Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones. The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone. About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone. The stones are treatable and do not justify discontinuation of the diet. Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones. However, this empiric usage has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions. Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.
Therein lies the problem, of course. You can’t just walk in to any store or restaurant and grab yourself some keto snacks. We are making progress on that front, for sure, but we’ve still got a ways to go. While there are a number of decent store-bought options like cheese, nuts, and hard-boiled eggs, there are potential pitfalls everywhere. Like beef jerky, which can often contain a startling amount of sugar and carbs.
Jump up ^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
You should check with your physician if you have any concerns about starting a ketogenic diet plan with pre-existing health conditions, especially if those conditions involve kidney or heart problems. People with kidney disease should definitely consult with their physician about starting a ketogenic diet. Other contraindicated conditions and health issues are listed here. Make sure you check this list and rule these out before starting the diet.
To help your busy lifestyle, we include grocery lists with each of our keto meal plans. We include a 7 day weekly grocery list for each week. The grocery list will include everything you need for the following 7 days of the menu (except the "stock" or "common" ingredients like condiments). Our weekly grocery list comes with quantities for feeding ONE person. You can either multiply for additional people, or use the Meal Plan Software to do it for you.
Generally, the ketogenic diet reduces or excludes carbohydrate-containing foods, including breads, breakfast cereals, pasta, rice, quinoa, couscous, starchy vegetables (potato, sweet potato, corn), fruit, and legumes. Instead you are encouraged to consume more high fat foods, such as fatty meats, full-cream dairy, butter, nuts, avocado, olive oil and coconut oil.
Ketosis is a state of physical being and energy utilization when the body is running on ketones instead of glucose. Ketones are a clean fuel the body and brain absolutely loves. Ketones are an alternative fuel for the body that is not sugar or glucose. Running on ketones is like running a car on electricity rather than diesel fuel. Ketones are a cleaner fuel source - an alternative fuel source that gives a person way more energy than glucose. Even professional athletes can outrun and outperform any other athlete on ketosis than carb loading. By lowering your insulin, your sugars and refined carbohydrates, way down there close to zero to 5% of your daily calories or lower, you will burn fat as opposed to glucose for diet purposes or because you want to run on this clean fuel that many people find can help them perform better in all areas of life, mentally and physically. When you’re running on glucose and insulin is spiked, you’re not dipping down into your fat stores for energy. You’re burning up your muscles, not fat. When you’re in ketosis, you’re no longer spiking your blood sugar and you begin running on your own fat for fuel, which is idea for losing weight—the right kind of weight—fat.
Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
Short for “ketogenic diet,” this eating plan is all about minimizing your carbs and upping your fats to get your body to use fat as a form of energy, says Scott Keatley, R.D., of Keatley Medical Nutrition Therapy. While everyone's body and needs are slightly different, that typically translates to: 60 to 75 percent of your calories from fat, 15 to 30 percent of your calories from protein, and 5 to 10 percent of your calories from carbs.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome, which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication. On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism. A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.
Fillenworth suggests Brami beans as a great snack for keto dieters, especially since most legumes tend to be too high in carbohydrates. With only 60 calories, 2 grams of fiber, and a whopping 7 grams of protein per 25 beans, these Brami beans are an excellent way to boost protein intake (especially if you need a break from meat). (Related: Is a Vegetarian Keto Diet Healthy?)
After initiation, the child regularly visits the hospital outpatient clinic where he or she is seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks. A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet. Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect. This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).
Stay hydrated. As carb intake is lowered, the kidneys will start dumping excess water being retained as a result of the former higher carb intake. Make sure to drink enough water to replace what gets lost. The old 6-8 glasses is a good rule, I guess, although just drinking to thirst will probably do the trick. If you find yourself getting headaches and muscle cramps, you need more water, and more minerals such as salt, magnesium and potassium, because the water loss also takes minerals with it. (See my low carb diet side effects page for more info).
These nachos use the trendy Fat Head pizza crust as the “nachos” with a Tex-Mex twist, substituting cilantro, cumin and chili for the rosemary and garlic in the pizza base. After you cut them into tortilla shapes, you’ll load them with a meaty sauce and finish off the nachos with your favorite toppings, like guacamole, jalapeños and salsa. They’re the perfect snack to enjoy with family on movie night.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether. Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions. This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.