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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 calories 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.[36]
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[18]

The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[3] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] There is some evidence that adolescents and adults may also benefit from the diet.[9]
Vicky started Tasteaholics in 2015 with her boyfriend, Rami, hoping to document all their low carb cooking adventures. She lives in NYC and her favorite food is steak and lava cake. She enjoys photography, travel, cooking, working out, cats & Harry Potter. She loves sharing her knowledge, cooking tips and creative dishes with all of Tasteaholics’ readers.
Ketogenic diets often create a significant loss of water during the first phases. This is because carbs are converted to glycogen in your body, which is stored in water within the muscles and liver. As you deplete stored glycogen, your body flushes this water out. This is a huge part of the initial weight loss during the first few weeks of ketosis. While rapid fat loss does occur at first, a lot of water weight is often dropped as well, but this is a great encouragement as it often results in both weight loss and less bloating, allowing clothes to fit better.
A ketogenic diet, or keto diet, is a very low carbohydrate eating plan that forces the body to use fat rather than glucose as a primary energy source. When you follow the plan, you build meals around fatty foods and significantly restrict your intake of carbohydrates and protein. As a result of that macronutrient balance, acids called ketones are produced in the body. When ketone levels are high enough, the dieter is in a state of ketosis.
There are three kinds of ketones, and the urine is only tested for acetoacetate. As you switch to the more efficient fat-burning process, you convert that acetoacetate to beta-hydroxybutyrate. So, yes, your test can show negative or zero ketones. Look at other factors. Are you losing weight? Are you feeling good? If you’re doing 20 grams net carbs a day or less, you’re going to be in ketosis, no matter what.

Ketogenic diets are very, very powerful, metabolically speaking and this is especially important if you take any kind of medication for blood pressure, diabetes, cholesterol or triglycerides. The amount taken of these medications will most likely need to be sharply reduced while on a ketogenic diet to avoid negative effects such as excessively low blood sugar or blood pressure.

Switching to a ketogenic diet plan can be uncomfortable at first because your body metabolism is refitting itself to burn fat instead of relying on glucose.  However, you can avoid most of the symptoms. Here's a list of all of the common side effects that will happen the first week or so of starting a ketogenic diet. Knowing about them allows you to take steps to minimize them, and save yourself some carb withdrawal misery. Dr. Mike Eades has a great analogy for this process in this blog post.  I highly recommend you read it.
Keto breath, on the other hand, is less of a side-effect and more of a major (not harmful) inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone (yes, the same stuff that's in nail polish remover), Keatley previously told WomensHealthMag.com.
As for branched-chain amino acids, you'll find smart people who swear that they're keto-friendly, and others who don't. One of the BCAAs, valine, can be glucogenic, meaning that it can lead to glucose production and potentially contribute to leaving ketosis behind.[1] But does that mean it will happen? Not necessarily, particularly if you're just an occasional supplement user.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
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