The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter. Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.
Beware of added sugars or high-glycemic sweeteners in spice blends or condiments, but other than that, it’s fair game for keto. In spice-heavy dishes, carbs can add up, but don’t drive yourself crazy worrying about your teaspoon of turmeric. Check labels for additives like sugars, milk solids, potato starch, corn starch, or MSG, or make your own blends at home. Table salt often contains undisclosed fillers and anti-caking agents, so it’s best to opt for sea salt or Himalayan pink salt instead.
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. It's unclear, however; how long these effects last.
Burns fat: You can drop a lot of weight — and quickly — on the keto diet. Ketones suppress ghrelin — your hunger hormone — and increase cholecystokinin (CCK), which makes you feel full. Reduced appetite means it’s easier to go for longer periods without eating, which encourages your body to dip into its fat stores for energy. Learn more here about the keto diet and weight loss.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected. Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.
Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)
You may spot low-carb and sugar-free ice cream in your grocery store’s freezer case. Take one look at the ingredients, though, and you’ll find artificial colors, potentially moldy corn products, and sucralose that can harm your gut bacteria. This version tastes like a dirty keto recipe, but sweetens the results with grass-fed butter, collagen protein, and simple flavors like cocoa powder and cinnamon.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.
First, that study, which was reported upon widely, was on mice. Mice are not like humans in the way they fatten or contract metabolic diseases. Journalists/media should stop reporting on mice stories as if they were applicable to humans, especially when there is such a large body of clinical trial data on humans. Let’s be clear: rigorous clinical trial data on humans trumps any data on mice. Every time. And what does the rigorous data on humans say?
I tried the keto diet a couple years ago and about 6 weeks in of following it closely I started having significant episodes of lightheadedness and anxiety like symptoms. The coach I was working with said it was keto flu so I continued on the diet for a couple more weeks but it was making life difficult so I stopped. Now every time I try to go low carb the symptoms come back. Sometimes I wonder if it’s just anxiety response or all in my head. I would love to eat low carb but haven’t ever been able to figure out why this happens. I read somewhere that keto can be harder for women’s bodies and affect their adrenal glands. Would this increase anxiety symptoms.
While many health care providers aren’t comfortable recommending the keto diet for people with diabetes, there’s a substantial body of research indicating that it can help with weight loss, reduce the need for medication, and even lower A1C into the non-diabetes range. It’s so effective that when researchers assigned 349 volunteers with type 2 diabetes to follow either a keto diet or a traditional diabetes eating plan (the makeup of that plan wasn’t defined in the study) for one year, they observed some powerful results. While the people on the “diabetes diet” didn’t experience any positive movement in their A1C, body weight, or medication requirements, those on the keto plan reduced their A1C from 7.6 to 6.3 percent, shed 12 percent of their body weight, eliminated their need for sulfonylurea medication, and lowered or reduced their need for insulin by 94 percent. The results were published in 2018 in the journal Diabetes Therapy.
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.