A therapeutic ketogenic diet has a very low insulin load from non-fibre carbohydrates and a higher amount of dietary fat to achieve higher ketone to manage chronic conditions such as cancer, epilepsy, Alzheimer’s, dementia etc.
The chart below shows our insulin response versus insulin load, which is considered fibre and protein as well as carbohydrates. People wanting to follow a ketogenic diet should eat foods towards the bottom left of this chart.
We can quantify the insulin load using the following formula:
insulin load = total carbohydrates – fibre + 0.56 x protein
The foods listed below have a very low insulin load while still maximising nutrient density (ND) as much as possible. Also included in the table are the nutrient density score, percentage of insulinogenic calories, insulin load and energy density.
nuts, seeds and legumes for therapeutic ketosis
| food | ND | insulin load (g/100g) | calories/100g | MCA |
| coconut milk | -5 | 5 | 230 | 1.5 |
| flax seed | 0 | 16 | 534 | 1.5 |
| coconut cream | -6 | 7 | 330 | 1.5 |
| pecans | -5 | 12 | 691 | 1.5 |
| macadamia nuts | -5 | 12 | 718 | 1.5 |
| brazil nuts | -2 | 16 | 659 | 1.5 |
| sesame seeds | -2 | 17 | 631 | 1.4 |
| sunflower seeds | 3 | 22 | 546 | 1.4 |
| hazelnuts | -2 | 17 | 629 | 1.4 |
| coconut meat | -6 | 9 | 354 | 1.4 |
| pine nuts | -2 | 21 | 673 | 1.4 |
| walnuts | -1 | 22 | 619 | 1.3 |
| almonds | -1 | 25 | 607 | 1.3 |
| peanut butter | 1 | 27 | 593 | 1.3 |
| almond butter | -1 | 26 | 614 | 1.3 |
| pumpkin seeds | 2 | 29 | 559 | 1.2 |
| peanuts | -1 | 29 | 599 | 1.2 |
| butternuts | -3 | 28 | 612 | 1.2 |
| sesame butter | -1 | 33 | 586 | 1.1 |
| pistachio nuts | -2 | 34 | 569 | 1.0 |
seafood and animal products for therapeutic ketosis
| food | ND | insulin load (g/100g) | calories/100g | MCA |
| mackerel | 1 | 10 | 305 | 1.5 |
| sweetbread | -3 | 9 | 318 | 1.4 |
| bacon | -4 | 11 | 417 | 1.4 |
| liver sausage | -3 | 10 | 331 | 1.4 |
| bologna | -6 | 9 | 310 | 1.4 |
| bratwurst | -1 | 13 | 333 | 1.3 |
| pepperoni | -4 | 16 | 504 | 1.3 |
| beef brains | 3 | 8 | 151 | 1.3 |
| kielbasa | -3 | 12 | 325 | 1.3 |
| blood sausage | -5 | 13 | 379 | 1.3 |
| knackwurst | -4 | 12 | 307 | 1.3 |
| liver pate | -4 | 13 | 319 | 1.3 |
| pork ribs | -2 | 16 | 361 | 1.3 |
| salami | -1 | 17 | 378 | 1.2 |
| frankfurter | -4 | 12 | 290 | 1.2 |
| turkey bacon | -2 | 11 | 226 | 1.2 |
| beef sausage | -3 | 15 | 332 | 1.2 |
| duck | -3 | 15 | 337 | 1.2 |
| chorizo | -3 | 19 | 455 | 1.2 |
| meatballs | -3 | 14 | 286 | 1.2 |
| lamb rib | -2 | 17 | 361 | 1.2 |
| pork sausage | -2 | 16 | 325 | 1.2 |
| lamb brains | 4 | 10 | 154 | 1.2 |
| headcheese | -4 | 8 | 157 | 1.2 |
| turkey | -2 | 21 | 414 | 1.1 |
| pork sausage | 1 | 13 | 217 | 1.1 |
| cisco | 4 | 13 | 177 | 1.1 |
| caviar | 9 | 23 | 264 | 1.0 |
| bologna | -2 | 11 | 172 | 1.0 |
| ground turkey | 4 | 19 | 258 | 1.0 |
| T-bone steak | -1 | 19 | 294 | 1.0 |
| turkey drumstick (with skin) | -1 | 15 | 221 | 1.0 |
| ham | -0 | 11 | 149 | 0.9 |
| chicken liver pate | 5 | 17 | 201 | 0.9 |
vegetables, fruit and spices for therapeutic ketosis
| food | ND | insulin load (g/100g) | calories/100g | MCA |
| alfalfa | 15 | 1 | 23 | 1.8 |
| olives | -5 | 1 | 145 | 1.8 |
| endive | 18 | 1 | 17 | 1.7 |
| avocado | -1 | 3 | 160 | 1.7 |
| chicory greens | 16 | 2 | 23 | 1.7 |
| curry powder | 5 | 14 | 325 | 1.6 |
| escarole | 14 | 1 | 19 | 1.6 |
| coriander | 15 | 2 | 23 | 1.4 |
| poppy seeds | 2 | 23 | 525 | 1.3 |
| paprika | 8 | 26 | 282 | 1.3 |
| beet greens | 12 | 2 | 22 | 1.2 |
| sage | 5 | 26 | 315 | 1.1 |
| blackberries | 2 | 3 | 43 | 1.1 |
| caraway seed | 3 | 28 | 333 | 1.1 |
| zucchini | 14 | 2 | 17 | 1.0 |
| mustard greens | 9 | 3 | 27 | 1.0 |
| marjoram | 5 | 27 | 271 | 1.0 |
| mustard seed | 2 | 37 | 508 | 1.0 |
| banana pepper | 8 | 3 | 27 | 1.0 |
| eggplant | 6 | 3 | 25 | 1.0 |
| raspberries | 0 | 4 | 52 | 1.0 |
| collards | 8 | 4 | 33 | 1.0 |
| thyme | 7 | 31 | 276 | 0.9 |
| nutmeg | -5 | 32 | 525 | 0.9 |
| cloves | 7 | 35 | 274 | 0.9 |
eggs and dairy for therapeutic ketosis
| food | ND | insulin load (g/100g) | calories/100g | MCA |
| cream | -5 | 5 | 340 | 1.6 |
| butter | -6 | 3 | 718 | 1.6 |
| egg yolk | 5 | 12 | 275 | 1.4 |
| sour cream | -4 | 6 | 198 | 1.4 |
| cream cheese | -5 | 10 | 350 | 1.4 |
| Limburger cheese | -1 | 15 | 327 | 1.2 |
| camembert | -1 | 16 | 300 | 1.2 |
| cheddar cheese | -1 | 20 | 410 | 1.2 |
| brie | -3 | 16 | 334 | 1.2 |
| feta cheese | -1 | 15 | 264 | 1.2 |
| blue cheese | -1 | 19 | 353 | 1.1 |
| Monterey cheese | -2 | 19 | 373 | 1.1 |
| Muenster cheese | -2 | 19 | 368 | 1.1 |
| goat cheese | -3 | 14 | 264 | 1.1 |
| Swiss cheese | -0 | 22 | 393 | 1.1 |
| whole egg | 6 | 10 | 143 | 1.1 |
| Gruyere cheese | -1 | 23 | 413 | 1.1 |
| Colby | -2 | 20 | 394 | 1.1 |
| Edam cheese | -1 | 21 | 357 | 1.1 |
| gouda cheese | -1 | 21 | 356 | 1.1 |
| ricotta | -2 | 12 | 174 | 1.0 |
nutrient density for therapeutic ketosis
The chart below shows the nutrition provided by this high-fat approach. The therapeutic ketogenic dietary approach does not provide the DRI levels of:
- tyrosine,
- phosphorus,
- alpha-linolenic acid,
- threonine,
- vitamin A,
- copper,
- vitamin K,
- riboflavin,
- selenium, and
- lysine.
Hence this style of therapeutic approach is ideal for a shorter-term intervention, with a higher nutrient density approach being adopted when possible.
How Can I Calculate My Nutrient Intake?
If you’re interested in checking if you’re getting just enough dietary phosphorus, you can check your nutrient profile using our Free 7-Day Nutrient Clarity Challenge.
After a week of tracking your current diet in Cronometer, Nutrient Optimiser will give you a prioritised list of foods and NutriBooster recipes that will help you plug your current nutritional gaps.
Level Up Your Nutrient Density
To help you level up your nutrient density, we’ve prepared a Nutritional Optimisation Starter Pack to ensure you are getting plenty of all the essential nutrients from the food you eat every day.
The free starter pack includes:
- Maximum Nutrient Density Food List
- Sample Maximum Nutrient Density Recipe Book
- Sample Maximum Nutrient Density Meal Plan.
To get started today, all you have to do is join our new Optimising Nutrition Group here.
Once you join, you will find the Nutritional Optimisation starter pack in the discovery section here.
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