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.
One area where food tracking can be especially helpful, though, is ensuring that you're hitting the right ratios of macronutrients—protein, carbs, and fat. "The most researched version of the ketogenic diet derives 70 percent of calories from healthy fats, 20 percent from protein, and only 10 percent from carbs," explains Charles Passler, D.C., nutritionist, and founder of Pure Change. "In the ideal world, each keto meal and snack should have that same (70/20/10) ratio of macronutrients, but studies have shown that you'll still achieve great results even if each meal varies slightly from that ratio, just as long as you don't exceed 50 grams per day of carbs, or eat those carbs in one sitting," says Passler. In order to achieve these ratios without a preset meal plan from a dietitian or doctor, some food tracking is probably going to be necessary. But once you get the hang of things, you may not need it anymore.
I get asked this question a lot. Generally speaking, the answer is no. As long as you avoid vegetables like corn, beets, and carrots, which are high in starch and sugar, especially carrot JUICE, which is packed with sugar, for example, you don't have to worry about the vegetable family. In fact, you want to eat lots of green leafy vegetables, cruciferous vegetables, Brussel sprouts—make big kale salads with bacon bits and a full fat dressing. Or make a big beet green sauté in coconut oil with some bacon, garlic, and onion stirred in. These will be dishes PACKED with potassium which will quiet food cravings much like fat does. Often, food cravings are nothing more than your body crying out for NUTRIENTS and MINERALS you’re not giving it. Your body doesn’t really want chips and sugar—it wants more potassium, magnesium, vitamin A, K2, and B vitamins.
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.
Beyond just fat loss, ketosis has an additional benefit in that it spares muscle when you’re eating at a deficit. On a normal diet, when you eat fewer calories than you need for the day, your body breaks down muscle and fat in nearly equal amounts to make up for the difference. With keto, your body is primed to burn mostly fat, particularly if you’re meeting your protein goal for the day. This results in a better metabolism and more total fat lost. Low carb recipes offer:
Look at the glycemic index to choose the best foods for your ketogenic meal plan. There are websites that provide the glycemic index (GI) or glycemic load of different foods. The glycemic index tells you how your body's glucose and insulin system will respond to different foods. Foods that are lower on the index (or have a lower glycemic load) are foods that digest more slowly and will help you to feel full for a longer period of time.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.
Join our community of “losers” today and subscribe free to IBIH newsletters to get notified when I post new keto recipes and updated keto diet menu plans! Also head over to the IBIH Facebook page where the cool kids hang out – and you’ll get access to my daily Amazon freebies, health and fitness tips, and other fun content I only post on Facebook! Finally, be sure to register for our new IBIH Community Forum where you can get daily support for the 5 Day Keto Soup Diet, 5 Day Keto Egg Fast Diet, Weekly Keto Diet Menu Plans, or just gab with fellow IBIH fans who are following a low carb or gluten free lifestyle!
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.