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.
Low Carb Bars — There are a plethora of “keto-friendly” on-the-go bars that have hit the store online and on the shelves. Before you fall for their marketing scheme, check the ingredients and calculate the net carbs per bar. Make sure the bar will fit within your calorie and net carb limits for the day. The two most common bars that can be eaten on keto, albeit sparingly, are Quest Bars and NuGo Smarte Carb Bars. Use these as a last resort if you have no other keto snacks available.
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).
Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
It is not necessary to be as strict with children as you would be for yourself. Children are generally more insulin sensitive than adults, which means their bodies can deal with sugars and carbs more efficiently. Focus on whole foods, good sources of protein, lots of good fats (essential for brain development), and getting carbs from nutrient-dense sources.