Therapeutic Carbohydrate Restriction (TKB)

In brief

TKB lowers insulin levels and gives the body room to burn fat
Three levels: mild (50-130 g), TKB50/ketogenic (<50 g), ketocarnivore (temporary)
Basis: protein + vegetables + fat, avoid sugar and ultra-processed products
2-3 eating moments per day, no snacks
Always start under medical supervision with diabetes or blood pressure medication

What is therapeutic carbohydrate restriction?

TKB is a lifestyle treatment where you severely limit sugars and starches. This lowers insulin levels and gives the body room to use stored energy (fat). With metabolic dysfunction, hyperinsulinemia and insulin resistance are often central.

With low carbohydrate intake, the body gradually switches to fat burning. The liver can then produce ketones. This supports metabolic flexibility: smoothly switching between sugar and fat burning.

Three options customized

Choose a starting point that fits your goals, symptoms, and medication. You can scale up or down later.

Mild (50-130 g carbohydrates per day)

For mild symptoms or an active lifestyle
Carbohydrates mainly from legumes, tubers, and limited fruit

TKB50 / ketogenic (less than 50 g per day)

Often effective for overweight, prediabetes, insulin resistance, or PCOS
Carbohydrates mainly from vegetables and berries
Protein usually 1.2-1.5 g per kg target weight

Ketocarnivore (temporary)

Sometimes for severe intestinal complaints, autoimmune symptoms, or stubborn insulin resistance
Focus on animal products, minimal plant-based

Practical food choices

Yes

Meat and poultry
Eggs
Fatty fish
Full-fat dairy
Above-ground vegetables
Avocado and olives
Nuts and berries

Fats

Application	Choice
Heating	Butter, ghee, coconut fat
Cold	Extra virgin olive oil

Avoid

Sugar and sweet drinks
White flour products
Ultra-processed snacks
Industrial seed oils (sunflower, soy, rapeseed oil)

Eating rhythm and fasting

Aim for 2-3 eating moments per day, without snacks
Fewer eating moments works especially when meals are truly satisfying
Intermittent fasting can help (e.g., 16:8) - build up gradually
Start the day protein-rich and low-carb for satiety and stable glucose

Lifestyle fundamentals

Pillar	Advice
Movement	Walking after meals, 2-3x per week strength training
Sleep	7-9 hours; sleep deprivation increases stress hormones and insulin resistance
Light/rhythm	Morning light in the first hour after waking (20-30 min)
Stress regulation	Chronic stress can inhibit fat burning via elevated cortisol
Supplements	Optional: magnesium, omega-3, vitamin D (and possibly K2)

Metabolic and mental

Blood sugar fluctuations can cause restlessness, irritability, and energy dips. With fewer fluctuations, many people experience more stable energy and mood.

Ketones are an alternative fuel for the brain. Some people experience more focus or mental calm when they (temporarily) achieve nutritional ketosis.

Monitoring and safety

What to measure

Fasting glucose and fasting insulin (for HOMA-IR) - follow trends over time
Triglycerides/HDL ratio - often drops with TKB
Blood pressure at home - multiple measurements in a row if you have hypertension
Consider temporary CGM or glucose/ketone meter to learn personal tolerances

Personal goal

Make your ‘why’ concrete:

More energy
Less belly fat
Better sleep
Fewer symptoms

Agree on an achievable first step for 2 weeks, and then evaluate what can be improved.

Veelgestelde vragen

What is the difference between TKB and a ketogenic diet?

TKB50 (less than 50 g carbohydrates per day) is comparable to a ketogenic diet. With TKB, there is also a mild variant (50-130 g) for people with mild symptoms or an active lifestyle. TKB is a spectrum: you choose the level that fits your goals and symptoms.

How long until I notice results?

The first 1-2 weeks you may experience 'keto flu' (headache, fatigue). This can be limited with adequate fluid and salt. After 2-4 weeks, many people experience more stable energy and less hunger. Metabolic improvements (glucose, insulin) are often measurable after 4-8 weeks.

Can I combine TKB with strength training?

Yes. Ensure adequate protein (1.2-1.5 g per kg target weight) and eat especially around training. Some people choose a mild variant (50-130 g) with intensive training. After adaptation, many people perform well at a ketogenic level.

Do I need supplements with TKB?

Optional but often useful: magnesium (muscle function, sleep), omega-3 (anti-inflammatory), vitamin D (and possibly K2). Salt is especially important in the first weeks. Consult with medication or specific conditions.

Is TKB safe with diabetes?

TKB can be very effective for type 2 diabetes and prediabetes, but always start under medical supervision. Blood sugar values can drop quickly and medication sometimes needs to be adjusted promptly. Contact your healthcare provider immediately with repeated hypos.

Medische Disclaimer: De informatie van Stichting Je Leefstijl Als Medicijn over leefstijl, ziektes en stoornissen mag niet worden opgevat als medisch advies. In geen geval adviseren wij mensen om hun bestaande behandeling te veranderen. We raden mensen met chronische aandoeningen aan om zich over hun behandeling goed door bevoegde medische professionals te laten adviseren.

Medical Disclaimer: The information provided by Stichting Je Leefstijl Als Medicijn regarding lifestyle, diseases, and disorders should not be construed as medical advice. Under no circumstances do we advise people to alter their existing treatment. We recommend that people with chronic conditions seek advice regarding their treatment from qualified medical professionals.