type 2 diabetes, epilepsy, Alzheimer's, Parkinson's, neurological disease, and even cancer. Scientifically speaking, it has been around for millions of years and was the way we ate to evolve as a species, becoming the people we are today.

To read more about the health benefits of keto, click here >

Where to Begin

If you have no idea where to begin, this is the perfect place to start. First, you need to be able to wrap your head around the information and understand what is going on when you're in ketosis. You need to learn what to eat, how to eat, and how to properly cook in order to help yourself strive for the success you want.

The Cookbooks and Meal Plans

I love to write and cook, and I'm extremely thankful for all the support I've gotten from my readers.

I published Cooking by the RULED Book in early 2014, and due to its popularity, followed up with a second title. Then in late May of 2015, I decided that slow cooking needed to have a light shined on it and published my latest title, Keto Slow Cooking Made Easy.

Meal plans are perfect for everyone. They cut out all of the excess guesswork and hardships that come along with keto - from what to eat, to how much of it. My 30 Day Meal Plan was a massive hit, and I wanted to dig into the nitty-gritty and offer a wide variety of different plans for everyone. Then, The Keto Academy was born - a full set of three 30 day meal plans that also includes our standalone cookbooks.

I've sold well over 10,000 copies of my books and I regularly receive insightful, helpful feedback, which I am able to use to make periodic updates to my titles to better serve my readers' needs.

So, if you give any of my books a read, I'd love to hear your feedback!

Oh, and in case you're wondering why you should buy my books when I provide so much free content on the site...

My books contain a lot of book-only content. While I write many recipes on the website, I can't give them all away. I keep the best of the best and my personal favorites ready to go inside neat and easy to read books. I don't just throw a bunch of blog posts together inside and call it a book.

My books make things simple and cut out all the excess. Not only do they contain recipes, my Keto Academy includes a very easy and brief overview of the ketogenic diet. From where to start to what to do, it cuts out all the excess information and gives you a quick and easy read on what everything is about and how to apply it.

I have an expensive girlfriend. Okay, that last one is a joke...kind of 😉

In all seriousness, I make my living as a writer and a cook, so every book I sell helps me continue doing what I love: writing helpful stuff for you!

Alright, let's get to it...

The Keto Academy

Kitchen Recommendations

If you're like me, you probably spend a fair amount of time in the kitchen preparing your meals.

Just as wide an array of recipes I have, I also like to try a variety of kitchen equipment. I've tried all kinds of blenders, mixers, food scales, kettles, tea mixers, and even the obscure stuff like silicone egg molds and oven mitts.

In this section of my recommendations, you'll find my favorite kitchen products. These are what I use and enjoy, and think you will, too.

View Kitchen Recommendations

Cooking Recommendations

Since a lot of my time is spent cooking in the kitchen, I've narrowed down the products that I love to use that save me time and hassle. From pots and pans to cupcake molds, these are the products that I've had the best success with and have lasted me months on end.

In this section of my recommendations, you'll find my absolute favorite cookware products. These are exactly what I use to cook with, and I know you'll love them.

View Cooking Recommendations

Specialty Recommendations

While we can get away with eating meat and vegetables for most of our meals, these items will help you be able to cook things you never thought possible on a low carb diet.

While the quality of foods you eat doesn't matter as much for losing weight (you can lose weight eating gluten and junk), it certainly impacts your health.

In this section of my recommendations, you'll find my ever-growing list of favorite food products that are not only healthy, but delicious as well.

View Specialty Recommendations

Exercise Recommendations

Although you don't need much to work out properly, the right equipment certainly makes a difference. Fortunately, I've tried TONS of products over the years and I can save you money and frustration sorting through the junk.

In this section of my recommendations, you'll find the products I've used for many months or even years, and am very happy with.

View Exercise Recommendations

Supplement Recommendations

Here's a simple truth that most companies and magazines don't want you to know: You don't need to spend a bunch of money on fancy supplements and drinks to get the body you want.

Proper eating habits and self-control are the keys to building the body you want. That said, there are a handful of supplements that have good science behind them and that can speed up the weight loss process while improving your overall health.

In this section of my recommendations, you'll find the exact products I have used and liked, along with a bit of an explanation to why I believe they're worth the money.

View Supplement Recommendations

The Community

Getting a little more technical, we start reaching into the vast foods we have available to us. From natural sweeteners to specialty flours, we use what we have available to really boost what we put in front of us.

From day one I wanted Ruled.me to be a place where people could discuss and debate the many issues relating to the ketogenic diet. Getting healthy and staying that way is attained through many paths, and there's so much out there to be learned from other people's experiences.

If you have any questions and need help on how to start on the ketogenic diet, or just want to talk to other people that are doing this too, head over to the forum! There, you'll find an inviting community of like-minded people that would love to have you join in our group and conversations.
Visit the Community
Connect with Me

I think it's incredibly important to stay in touch with you all! You took the time to find the website, so I'm giving the time back to connect with my readers, followers, and fans. My inbox is always open and you're always welcome to send me an e-mail.

First off, you can find me on the usual social media sites:

Stop by, say hi, and Like or Follow if you like and want to follow what I do.

I spend several hours a day (including weekends!) reading and replying to as many e-mails, messages, and posts as I can. Please don't be offended if I can't get to yours - if only I could read and type faster!
That said, you can increase your chances of getting a reply by doing the following:

Search my website (at the top) to see if I've already written an article or post that answers your question

Avoid medical questions. While I do try to offer my best advice, I'm not a doctor, and I don't feel comfortable in giving advice to treat any type of disease. Hold those out for your own personal physician.

Please keep your e-mails as brief as possible so I can give my time to as many people as possible. The more questions you ask in a single e-mail, the less likely I'll be able to answer any of them.

Okay, now that that's out of the way - you can use the form below to reach me:
If you're looking to lose weight and get healthy in the process, then I can help you. I hope you enjoy my website and books and feel free to contact me with any questions or suggestions on how to make everything even easier. I'll always do my best to try to help!

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What You'll Get from Ruled.Me This website is run by the self-published, research-oriented author Craig Clarke, and it will show you how to finally take control of your health and weight. You'll learn exactly how to cook, eat, and live to lose the weight you want, get more energy, and feel better than you ever ...