A Keto Dietitian’s Tips for Families Celebrating the Winter Holidays, Keto-Style!

Thanksgiving is a week from today and the rest of winter holidays are right around the corner! In today’s guest blog post, ketogenic dietitian Robyn Blackford, RDN, LDN, provides her tips for families celebrating the holidays while on the ketogenic diet. Thanks for these awesome tips, Robyn!


For people following a ketogenic diet during the holidays, it doesn’t have to be a season of additional stressors. Parents of children who follow a special medical diet, including the ketogenic diet, may even find the upcoming holidays easier to survive than they first thought.

I often hear that extended family members are very supportive of their child’s special diet. Educating others on the diet will open your family up to a potentially strong support system. Most people like to hear about the nuances of the special diet and learn how they, too, can help. Talking about the diet and getting that ‘pat on the back’ can give you just enough motivation and energy to make the next special meal. Siblings may ask if they, too, can have the yummy, magical keto food that you are preparing. What a nice, fun, supportive time that this can be for your whole family!

Whether you are hosting holidays at your house or joining others elsewhere, you are sure to be successful to sticking to your ketogenic diet during these festive days if you practice these tips.

Holidays at your house:

* Consider serving a low carb dish on your menu. There are many low carb recipes readily available, such as a cauliflower mash in place of mashed potatoes. This may be helpful for others to understand some of the details and enjoy the foods that are part of the special diet

* Using festive holiday plates, bowls, and napkins to distract from ordinary or special diet food is a welcome change for people of any age! Try using cookie cutters to make foods more appealing and brightly colored toothpicks to add fun to your holiday meal.

* Keep food out of reach for tiny guests that are on a special diet. This way they cannot snatch foods quicker than you can say no or be able to take it away from them. They can be faster than you anticipate!

Holidays as a guest:

* Consider eating or serving your keto meal before leaving the house. This way you do not have to worry about finding foods you can eat later when you or your child is hungry. Talking to the holiday host can help you be successful if you plan on eating a little something at the get-together.

* Plan to serve and eat your favorite keto foods while away from home in easy-to-warm-up containers. It can be quite a treat if you haven’t had that favorite food in a while.

* For smaller children, be sure to pack a bag full of toys and fun things to help distract them from focusing on food. Do not underestimate the power of non-food rewards during playtime!

 

In any case, make sure that you plan ahead. Mentally prepare your child to resist food that is not part of their special diet and prepare yourself to teach others about the positive impact the diet has had on your lives.

Helping people follow their ketogenic diet can be one of the best gifts you can give them during the holiday season!

-Robyn

The Ketogenic Diet & Halloween Blog Round Up

Halloween on the ketogenic dietAs Halloween quickly approaches, we’ve compiled a list of blogs all about managing your child’s ketogenic diet on this food-focused holiday.

Happy keto-friendly Halloween, everyone!

Halloween on the Ketogenic Diet: New Ideas & Traditions

In today’s guest blog post, ketogenic dietitian and keto ambassador Vanessa Aldaz, MPH, RD, CDE, shares her tips for parents managing Halloween with a child on a ketogenic diet. Thanks for these fabulous ideas, Vanessa!


It’s that time of year again when not only is it getting colder outside, school is on a roll and well, everything is going well. However, you walk into pretty much any store to find decorations colored in black and orange and entire sections of candies and sugar right at the entrance! What is a keto-parent to do?  You hear the chatter of children talking about what costume they’ll be dressing up as this year, and then there’s the whirlwind thought of “Can my keto kid go trick or treating? Can we make it through this holiday without a sentimental scratch?” The answer is: yes! Children on the ketogenic diet can have just as much fun as any other kid out there celebrating Halloween. There may need to be some rules that other kids may not need to stick to, but the fun won’t be a disappearing act. Here are more than a few ideas to make Halloween on the ketogenic diet fun, crafty, ghoulalicious, and sure to set new traditions.

Can my child go trick or treating? Yes, yes, and sure! Let them only collect a bag full of candy and not eat them, but at the end of the night you can have them participate in a few new fun ideas or traditions (read ideas below). The other great thing about this is that they went for a walk and got some exercise. A good rule of thumb is to have them eat dinner or a filling snack BEFORE going trick or treating so they don’t get the munchies once they are out there.

New Fun Ideas & Traditions

  1. The first one, I truly have to say I stole the idea from one of my patients with diabetes a while back, but come to think about it, it works!! For a keto kid it’s genius! Once your child has come home with a bag full of candy and treats, have them count them with you and put them in a bag for the “Switch Witch” – yes she’s that sweet tooth , sugar eating witch with rotting teeth who’s willing to take your child’s candy and switch them over for a fun toy or surprise that your child will wake up to the next morning! – taadaa you have replaced a treat your child cannot eat with a fun surprise of your choosing that your child is sure to love and not miss that candy. Feel free to come up with your own Halloween “goblin” that will replace candy for a treat.
  2. If the above doesn’t work for you or if it just screams of spoiling your child then have your kids collect the candy and donate the candies to our troops overseas. Many dental offices will collect candies that your little ones collect. Not sure if this includes a discount on your next visit though, hehe.
  3. You can also try to have close friends and neighbors have a pre-set keto treat bag for your little one when they ring their door bell and say “trick or treat”. A bag full of little non-edible goodies like Halloween stickers, spider rings, bubbles, erasers, pencils, etc. Places like Walmart, the dollar store or 99 cent sections at other stores are filled with fun little trinkets. These can also be taken to school to hand out to your child’s classmates.
  4. Focus on costumes, not on the candy! – have a costume contest. Dress up your child in their favorite costume or disguise. Be creative, decorate their stroller or make their wheelchair part of their disguise. Pinterest had some amazing ideas like a brand new toy still in the box, the box is the stroller and the doll or toy is your child.
  5. Host a Halloween party, play games and focus on non-edible treats. You can have them paint mini pumpkins, tossing balls or any other fun game. Focus on the fun decorations! If you do get trick or treaters to your house, instead of having a large bowl of candy that might get into the wrong hands or mouth, try pre-packaging them into sealed “grab bags” for  non-keto kids to take home.
  6. Go on a Halloween-themed adventure! Visit a pumpkin patch, go on a hay ride or if your child is old enough and able, perhaps a not so haunted house might not be a bad idea. Or go to a theme park- Many theme parks will be all decked out all month long or host a series of fun events for the whole family to enjoy. Disney theme parks are amazing that time of year.
  7. Lastly, if you would like to make some fun Halloween Keto treats, here are some ideas. Just make sure you double check with your keto team and RD to ensure it fits your child’s keto diet prescription.

-Keto Chocolates: cocoa butter flavored with stevia flavoring drops, put in fun candy molds and enjoy.

-Sugar free jell-o molds. Try the Sugar free Jell-O mixed with vanilla KetoCal 4:1 LQ and put in fun Halloween molds, yummy!

-KetoCal crustless pumpkin pie

-KetoCal chocolate cupcakes

Happy Halloween and enjoy.

-Vanessa

 

Back to School on the Ketogenic Diet: A Keto Dietitian’s Guide

In today’s guest blog post, ketogenic dietitian and keto ambassador Vanessa Aldaz, MPH, RD, CDE, shares her tips for parents with a child going back to school on the ketogenic diet. Thanks, Vanessa!


Back to SchoolSo perhaps one of the major things you did with your child this summer was going on the ketogenic diet. School will soon be back in session and managing the diet may now require the assistance of others involved in your child’s care. This can be very anxiety-producing to many parents. You can try to set up a meeting with school officials and your child’s teacher and school nurse and see what or how they are willing to help. Educating them on the importance of the ketogenic diet in a positive way can lead to a lot more assistance than an overwhelming feeling and having them too scared to help. Remember you want them to be on your side and help but not scare them to the point that they become too nervous to help.

Here are a few tips that may help to make this transition a lot easier.

1. Kindly ask your keto team or RD to write you a school letter addressing key points of the ketogenic diet. Include in the letter all that pertains such as: important do’s and don’ts, foods allowed or not allowed, a feeding schedule and how meals will be given (orally or tube-fed), any meds or supplements that may need to be given during school hours and a clear indication of whether snacks and or lunch will be provided from home only, or if the school will be expected to prepare any part of a meal. If on tube feeds make sure all is specified including any water flushes, formula name, amount and how feeds will be given.

2. Ask your Social worker or keto team to also assist with a 504 plan or IEP for support ensuring supervision during meal times and support making sure that no unplanned snacks are given or unexpectedly taken. Unfortunately, I have had some families quit the diet too early on because of lack of support from the school.

3. Look up Nutricia’s “Epilepsy and the School Lunch Program”- a helpful way to ensure your child receives her keto formula at school as part of her school lunch.

4. It is also helpful to provide the school or day care with extra cans of keto formula and additives, if any, along with the most current recipe for your child’s formula preparation in case of an emergency.

5. It would be wise to also have a ketogenic diet emergency kit: include important phone numbers, keto formula (KetoCal 4:1 LQ is ideal as it comes in a tetrapak and can be used anywhere), bottled water, flash light, batteries, an extra scale with batteries, diapers, wipes, a change of clothes, blanket, urine ketone testing strips, and keto friendly dried foods such as KetoCal powders, sugar free jell-O, canned veggies or low carb foods (baby foods are small and compact), and instructions just in case.

6. Providing “all in one meals” versus foods separated in different compartments can ensure that even if your child does not finish his lunch he will still be eating his few bites in the correct ratio!

7. In case of a food cheat or unplanned extra carb, omit the carb from the next meal or discuss a “fat bomb” recipe option with your dietitian.
8. Make lunch fun- don’t forget the cool lunchbox in your child’s favorite cartoon or comic character and if you want send sticky notes daily reminding them of how wonderful he/ she is and how much they are loved! You are also their cheerleader!

To continue making school lunches fun: here are a few ideas for fun keto lunches. Ask your keto RD for more ideas. For MAD or Classical Diets:

-Pizza: Try KetoCal pizza (3:1,4:1,MAD), pizza muffins, or pizza rolls made with low carb, high fiber tortillas or an egg base.
-Veggie Rolls: On a Nori seaweed paper sheet add cucumbers, spinach, grated carrots and combine with a keto dip like avocado and mayo or a cream cheese dip.
-Skewers: Make pepperoni and cheese bites on skewers. Other ideas include fruit, veggie, meat or cheeses.

Sign up, if you haven’t already to http://www.myketoplanner.com for more recipes and shared ideas.

-Vanessa

For more information & tips on going back to school on the ketogenic diet, check out these previous blogs:

Informing the School About Your Child’s Ketogenic Diet

Packing the Ketogenic Lunchbox

KetoCal and the National School Lunch Program

A Keto Mom’s Guide to Preparing Keto Lunches

Keto Recipe Ideas for Summer

In today’s guest blog post, ketogenic dietitian and keto ambassador Zahava Turner, RD CSP LDN, shares some ketogenic recipes that are perfect for hot summer days. Thank you for these tasty recipe ideas, Zahava!


Summer is a time to enjoy the warm weather and spending time outdoors. So whether you are preparing a family BBQ, picnic or pool party or it’s just too hot to cook, here are a bunch of ketogenic recipes to use. Each one of these recipes can be adapted for your child’s ratios or even taste preferences.

Gazpacho

California Salad with Avocado & Bacon

BBQ Rosemary Chicken Breast & Grilled Vegetables

-Zahava

 

 

Time Management Tips for Keto Moms & Dads

We are excited to share this guest blog post from keto mom Dana Haddox-Wright. As always, Dana is full of helpful tips and insights for other parents. Be sure to check out her previous posts:


I have a daughter with a debilitating form of epilepsy, and before starting on the ketogenic diet she had status seizures at least twice a week requiring emergency intervention.  When my daughter’s neurologist suggested to my husband and me that we put her on the keto diet, I was instantly stressed by the idea.  I knew that it may help, but I was concerned that I would not be able to fit it into our daily routine.

I was also apprehensive because keto is so restrictive. Living in a world where food is such a large part of our culture, I was afraid that I would be depriving her in some way.  However, I came to the realization that having her in an ambulance on a weekly basis was no way for her to live.  I consulted with friends about how they manage the diet.  Most of the parents with kids on the ketogenic diet had only good things to say about it in terms of seizure control, so we decided to try it.  Within 3 days of being on the ketogenic diet my nearly 3 year old daughter was fully potty-trained, and she was more verbal than ever before.

Fast forward to 3 years later and my daughter is still on the ketogenic diet.  It has become part of our daily schedule.  It is not always easy, but we have a system in place that seems to work.

Below is my daily schedule, and I am sure other parents may relate:

6:45am – Wake up and get to cooking
7:00am – Prepare keto lunch and keto snack for the oldest
7:15am – Place keto meal in oven and start packing non keto meal for the youngest
7:45am – Finish packing lunches and start preparing keto breakfast and typical breakfast
8:00am – Breakfast finished and ready to eat
8:15am – Get the little ones dressed and ready for school
8:30am – Drop off the kids
9:00am – Work
3:15pm – Pick up the oldest
3:30pm – Prepare second keto snack
4:45pm – Pick up the youngest
5:15pm – Both kids home, time to prepare all the meals (keto and typical)
6:00-6:30pm – Dinner is served
7:30pm – Time to get ready for Bed
8:00pm – Kids are asleep.  Need to finish the work I could not finish during the day

Based on this routine, how does one find free time?  How can we incorporate keto into our day without becoming overwhelmed?  There are certainly ways to manage the keto diet and follow the daily regimen without losing all sanity.

1 – Cook ahead of time.  I laugh when I read this.  The concept of dragging my tired-self off of the couch when the kids are in bed is almost painful, but sometimes I do have a little extra energy to make a few bake and freeze pizzas or some school snacks before I relax.  What you accomplish at night will save you some stress in the morning.

2 – Time is ticking.  Think fast.  On any given day, I have a short amount of time to think through what to prepare for my daughter’s breakfast, lunch, and snacks.  I typically ask my daughter what she would like for lunch and/or snack.  On some mornings, she will request a vanilla KetoCal shake (“happy dance” time).  Otherwise, she has her “go to” meals or favorites that I can make quickly:  hot dogs in sauce (mayo and low sugar ketchup) with cream on the side, pizza, or cake with whipped cream frosting.  I have become very efficient at putting these things together and having them baking/cooking while I pack lunch for my younger daughter.  Again, the better (least realistic) option is to cook ahead.

3 – Dinners are made easier when keto meal looks like everyone else’s dinner. One can use items for keto meals that the rest of the family will have in their food.  For example, if it is taco night create a keto-taco recipe that contains the same ingredients.  I have a simple keto-taco recipe that includes:  iceberg lettuce, cheddar cheese, sour cream, ground beef, and oil.  I usually measure out and/or cook the keto meal first and then focus on the meal for the rest of the family.  That way, we can all eat at the same time.

4 – Keep It Simple. It may seem silly, but the longer I cook keto the easier it is for me to build-in time savings.  Recipes do not have to be elaborate or complicated.  If you don’t feel like whipping egg whites to make a crust, don’t whip them.  Taste is what really matters.  If mixing all ingredients in one bowl will not affect taste, then do that.  You can even create more all-in-one recipes that keto kids will enjoy.  Also, rely on your keto kids to let you know what they like.  My daughter will often cycle between 3 or 4 different recipes for a while.  Giving choices empowers keto kids in an otherwise restrictive situation.  I want my daughter to enjoy her food, so I feel that she deserves to have a voice in meal planning.

In a perfect world no child would ever need to be put on the ketogenic diet, but we all know that we do not live in a perfect world.  Our lives are not perfect and we are not perfect, so we have to make the best of our circumstances.  Provided we stay within the parameters of the diet set by our keto dieticians, we can be creative and make the diet fun.  This regimen is literally a labor of love, because if we did not love our children we would not be spending so much time on their meals.  It takes a lot of thought and practice finding ways to make the ketogenic diet less tedious, but once we get a knack for it, we may be surprised how fast things come together.

-Dana

The Ketogenic Diet: 5 Things To Do Before You Go on a Trip

Taking a summer trip requires a little more planning when you or a family member is on a special diet. In today’s guest blog post, ketogenic dietitian and keto ambassador Stacey Bessone, RDN, LDN, shares her list of 5 things to do before going on a trip while on the ketogenic diet. Thank you for your tips, Stacey!


trip 2Sometimes planning for a trip can be overwhelming, even for people not on a special diet. When you or a family member is on a special diet, such as the ketogenic diet, the task can be even more daunting.  Here are a few tips to help preparations so that you do not need a vacation from your vacation.

  1. Plan for the travel portion (there and the way home).

    Try to bring non-perishables and pre-made snacks/meals that can be consumed on the way there AND the way back.  Some suggestions would be a sugar-free jello with whipped cream, avocado or a KetoCal LQ.  Make 2 travel meals/snacks and save one for the return trip.

  1. Plan for airport security.

    Below is a link for items NOT allowed through the check points for carry on. Liquids need to be less than 3.4 fluid ounces with the exception of medically-necessary liquids, such as special formulas or liquid medications. Let the TSA agent know if you have medically-necessary liquids as these will need to be screened separately from the rest of your belongings. You may also consider bringing a letter from your doctor or dietitian explaining the diet and need to carry special food, liquids, or medications.

https://www.tsa.gov/travel/security-screening/prohibited-items

  1. Research grocery stores in the area you will be visiting.

    This may help with brand names and usual food items that you will want to have menus for. Call your hotel to see if there is grocery delivery and order ahead so that items will be available when you arrive.  Also, most hotels can provide small refrigerators which can be used to store cream, butter and other cold items.

  2. Review menus of local restaurants where you will eat.

    Many restaurants have online menus. This may make it easy to make a plan for ordering and bringing along items needed to compliment the meal. If you are staying or eating in a relative’s or friend’s home, call the host ahead of time to explain the situation.  This way you can make a plan for the host to supply certain foods or the need for you to bring food with you. Always have a fast food meal menu for back up.

  3. Have fun!

    By preparing and making a plan, the ketogenic diet can fit into a great vacation. This can be a good time to try new foods that may be part of the experience.  For example, BBQ in the south or fish/seafood near the ocean.  Preparing a menu for these foods and taking some of the steps above can make for an interesting dining experience.

-Stacey


See Stacey’s other guest blog post: “How to Make Valentine’s Day Extra Sweet on the Ketogenic Diet”

 

Ketogenic Diet –A Dietitian’s Tips for Summer Break

As summer break approaches, you may have some anxiety about being out of your regular keto routine. In today’s guest blog post, ketogenic dietitian and keto ambassador Lindsey Thompson, MS, RD, CSP, LD, shares her tips for managing your child’s ketogenic diet over summer break. Thank you, Lindsey!


Summer break can be school-free splendor for kids (and parents!); however, the relaxed schedule can pose some challenges for kids with epilepsy who are on a ketogenic diet.

Many kids and teens with epilepsy rely on the structure and schedule that the school year provides. Furthermore, as a treatment for epilepsy, the ketogenic diet tends to work best when provided on a schedule. As we transition into summer, here are some tips for managing the ketogenic diet in a more spontaneous environment:

Create a schedule for summer

Start with a monthly calendar and identify the different types of days (such as typical, weekend and vacation days). Then create templates for times meals and snacks will be offered depending on the day. The schedule you create can be similar or different to typical school days depending on what is best for your child. Include all of your children in the schedule so that everyone is expected to follow it. Visually display the schedule and use sticker charts if needed for motivation.

Plan ahead

Pick a day or time to prepare ketogenic meals and snacks for the days or weeks ahead. Many of you already do this during the school year, and there is no need to discontinue this for summer. You’ll also want to plan for extra snacks given that your schedule may be more variable in the summer with sports games, visits to the zoo or other family outings. Planning ahead will help you avoid a “keto emergency” i.e., your child is starving and you don’t have a meal or snack weighed out and ready-to-go.

If you’re taking a vacation, you’ll also want to do plenty of planning related to the travel itself (you may need letters from your physician describing your child’s diet for airplane travel, etc), acquiring ketogenic-friendly food in your vacation destination (you may need to call the local grocery stores or the hotel itself) and having adequate accommodations (such as a refrigerator and microwave in your room).

Drink plenty of fluids!

Fluid is important for children on ketogenic diets in order to avoid many of the possible side effects of the diet. Your child will generally need more water in the summer to stay hydrated. Ask your dietitian how much fluid your child needs if you are not sure.

Have your child/teen involved with the preparation of his or her diet

Since your child will likely have more time on his or her hands, there will be a great opportunity for him and her to be involved in meal preparation. You can make an activity out of it by having your child make shopping lists, prep or weigh foods, cut fruits or vegetables (if age appropriate) and assemble meals. A benefit here is that children and teens who are involved in meal preparation are more likely to eat and enjoy what is prepared. Additionally with more active involvement, your child may take more ownership of his or her diet …and this may roll over into the school year as well!

Have fun! Use the extra time to get creative with new recipe ideas.

Here are some suggestions for fun summer treats:

Ketocal Blueberry Smoothie:

Ketocal Creamy Gelatin Treat

Ketocal Cheese and Tomato Pizza

Ketocal Ice Cream

I hope these tips will help ease you and your child on the ketogenic diet into a safe and fun summer!

-Lindsey


Check out Lindsey’s other guest blog post, “Tips for Families Getting Ready to Start the Ketogenic Diet”

A Dietitians Tips for Celebrating Passover on the Ketogenic Diet

Zahava Turner, RD CSP LDN

Zahava Turner, RD, CSP, LDN

We are happy to share today’s guest blog post written by ketogenic dietitian and keto ambassador Zahava Turner, RD, CSP, LDN, who shares her tips for families celebrating Passover with a child on the ketogenic diet. Thanks, Zahava!


 

Passover is a Jewish holiday celebrated in the springtime commemorating the Israelites being freed from slavery from Ancient Egyptians. For those of you not familiar with it, the story goes that God sent ten plagues to the Egyptians to free the Israelites. The final plague killed all of the Egyptian firstborn sons but spared the people of Israel, “passing over” their homes—hence the name of the holiday. Pharaoh’s resistance was finally broken, and he chased his former slaves out of the land. The Israelites left in such a hurry, that they did not have time to let the bread that they baked rise. Therefore on Passover the custom is to only eat unleavened bread called Matzah. On the first night of Passover families get together and relay the story of how the Israelites went from slavery to freedom. The meal is called the “Seder” which is a ritual feast telling the story.

Any holiday and occasion can be difficult to follow while on a special diet, especially one that revolves around food. However, of all the holidays, Passover might be the easiest to follow while on the ketogenic diet because we don’t eat any leavened bread. Many foods or drinks that contains even a trace of wheat, barley, rye, oats, spelt or their derivatives, and which wasn’t guarded from leavening, are excluded during Passover. This includes carb-heavy foods like bread, cake, cookies, cereal, pasta and most alcoholic beverages.

For children on the ketogenic diet, a small piece of matzah can be calculated into the meal consisting of chicken or meat and vegetables, which will be very similar to what the rest of the family eats. Of course, the quantities will need to be calculated to work with your child’s diet plan and additional fat will likely be required to meet your ketogenic ratio. If needed, ask your child’s dietitian for help ahead of time so that you don’t have to worry about calculating the recipe on the day of the feast. Almond flour or any nut flour can be used to create dessert recipes, similar to recipes already calculated for the ketogenic diet. Again, ask your dietitian for help if there is a specific dessert recipe that you want to make “keto-friendly”.

With a little extra planning and help from your dietitian, any person following the ketogenic diet should have no trouble joining the rest of the family in enjoying all of the Passover festivities.

-Zahava

For more tips on celebrating Passover on the ketogenic diet, see our previous post “Tips and Recipe Ideas for Celebrating Easter or Passover on the Ketogenic Diet”.

A Dietitian’s Tips for Celebrating Easter on the Ketogenic Diet

Lindsey Thompson, MS, RD, CSP, LD

We are pleased to welcome back Lindsey Thompson, MS, RD, CSP, LD.  Lindsey is a ketogenic dietitian and Keto Ambassador from Kansas City. In today’s guest blog post, Lindsey shares her tips and recipe ideas for families celebrating Easter with a child on the ketogenic diet. Thank you for sharing your wisdom with us, Lindsey!

In case you missed her previous guest blog post this month, be sure to check out Lindsey’s tips for families preparing to start the ketogenic diet.


One of the challenges for children on specialized diets is that food is often the focal point of holidays. Easter is a holiday that many families celebrate together and is no exception. If you have a family member on the ketogenic diet, including them in your family meal is imperative, but will require some extra planning.

Easter Meals

On Easter many families feature meals with ham or lamb, pies, breads and dishes with eggs. Consider incorporating the type of meat you are serving into a ketogenic meal for your child, such as ham or lamb with a side of fruit or vegetable and cream or other fats. In addition, here are a few keto-friendly dishes you might consider for your family member’s Easter meal:

KetoCal Cheese and Ham Tart

KetoCal Cheesy Tomato Tart

KetoCal Apple Crumble with Whipped Cream

Ketogenic Deviled Eggs:

Use the following ingredients to put into your child’s ketogenic diet planner to calculate his or her recipe:

  • Egg white- cooked
  • Egg yolk- cooked
  • Mayonnaise
  • Butter- softened
  • Small amounts of mustard, Worcestershire sauce and hot sauce (if your family member likes spicy foods)
  • Salt, pepper and paprika to taste

Instructions:

  1. Hard boil eggs. Slice eggs in half and remove yolks.
  2. Place the cooked egg yolks in a bowl & mash them up with a fork.
  3. Stir in the mayonnaise, mustard, Worcestershire sauce, hot sauce. Sprinkle with salt and pepper.
  4. Scoop the filling into the halved egg whites.
  5. Sprinkle with paprika.

Easter Egg Hunts

In addition to family feasts, many families will attend or have Easter egg hunts for the Easter holiday. Children often hunt and discover plastic eggs filled with treats or goodies. Here are some tips to help include your family member on the ketogenic diet in your family’s Easter Egg Hunt:

Easter is a special holiday for families. With a little extra planning, your child on the ketogenic diet can enjoy and feel included as a part of your family’s Easter traditions.

Happy Easter to all!

-Lindsey

 

For more tips on celebrating Easter while on the ketogenic diet, read Tips and Recipe Ideas for Celebrating Easter or Passover on the Ketogenic Diet.

Tips for Families Getting Ready to Start the Ketogenic Diet

Lindsey Thompson, MS, RD, CSP, LD

We are pleased to share today’s guest blog post written by ketogenic dietitian and keto ambassador Lindsey Thompson, MS, RD, CSP, LD. Thanks for sharing your tips for families preparing to start the ketogenic diet, Lindsey!


The ketogenic diet is an option for managing intractable epilepsy, and it often provides a liberating alternative for families struggling with heavy medication loads, side effects and persistent seizures. I have seen hundreds of families benefit from the diet in incredible ways both in terms of seizure control and quality of life. Nonetheless, starting the ketogenic diet can be a challenging transition for families for many reasons. Some of the challenges relate to things other than the actual food being provided, such as mealtime structure or schedule, child behaviors around mealtime or medication/supplement administration. The ketogenic diet is initiated during a several day inpatient stay (or possibly a series of outpatient visits) and many of these challenges cannot be worked through in this short period of time.

In my experience having worked with the ketogenic diet for a number of years, there are a lot of areas families can be working on before they “formally” start the diet that can make the transition onto the ketogenic diet a lot easier.  Families appreciate working on these at home beforehand and come to the diet initiation much more prepared with what will be expected.

If your provider has started talking to you about the ketogenic diet or you in the process of getting scheduled to initiate, here are some tips to get your family ready:

Focus on Mealtime Structure

Once your child is on the ketogenic diet, he or she will be expected to consume all of the foods prepared for him/her at a scheduled meal or snack in order to consume his or her prescribed “ratio” of the diet. If your child is currently a “grazer” or very picky eater, this will be a difficult part of the transition. It will help to have put some structure in place before starting the ketogenic diet. Here are a few tips to implement this mealtime structure now:

  • Create a schedule of meals and snacks for your child.
  • Sit together at the table as a family for meals and snacks. Avoid allowing your child to eat on the couch, in front of a TV or “on-the-go”.
  • Avoid food battles. Provide your child with a plate of food and give him or her 20-30 minutes to finish what they would like to eat from the foods you have provided. After 20-30 minutes, remove the plate of food and end the meal/snack time.
  • Avoid offering alternatives to foods that are provided. If your child is very picky, have at least one “preferred” food available with the meal or snack, but avoid being a “short-order cook” for your child. If your child has not eaten a lot of the meal/snack at the end of the meal/snack, remind them that another meal or snack will be available at the next scheduled time. This will help your child to learn that they should eat what is available. When alternatives are provided, your child sees this as a reward for not eating the foods that have been provided and will make the picky behaviors worse.
  • Offer water between meals and snacks. Avoid offering drinks with calories such as juice or milk between meals or snacks, as these can make your child just full enough to not be interested in the foods offered for their next meal/snack.

Encourage Fluid Intake

Fluids are an extremely important part of the ketogenic diet. Consumption of adequate fluid helps protect against the possible side effects of the diet such as constipation, metabolic acidosis and kidney stones. I have found that children who consume adequate fluid have a much easier transition onto the ketogenic diet and do not suffer as many side effects of the diet later.

  • Ask your dietitian or pediatrician how much fluid your child needs each day (will be based on your child’s weight). Most of the time, our patients and families are very surprised by the amount of fluid their child needs each day and their child is getting less than what is expected.
  • Offer water frequently, and recognize that your child may need to be prompted to drink more regularly.
  • Get your child a special cup or bottle that he or she will enjoy drinking from.
  • Discontinue sugary drinks such as juice and soda as these will not be an option on the ketogenic diet.
  • If your child is struggling with water intake, introduce sugar free beverages (such as sugar free powders or drops) that will also be an option when your child is on the ketogenic diet. Dilute these with water as much as possible because they do contain small amounts of carbohydrate.

Start Brainstorming Ideas about Medication Administration

If your child is young, it is likely that his or her medicines or vitamins are currently in a liquid, chewable or gummy formulation. At the start of the ketogenic diet, these formulations will be changed to tablet or capsule forms because the liquids, chewables and gummies have too many carbohydrates (sugars) for someone on a ketogenic diet. For children who are not able to swallow tablets or capsules, their medicines must be crushed and administered. These are not very palatable and can be another challenge we would rather work through before the diet initiation.

  • If your child seems ready to learn to swallow pills, now is the time! Before the diet start, you can practice with mini candies or other tasty treats which will not be an option after diet initiation.
  • If possible, contact your epilepsy provider and have them change your child’s liquid medications to tablets/capsules so you are able to start practicing how your child will be able to consume these at home.
  • Test different foods your child will tolerate the medicine being mixed into such as yogurt, applesauce or peanut butter. Once on the ketogenic diet, your dietitian can create “medication snacks” that would include the above foods mixed with a certain amount fat (such as applesauce and oil, yogurt and sour cream or peanut butter and butter).
  • You can also try mixing the medicine into a small amount of a sugar free beverage that would be given via syringe.

Introduce Various Fats into your Child’s Diet

Once your child is on the ketogenic diet, high fat foods will comprise about 70-90% of his or her calories. It can be overwhelming for a child to be trying new foods for the first time when they are also in the hospital starting the ketogenic diet. If your child is not currently exposed to a variety of fats, give them a try now, so that you can let your dietitian know the fats your child prefers at diet start.

  • Heavy whipping cream: most children on the ketogenic diet drink heavy cream instead of milk. To get started, offer a small amount (1 oz) diluted equally with water and a drop of liquid Stevia added for sweetness. You can also mix your child’s milk with a bit of cream to start the transition.
  • Butter: melt over vegetables, meats or fruits
  • Sour Cream: offer as a dipping sauce with a pinch of dried herbs or mix into yogurt
  • Mayonnaise: make cold egg, chicken or tuna salads or use as a dipping sauce
  • Peanut butter: mix with butter and offer on fruits or vegetables
  • Vegetable oil (olive, safflower, grapeseed, or whatever oil is used in your home): can be used to cook with, mixed into any sauce (spaghetti sauce, barbeque sauce, ketchup) or atop meats, fruits and vegetables

The ketogenic diet can be a helpful and rewarding option for families struggling with seizures or other neurological disorders. Being prepared for the transition can make the diet initiation much more manageable, successful and enjoyable! I hope the above tips will be helpful in getting you ready to start. Good luck!

-Lindsey

How to Make Valentine’s Day Extra Sweet on the Ketogenic Diet

We are excited to share today’s guest blog post by ketogenic dietitian and Keto Ambassador Stacey Bessone, RDN, LDN. Thanks for these helpful tips, Stacey!


Being on any diet can be a little tricky on Valentine’s Day.  For some it may be keeping on track for a new year’s resolution.  For people on the ketogenic diet it can be extra complicated.  Candy hearts and boxes of chocolates are everywhere.  Here are a few ideas to make Valentine’s Day extra sweet for your little one.

  1. Nonfood items are always a thoughtful token. Decorating homemade valentines with colored paper and lace are wonderful little ways to say I love you.  They also keep, so you can hang them up and enjoy them for days to come.
  1. Keto friendly treats. Make your own little frosting candies. Prepare a keto frosting, such as this chocolate frosting recipe, then spoon into heart-shaped silicon molds and refrigerate to set.
  1. The same heart-shaped silicon molds can be used to make sugar free gelatin hearts or heart-shaped ice cubes (water and food coloring).
  1. A fancy dinner can be as simple as steak with cream sauce and a bit of veggie with a KetoCal® crème brule for dessert.
  1. Doing an activity together such as a movie or a bike ride can be healthy and fun without any mention of eating.
  1. Dress up is always fun too. You can dress up and create a fancy restaurant-type atmosphere at home with a waiter.  You can put flowers on the table and use cloth napkins and low lighting.  Kids think it is a treat and usually love to be the servers!

These are just a few tips to get you thinking about Valentine’s Day the keto way.  There are plenty of fun things to do and make to make someone feel special- even if they are on the ketogenic diet.

For more information, see “Tips and Recipes for Making Valentine’s Day Fun for Your Keto Kid”.

A Dietitian’s Tips for Tasty Ways to Incorporate Fat into the Diet

We are excited to share today’s guest blog post by ketogenic dietitian and Keto Ambassador, Vanessa Aldaz, MPH, RD, CDE. Thanks for these awesome tips, Vanessa!


BleVanessa Aldaznding in the fats- Can we make them taste better?

By Vanessa Aldaz, MPH RD CDE

I often hear the same complaint from new keto parents: “It’s just too much fat– my child has a hard time eating it all”. Or “It just doesn’t taste that good”.  Even parents that have been doing the diet for a longer time will come back eventually and ask “How can we continue giving the fats?”

Whatever happened to the old saying ”Fat makes everything taste better”?  Yes, I imagine it especially does when it is also covered in sugar and simple carbs! But not so much in this magical diet known as the ketogenic diet when sugar is not allowed and loads of butter, oil, mayo, lard or other fatty goodness are needed to keep our children away from those vicious seizures.

So how can we keep the magic happening each time we slather and pound the fat component of the diet on our child’s plate? Can we make it go down easier? Well, perhaps! If you haven’t tried some of these tricks and tips, you might find some of these useful. Remember to mix it up and continue to use creativity. Here are a few tasty ways to blend in the fats on a high fat diet! Hmm, maybe fat does make everything taste better…..

Note- Be sure to tailor these ideas to work with your prescribed ketogenic ratio or diet type. Consult with your dietitian for help.

  1. Mix in the MCT oil. If using MCT oil in your diet- mix it into mayonnaise or a dressing.
  2. Make herbed butter! Fresh or dried herbs work just fine– Use a pinch or weigh out and calculate into your ratio if using more. Add herbs like parsley, oregano, tarragon, lavender, cilantro, rosemary, thyme or herbs de Provence to butter, ghee or even coconut oil. Make it into a log, freeze or keep refrigerated and use as needed for fats that add flavor, freshness and color.
  3. Spice it up! Same as above but add spices. Paprika, cayenne and even a pinch of curry are enough to give your fats a kick!
  4. Make a dressing! Mix oil, heavy cream, salt and pepper, and an acidic component whether it be lime or lemon juice or vinegar. Try to use 3 parts fat to 1 part acid component. Don’t forget to calculate the vinegar or citric juices as these may add extra carbs.
  5. Infused oils! Yes, infused oils have very low or even no carbs but provide plenty of aroma and flavor. Take 1 cup of any oil (except flaxseed)- such as olive, coconut oil, canola or corn oil and add a flavoring component, such as 2 cloves of garlic, or 1 tsp red pepper flakes, dried rosemary, oregano, thyme, or basil. You could also add 1-2 star of anise, some cloves, a piece of fresh dried turmeric (which is also a great antioxidant), or ginger root. Add the oil blend to a small sauce pan. Bring to a low simmer then turn off heat and let stand until cool for 30 minutes. Once cooled, use a sieve and keep only the oil. Drizzle on foods like fish, vegetables, or meats! YUMM!
  6. Infused cream! To 1 cup of heavy cream- add 1 TBSP of one of the following: dried herbs or spices (such as basil, garlic, curry, peppermint or mint leaves), tea leaves like green tea, cinnamon sticks, orange or lemon peel, macha green tea, or a chai tea bag. Bring the mixture to a low simmer for 10-15 minutes or until cream is infused with enough flavor. Do not boil. Cool to room temperature or refrigerate. Depending upon whether you made a sweet or savory cream infusion, you can add salt or your choice of sugar substitute. The infused cream can be made into a sauce or dessert topping or as a twist on a fat bomb!
  7. Create a mousse using heavy cream whipped and blended with applesauce or pureed fruit.
  8. Make a savory mousse by mixing an infused oil, heavy cream and pureed chicken, tuna or salmon. Use to dip with keto crackers or veggies.
  9. Keto ice cubes! Mix MCT oil and heavy cream together (emulsified forms of the MCT oil work best), pour into fun shaped ice cube trays, and freeze! These work great in a diet orange soda or diet root beer as a “keto float”!

Christmas on the Ketogenic Diet: Blog Roundup

Christmas

Christmas is just over a week away! As you know, when you have a child on the ketogenic diet, party and meal planning takes a little extra time. To help you prepare, we’ve compiled a list of blog posts with tips and recipe ideas for celebrating the holidays with a child on the ketogenic diet.

Do you know of any other useful blog posts or articles about celebrating the holidays on the ketogenic diet? Please let us know so that we can add it to the list! Also, please share your own tips for other parents in the comment section below.

We hope that your family has a very merry Christmas and happy holiday season!

Tips for Managing Your Child’s Ketogenic Diet over the Holidays (KetoConnect guest blogger)

KetoCal Christmas Recipe Ideas (KetoConnect)

A Keto Mom’s Tips for Managing the Holidays on the Ketogenic Diet (KetoConnect guest blogger)

Winter Holidays on the Ketogenic Diet (Epilepsy Foundation)

Holiday Baking (KetoCook)

Keto Gingerbread House & Gingerbread Men (KetoCook)

Although Hanukkah has already passed for 2015, we also have some tips and recipe ideas for families celebrating Hanukkah on the ketogenic diet in case you missed them.

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Introducing MyKetoPlanner!

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Are you looking for new keto recipe ideas or a platform to contribute your keto recipes to help other families just like you?

We are excited to introduce MyKetoPlanner™: a brand new diet management tool, recipe sharing database, and social network, specifically designed for the Ketogenic Diet Community!

Please note that this program is currently available only in the U.S. For information on availability in your country, please contact your local Nutricia office.

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How Can You Start Using MyKetoPlanner?

Parents of children on the ketogenic diet and adults on the ketogenic diet can register on MyKetoPlanner.com. When registering, you will be prompted to select your health care provider(s) from a list of providers who are registered on the site. Note:

  • If you don’t see your health care provider in the list, you have the option to invite him/her to join.
  • If your keto center has more than one health care provider who will be managing the diet, you can link your account with multiple providers. Simply hold the Control (“Ctrl”) key to select more than one provider.
  • Your account must be linked with a health care provider in order to access the full features of the site.

What Can You Do with MyKetoPlanner?

Create recipes and share them with others in the keto community.

  • Keep your recipes private or share them with the keto community.
  • Include a photo so that others know how to expect the recipe to look.
  • Select the appropriate Category for your recipe (for example, Classical Diet, MAD, LGIT) and select identifying tags (such as 4:1 Ratio, breakfast, dessert, etc.) to make your recipe easy for other users to find.

Search for recipes created and shared by other families and dietitians.

  • Type what you are looking for into the search bar and click “Begin Search” (for example, pizza, pancakes, cookies) or
  • Click on the colored tags to search for recipes that fall under that description. For example, click “breakfast” to see all breakfast recipes, “KetoCal 4:1 Powder” to see all recipes that use KetoCal 4:1 Powder, or “4:1 Ratio” to see all recipes in a 4:1 ketogenic ratio.search

Save shared recipes to your account where your health care provider can review, modify, and verify them for you.

  • When viewing a shared recipe, scroll to the bottom of the page and click “Add to My Saved Recipes”. Then send your health care provider a message to ask them to review the recipe and make any necessary modifications for you. Once your health care provider has reviewed it, he/she will “Verify” the recipe so that you know it is okay to use. When viewing your list of saved recipes, you can see whether or not a recipe has been verified by your provider.

Provide your feedback on shared recipes by rating them on a scale of 1 to 5 stars.

Connect with your keto health care provider.

  • Send your provider private messages to ask questions, request new recipes, or to ask him/her to verify recipes that you have created or saved from shared recipes.

Where Can You Access MyKetoPlanner?

The website version of MyKetoPlanner is now accessible at www.myketoplanner.com. Soon MyKetoPlanner will be available through a mobile application which will allow you to access your MyKetoPlanner account on-the-go from your tablet or smart phone! Look out for an announcement in the coming weeks.

We hope that you love MyKetoPlanner and that it makes the ketogenic diet a little easier for you. If you have any questions or comments, contact us using the “Contact Us” page on the site or contact Nutrition Services at 1-800-365-7354, Option 2 or at nutrition.services@nutricia.com.

As always, consult with your health care provider before making any diet changes or introducing any new recipes.

A Keto Mom’s Tips for Managing the Holidays on the Ketogenic Diet

Our favorite keto-mom blogger, Dana Haddox-Wright, is back for another guest blog post! In today’s post, Dana shares her tips and recipe ideas for managing the holidays with a child on the ketogenic diet. Thanks for sharing with us, Dana.

Happy Holidays, everyone!


Happy Holidays

The holiday season is approaching quickly and for most families, this means taking in all of the feasts and treats that come with the territory. Food tends to be a focal point of the festivities as families get together to share in traditions either set by the family or by their religious affiliations.

Having a child on the ketogenic diet can be a challenge during the holidays. It is important to include them in our traditions as much as possible, even if their meals are much smaller than everyone else’s. Infusing keto meals with the holiday spirit requires a lot of thought, but it is not impossible. Though I am by no means an expert keto chef, I do have some ideas for making keto-friendly versions of holiday classics. To keep things simple, and I apologize ahead of time for leaving out any other holidays, I will be focusing on Thanksgiving, Chanukah, and Christmas.

THANKSGIVING MEAL:

Cauliflower and turnip make great substitutes for potatoes. Sweet potatoes may be switched to rutabaga. For our daughter, we make three dishes of the traditional Thanksgiving feast: Turkey breast, cauliflower, turnip, or rutabaga mixed with European butter, and a side of 40% cream (put into the keto calculator to fit your child’s caloric count and ratio). These dishes are easy to prepare and the kids will love to “gobble” it up (pun intended).

For more tips and recipes for Thanksgiving, here are some previous KetoConnect posts on the topic:

CHANUKAH FEAST:

I may not be Jewish, but I have wonderful friends who were willing to share some of their Chanukah favorites with me. Sufganiyot are custard or jelly filled doughnuts typically consumed every day of the Chanukah festival. I have created two types of doughnuts, and although they are not filled with anything (but love), they are delicious. One of my recipes uses ground macadamia nuts, egg, canola oil, frozen berries, a touch of vanilla, and liquid stevia to taste. A second is a nut-free recipe. It includes: baking powder, ground cinnamon, Truvia®, vanilla, coconut flour, xantham gum, egg, canola oil, and European butter. Each of the mixtures can be baked in a silicone mold (bundt shaped).

Latkes and brisket are also enjoyed during Chanukah. Though latkes are typically made with potato, one could create a keto-version with shredded or whipped turnip, a dash of onion powder, egg, olive oil with greek yogurt for dipping. In order to make it a full meal (which would make calculating it easier), one might add cooked brisket and a side of cream.

For more ideas, check out some previous Chanukah-related KetoConnect posts:

CHRISTMAS DINNER:

Some families serve turkey, some roast, and others serve ham. In a similar manner to Thanksgiving, consider substitutions. If you serve turkey, create a meal akin to what I suggested above. For roast, you can serve with butter and cooked carrots or rutabaga (with side of cream). You can also make a ham and cauliflower casserole (ham, cooked cauliflower, cheddar cheese, cream, and European style butter cooked in one pan).

For more Christmas recipe ideas, visit:

HOLIDAY SNACKS:

Chanukah gelt is typically a coin-shaped chocolate treat. An easy way to make chocolate is to melt coconut oil with unsweetened baker’s chocolate, add in liquid stevia and little vanilla. For texture, shredded coconut or whole flax seed can be added. You may be able to find coin molds and foil wrappers. The only catch is that the chocolate must be refrigerated until it is to be eaten.

Cookies can be made for any occasion. I like to keep it simple and make keto sugar cookies. Each batch makes 3 small cookies. Simply combine: melted European butter and coconut oil, mixed egg, coconut flour, Truvia®, a dash of vanilla and liquid stevia to taste. You can use different silicone mold shapes and keto-safe food colorings to make them look a little more festive.

I also make a coconut based candy that includes coconut oil, coconut flour, and shredded coconut. Simply melt the coconut oil and mix in other ingredients, then transfer into any mold and leave in refrigerator or freezer until completely set.

Finally, please try to keep your sanity during the holiday season.  Even if your child does not like certain items in the keto-versions of the traditional meals, they will always have their other favorites to fall back on.  If they like sausage, incorporate sausage.  If they like crunchy vegetables, work those in.  Making keto recipes is all about trial and error.  Feel free to test your holiday recipes beforehand, so that you know what needs tweaking.  I always tell people that I feel like a mad scientist in the kitchen, maybe that is because I am actually a little crazy.

In the end, both you and your kids will be happy that no one was left out.

-Dana

For more holiday tips and resources, visit the following KetoConnect articles:


Read more posts from Dana:

 

 

Keto-friendly Thanksgiving Recipes!

Chef Rachel

Chef Rachel

Thanksgiving is right around the corner! For keto parents, it can be difficult to come up with keto-friendly variations of traditional Thanksgiving recipes. Chef Rachel Finn, from Kansas City, KS, has saved you some time! Rachel specializes in creating recipes for individuals on special diets and often works with families of children on the ketogenic diet. Her keto Thanksgiving recipe creations are sure to please your little one’s taste buds! Below are instructions for making these recipes at a 4:1 or 3:1 ratio. We hope that your family has a wonderful Thanksgiving!

Note, the recipes below are intended for individuals on a 4:1 or 3:1 ketogenic ratio. As always, consult with your health care provider to ensure that a recipe is appropriate for your child’s diet. Work with your provider to adjust recipes to meet your specific ratio and calorie requirements.


Recipes for a 4:1 Ratio

Thanksgiving Tart (4:1)

tart

Ingredients:
16 g Butter
20 g KetoCal® 3:1 powder, Nutricia NA
18 g Oil, Olive
10 g Cream Cheese, Philadelphia Brand
8 g Flour, Coconut – Bob’s Red Mill Organic Hi Fiber
11 g Egg (raw, mixed well)
2 g Bouillon, Wylers Instant-Beef/Chick granules
7 g Turkey, dark meat (no skin) – cooked
5 ml Water

Directions:
1. Preheat oven to 325 °F
2. To make the tart crust, place coconut flour and KetoCal into bowl and rub in butter with fingertips. Add a pinch of poultry seasoning, dried rosemary or rubbed sage, if desired.
3. Dissolve bouillon granules in the 5 mL water. Sprinkle bouillon over top tart crust dough and mix until it becomes a stiff, crumbly pastry dough. Save 5 grams of the pastry dough for the tart topping.
4. Line tartlet tin with your crust dough (minus the 5 grams saved for the top), using your fingers to press the pastry into the edges.
5. In a bowl, mix together cream cheese, egg, olive oil, and turkey. Pour the mixture into the crust.
6. Season with salt and pepper, and top with remaining 5 g of crust dough. Add another pinch of dried rosemary on top.
7. Place on oven tray and cook for 10-15 minutes. Allow to cool before removing from tart pan.

Nutrition Information (for entire recipe):
Carbohydrate: 3.87
Calories: 507
Fat: 50.87
Protein: 8.8
Ratio: 4.01:1

Mashed Fauxtatoes (4:1)faux

Ingredients:
76 g Cauliflower, cooked
8 g KetoCal® 4:1 LQ Unflavored – Nutricia
14 g Butter

Directions:
1. In a small saucepan, heat KetoCal 4:1 LQ with butter and cooked cauliflower until warm.
2. Puree mixture in a blender or food processor until smooth.
3. Season with salt and pepper.

Nutrition Information (for entire recipe):
Carbohydrate: 1.44
Calories: 129
Fat: 12.88
Protein: 1.77
Ratio: 4.01:1

Thanksgiving Green Bean Casserole (4:1)gbc

Ingredients:
10 g KetoCal® powder 3:1, Nutricia NA
36 g Cream, 36%
50 g Green Beans – cooked
28 g Butter
46 g Sour Cream – cultured (not low-fat)
10 g Durkee French’s fried onions

Directions:
1. Melt butter; Mix with KetoCal 3:1 powder, sour cream, and cream.
2. Stir in green beans.
3. Pour mixture in a ramekin or a small baking dish. Season with salt & pepper.
4. Top with fried onion (if desired, save some of the onions to place on top after baking for a crunchy texture).
5. Bake in 350 °F for 15 minutes.

Nutrition Information (for entire recipe):
Carbohydrate: 9.77
Calories: 566
Fat: 56.66
Protein: 4.38
Ratio: 4:1


 

Recipes for a 3:1 Ratio

Thanksgiving Tart (3:1)tart

Ingredients:
17 g Butter
20 g KetoCal 3:1 Powder
7 g Oil, Olive
10 g Cream Cheese, Philadelphia Brand
10 g Flour, Coconut – Bob’s Red Mill Organic Hi Fiber
14 g Egg (raw, mixed well)
2 g Bouillon, Wylers Instant-Beef/Chick granules
6 g Turkey, dark meat (no skin) – cooked

Directions:
1. Preheat oven to 325 °F
2. To make the tart crust, place coconut flour and KetoCal into bowl and rub in butter with fingertips. Add a pinch of poultry seasoning, dried rosemary or rubbed sage, if desired.
3. Dissolve bouillon granules in the 5 mL water. Sprinkle bouillon over top tart crust dough and mix until it becomes a stiff, crumbly pastry dough. Save 5 grams of the pastry dough for the tart topping.
4. Line tartlet tin with your crust dough (minus the 5 grams saved for the top), using your fingers to press the pastry into the edges.
5. In a bowl, mix together cream cheese, egg, olive oil, and turkey. Pour the mixture into the crust.
6. Season with salt and pepper, and top with remaining 5 g of crust dough. Add another pinch of dried rosemary on top.
7. Place on oven tray and cook for 10-15 minutes. Allow to cool before removing from tart pan.

Nutrition Information (for entire recipe):

Carbohydrate: 4.32
Calories: 424
Fat: 9.18
Protein: 9.18
Ratio: 3.05:1

Mashed Fauxtatoes (3:1)

Ingredients:faux
107 g Cauliflower, cooked
10 g KetoCal® 4:1 LQ Unflavored
14 g Butter

Directions:
1. In a small saucepan, heat KetoCal 4:1 LQ with butter and cooked cauliflower until warm.
2. Puree mixture in a blender or food processor until smooth.
3. Season with salt and pepper.

Nutrition Information (for entire recipe):
Carbohydrate: 2.01
Calories: 138
Fat: 2.4
Protein: 2.4
Ratio: 3.02:1

Thanksgiving Green Bean Casserole (3:1)gbc

Ingredients:
13 g KetoCal 3:1 Powder
28 g Cream, 36%
54 g Green Beans – cooked
16 g Butter
34 g Sour Cream – cultured (not low-fat)
12 g Durkee French’s fried onions

Directions:
1. Melt butter; Mix with KetoCal 3:1 powder, sour cream, and cream.
2. Stir in green beans.
3. Pour mixture in a ramekin or a small baking dish. Season with salt & pepper.
4. Top with fried onion (if desired, save some of the onions to place on top after baking for a crunchy texture).
5. Bake in 350 °F for 15 minutes.

Nutrition Information (for entire recipe):
Carbohydrate: 10.44
Calories: 462
Fat: 4.41
Protein: 4.41
Ratio: 3.01:1

Keto-friendly Finger Foods for Kids

It can be challenging to find keto-friendly finger foods for your little one, so in today’s post, we’re sharing some of our favorite bite-sized recipes.

Savory Cheese Crackers (3:1 ratio or MAD)

Almond Coconut Cookies (3:1 ratio or 4:1 ratio)

You can also make many recipes into finger foods by cooking them in bite-sized portions.

For example, you can make Bite-sized Pancakes by preparing our KetoCal Pancake Recipe (3:1 ratio, 4:1 ratio or MAD) as you normally would, but pouring into tiny pancakes when cooking.  You can also find mini pancake makers to make things easier- Here are some options. Serve pancakes alone or with carb-free pancake syrup for dipping!

For a savory snack, you can apply the same concept to make Cheesy Tomato Bites by preparing our KetoCal Cheesy Tomato Wrap Recipe (4:1 ratio, 3:1 ratio, or MAD) as you normally would, but shaping into bite-size circles to cook (you could try the mini pancake maker here too!). Serve alone or with a savory dipping sauce!

What are your child’s favorite finger foods? Have you been able to come up with keto variations for them? If you could find a keto-version of any kid’s food, what would it be? (Maybe our keto chef can help!)

Back to School on the Ketogenic Diet: Blog Roundup

back to school busWe don’t have to tell you that managing your child’s ketogenic diet can be tricky. As the kids head back to school, you may find that it gets a little more complicated. We’ve compiled a list of blog posts to help support you. From tips for informing the school about the diet to ideas for packing a keto-friendly lunchbox, we hope that this blog collection will help make your keto kid’s transition back to school as smooth as possible.

 

 

Back to School: Tips for Packing Keto Lunches

We are excited to welcome back Dana Haddox-Wright, keto mom and guest blogger extraordinaire! Dana lives in Connecticut with her husband and two adorable daughters. Her 6-year-old daughter has Dravet Syndrome and has been on the ketogenic diet for over two years. As you prepare for your children to head back to school, we hope you will find Dana’s tips for packing a keto lunch box useful and timely. Be sure to check out Dana’s previous blog posts: “Tips for Making the Ketogenic Diet Funand “Ten Things That Only Keto Parents Would Understand“.

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Preparing food for children can be a daunting task, particularly when they are on the ketogenic diet. Kids on the diet are not always predictable. What they absolutely love one day, they may not want to touch the next. And the hours spent in the kitchen might drive any parent crazy (or to drinking, whichever comes first). The struggle is real for us. Just when we narrow down several “favorites” the kids love, we are then confronted with another challenge….SCHOOL.

Work Around School Policies

School policies on food vary by district, but most do not allow tree nut products. No macadamia nut, almond, or peanut-based foods are allowed much of the time. This significantly limits our fat options. If your child’s school cafeteria does allow nuts at designated tables, then you are ok. Other parents will need to get creative. Coconut is a useful substitute, but you may need to convince your school administrators that it is ok. When my daughter’s school told me that I would not be able to send in coconut based foods, I was confused. I contacted the keto dietician, and she told me that though coconuts grow on trees they are technically not “tree nuts,” and it is very rare for individuals with tree nut allergies to have a reaction to them. She wrote the school a letter that was shared with the school nurses, and problem solved. Once you know what you CANNOT send to school, you can experiment with alternate recipes. Try using coconut flour or flaxmeal in exchange for nut flours.

Keep It Simple

Another helpful hint is to keep things simple. You can make delicious meals that do not require a lot of components or ingredients. A few of my daughter’s favorites that are not messy or complex include the bake and freeze pizzas (using flaxmeal instead of macadamia nuts), cheesecake, hotdogs with “awesome sauce” (low sugar ketchup and mayonnaise with cut up cooked hot dog mixed in) and a side of cream (made into whipped cream). Last, but not least, a nice water bottle with a keto-safe flavoring and some liquid stevia is a great alternative to the juice boxes that kids often have.

Remember the Social Aspect

Lunch period is time that kids socialize. Something to remember is that kids pay attention to what their peers pack in their lunches. Knowing this, I try to make my daughter’s lunches tasty and fun while meeting all the keto requirements. You may also want use the school lunch calendar as a guide. Attempt to mimic what the school cafeteria will be serving.

Listen to Your Child

Take time to listen to your children. If they say they want carrots or apple, attempt to work them into new recipes (assuming you have time in your busy schedule). In the end, it is all about making things easier while keeping our little ones safe.

Put On Your Advertising Hat

As the head keto-chef in my house, I try to prepare things that even I would want to eat. Think like an advertiser. Market to your child, and everyone wins. Find keto-friendly food coloring for cookies or cakes, or even for their water to add to visual appeal. On a diet that is so restrictive, there are ways to turn limits into opportunities.

Know That It’s All Worth It

Know that the time you spend being a keto mad scientist, is time well spent. Your kids, whether they can verbalize it or not, will appreciate your effort. They will know that you put your love for them into everything including their school meals.

-Dana

Tips for Managing Non-Neuro Doctor’s Appointments on the Ketogenic Diet

We are so pleased to share a special guest blog post today by Robyn Blackford, RDN, LDN, who is a ketogenic dietitian at the Ann & Robert H. Lurie Children’s Hospital of Chicago. She is also a Keto Ambassador. Robyn often receives questions from her patients’ parents about how to educate non-neuro medical professionals about the requirements of their child’s ketogenic diet. She compiled a list of her tips to share with all of you. Thank you so much for sharing your insights and knowledge with us, Robyn!

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If your child is on dietary management for intractable epilepsy you will soon find that you are the expert. It is safe to assume that most people are unfamiliar with the ketogenic diet. Sadly, this would also include many healthcare professionals. It is true that more and more people are hearing about the diet and understanding it’s general rules, but oftentimes I hear from families that they are the ones that are teaching other healthcare teams (besides their neurologist) the intricate details of the diet.

Have you gone to your local pediatrician, dentist, or maybe even another healthcare team within the same hospital that manages your child’s diet just to find out that nobody else knows what to do in regards to the diet? Even the simplest illness such as a cold becomes a huge undertaking by the pediatrician. What used to be a simple dentist visit now takes much more planning than it did before the diet. Here are a few things to consider when your child has an appointment with another health professional outside of the neurologist’s office.

Share info ahead of time. Leading up to the planned admission date for your child’s ketogenic diet initiation, you can prepare your other doctors for this major change in your child’s life. Share diet information that you receive from your neurologist and dietitian with your pediatrician and any other doctors or medical teams that they see. The authors of Keto Cookbook offer a sample letter that your neurologist can use as a template. Also, have the doctor’s office add “dextrose” as an allergy in your child’s electronic chart. This will help to flag medications that are prescribed to your child if it is in liquid form and not allowed on the ketogenic diet. Doctors’ offices usually review allergies with you at the beginning of every visit. This is a good time to reiterate that you child is following a special diet.

Your child doesn’t have to try new foods. When you’re using the ketogenic diet for management of epilepsy, you get a free pass to use the same meals and snacks over and over again. Reminding the pediatrician and therapists of these things will help them to remember the specifics of the diet. They are used to encouraging their patients to try new foods, so give them a little leeway if you have to repeat yourself to them.

Keep repeating yourself. I’m sorry that you’ll have to do this, but it’s true. People, even professionals looking at your child’s medical chart, have a short memory and may forget about the special conditions and extreme restrictiveness of the diet. People may not “get it” or take the restrictions seriously. You’re repetitiveness can only be helpful to avoid errors.

Provide exact names or samples of products. If your keto kid needs a specific toothpaste at the dentist office or an exact consistency of liquids with the speech therapist, then help them out by offering a sample of the product your child needs or a list of acceptable options for use in that office. The more you “spoon feed” that professional information about what your child needs, the more likely you will have a successful visit that encourages compliance on the diet. It makes for a more pleasant experience in that office and you can focus on why you are there instead of focusing on the diet for so long.

Be gentle and kind. You’ve heard the old adage: You can catch more bees with honey than you can with vinegar. Repeating yourself, correcting people and shielding your children from unwanted foods is exhausting. I understand. But, I also know that health professionals (who love taking care of your child!) will appreciate you and listen better when you handle them with the same kid-gloves as your keto kid. Showing appreciation to your health professionals will go a long way. They might just remember the diet guidelines easier when mutual respect is shared.

Send them to the websites. There are many great resources for parents and professionals for the ketogenic diet. Instead of spinning your wheels and trying to explain the diet (again and again), simply send them to these websites. Here are a few that I like and trust:

In addition to the neurology team, keto kids may be cared for by pediatricians, emergency room professionals, dentists, community hospitals, surgeons, gastroenterologists, nurses, therapists and the list goes on. We hope this blog post has helped you to help your other medical teams take the best care of your child while on the ketogenic diet.

Again, as a keto parent, you really are the expert! Do you have any experiences or advice to share with others?  Please share in the comments below.

-Robyn

Fight Flavor Fatigue- Spice Up Your KetoCal!

Moms, dads and other caregivers know that kids often change their minds, especially when it comes to foods and flavors. We all have our favorites but a little variety can help to prevent flavor fatigue, which can be a challenge for maintaining a special diet. Did you know that you can easily switch up the flavor of your child’s KetoCal by adding sugar-free, carb-free flavorings?

There are several brands* to choose from, including DaVinci Gourmet®’s Sugar-free Syrups (which use sucralose) or SweetLeaf®’s Sweet Drops™ (which use Stevia®).   From Double Chocolate to Strawberry to Cookie Dough, there are a variety of flavors to keep meal time fun each day of the week. The flavorings can be added to KetoCal 4:1 LQ Unflavored or Vanilla (which blends nicely with other flavors).

If you have not used carb-free flavorings before, be sure to check with your health care professional to ensure that they are appropriate for your child’s diet.

How do you spice up your little one’s KetoCal?

*Please note that Nutricia is not affiliated with the flavoring brands listed above. These brand names are provided for information purposes only.

Cold Keto Recipes for Hot Summer Days

Cold recipes for hot daysThis Sunday, June 21st, is the official first day of summer. This confirms what most of us are already feeling: It’s hot outside and only getting hotter! Cool off with some of our favorite cold KetoCal recipes.

Ice Cream

Ice Cream

Chocolate Ice Cream:

Vanilla Ice Cream:

Strawberry Ice Cream:

Smoothies

Smoothies

Blueberry Smoothie:

Chocolate Smoothie:

Strawberry Smoothie:

Raspberry Smoothie:

Summer Camp, Epilepsy, and the Ketogenic Diet

summer campIt’s hard to believe that summer vacation is almost here! Right about now, many of you are looking for summer activities, such as camps, to keep your little one busy over the break. Summer camp is an invaluable childhood experience full of fun, friendships and personal growth. But when your child has epilepsy, finding a suitable summer camp can be a bit more challenging.  If your child is on a ketogenic diet, it can be even more complicated. Fortunately, there are camps that can accommodate special circumstances and there are even camps specifically for children with epilepsy. With some extra research and planning, you can likely find a camp that will work for your little one. If you are eager for your child to experience summer camp but are unsure how to make it happen, today’s post will provide you with some resources to guide you.

Choosing a Camp:

The first thing to consider is the type of camp that will work best for your child. In some cases, a standard camp (that is, not specifically for children with epilepsy) may work fine as long as the staff is made aware and prepared in case of a seizure.

In other cases, a camp specifically for children with epilepsy, with medical personnel on site, is the best option. Some parents prefer this option because it allows their child to make friends with other children with epilepsy and just be “one of the gang”.  You and your child’s health care provider are the best judge of which option is most appropriate for your family.

If you are searching for an epilepsy camp near you, the Epilepsy Foundation provides a great list of camps in each state.  You can also contact your Epilepsy Foundation affiliate to learn about scholarship options. One epilepsy camp that is located near us and that we love is Camp Great Rocks. This camp is run under the medical management of the Children’s National Medical Center Neurology Team. If you live close to the DC Metro area, be sure to check it out–It’s a very special place!

Once you choose the type of camp, you should also consider whether you are interested in a day camp, where your child attends during the day but comes home in the evenings, or overnight camp, where your child sleeps over at camp. There are also overnight camps for both children and their caregivers. Again, you are the best judge as to which option is most appropriate for your child.

Taking the Ketogenic Diet to Camp:

These days, many camps are able to accommodate children with special diets, such as children with food allergies, so they are likely able to accommodate a ketogenic diet, so long as you discuss it ahead of time and provide the food and specific instructions. If your child is attending an epilepsy camp, they may already be familiar with the ketogenic diet, but you should still be sure to discuss it with the camp ahead of time to ensure they can accommodate the diet during camp. In most cases, you will need to provide the food and special instructions for the staff.Note- KetoCal LQ works great as a substitute for a meal while at summer camp since it is easily transportable and requires no weighing or mixing!

For a first-hand account, check out this keto mom’s article about her child’s experience at camp on the ketogenic diet: “Camping With Special Needs And A Ketogenic Diet

Preparing for Camp:

Once you’ve selected a camp for your child, you can take steps to prepare the staff and help keep your child safe while having a great time. The Epilepsy Foundation provides some awesome tips and resources, listed below:

Hopefully this post has provided you with some tips and resources to help guide your camp selection process but, as you know, the best advice comes from other parents. Have any of your children attended summer camp on the ketogenic diet? What advice or guidance would you offer other parents who are considering it?

-Mallory

Ten Things That Only Keto Parents Would Understand

We are excited to welcome back Dana Haddox-Wright, keto mom and guest blogger extraordinaire! Dana lives in Connecticut with her husband and two adorable daughters. Her 5-year-old daughter has Dravet Syndrome and has been on the ketogenic diet for nearly two years. Many of you will relate to Dana’s list of “Ten Things that Only Keto-Parents Would Understand” and hopefully it will put a smile on your faces! In case you missed it, be sure to check out Dana’s previous post on tips for making the ketogenic diet fun for your child.


Top10parents

  1. If “measuring to the tenth of a gram” was an Olympic sport, we would fill the medal podium. One of the best things about nailing a perfect measurement of heavy cream, egg, oil, or mayonnaise is being able to share the accomplishment with another keto-parent knowing that s/he will fully understand what a big deal it is, and will probably give you a well- deserved high five (or virtual high five in my case).
  2. It’s all about that spatula. Admit it. We have our favorites. If we see a good deal on “the one,” we buy the entire lot. Our motto is “no morsel left behind,” and we should expect nothing less from our utensils.
  3. Size DOES matter to us. Yes, when it comes to our keto-related staples, no “standard” sizes will do. We ALWAYS buy the industrial sized items found at our favorite wholesale store, and will rejoice in the idea of not having to shop for them again for weeks. Whether it is gallon sized bins of mayonnaise, triple stacked flat of eggs, or double rolls of parchment paper, we do what we have to do in order to ensure we never run out of what we use most. And lugging them from the car into the house does qualify as a workout. No flabby arms here.
  4. We have a system for organizing our recipes that only we understand. And I am certain that some of us even have stacks of papers with hand-written recipes which may or may not be stained with oil or butter. The funny thing is that no matter how unorganized my recipes might be, when I need to find something I know exactly where to find it in my mound of notes.
  5. We have highly developed ninja-like reflexes when it comes to “non keto-friendly” food getting into the hands (or mouths) of our children. We can snatch any carb-filled goody away from our kids within milliseconds if they are either offered something or if they find it on their own. We are also not opposed to digging food out of their mouths.
  6. We are forced to be short-order cooks. Making different meals for different people becomes pretty much a daily occurrence. We learn to cook quickly and efficiently for our entire family. And the mess of dishes left is reason enough to hire a bus boy.
  7. We often have a space designated for all of our keto paraphernalia. It usually will include lots of dry food items and small containers with color coded labels (and those beloved spatulas). Let us not forget the variety of cups and bottles, even straws we also have around in order to ensure we get enough water into our kiddos.
  8. We have more silicone items in our kitchen than in a plastic surgeon’s office, and probably spend nearly as much money as we would having a procedure done. Candy molds, cupcake liners, and baking pans (oh my!). If it does not stick, we must get it.
  9. We get every last bit of food into our kids at any cost. We see any minute speck of food left in a bowl, on a plate, or in a glass. We do not miss a thing, and I should add that we could probably work in a forensics lab.
  10. It is not uncommon to have a love/hate relationship with the keto diet. We really want to hate it because it takes up every last minute of our lives, but we love it for all of the benefits that following it has for the children. I hope that I speak for a lot of parents when I say that I would rather spend 30 minutes preparing a meal for my daughter, than I would witnessing her seize for another second.

-Dana

Tips and Recipe Ideas for Celebrating Easter or Passover on the Ketogenic Diet

Like most holidays, Easter and Passover have food-related traditions that can make it slightly more complicated to manage your child’s ketogenic diet. For today’s post, we’ve compiled some tips and recipe ideas to help you manage your little one’s ketogenic diet over the upcoming spring holidays.

Easter:

Instead of filling plastic eggs and Easter baskets with traditional candy, you can fill them with non-food treats (like stickers, jewelry, toy cars, etc.) or homemade keto treats.  The Charlie Foundation has some awesome recipes for keto chocolate candy and keto coconut candy.

Our basic keto cookie recipe (available in a 3:1 or 4:1 ratio), which makes the keto-equivalent of basic sugar cookies, is a great staple recipe for holidays. You can make them festive using Easter-themed cookie cutters and carb-free food coloring to color the cookie dough or the Truvia®* that you sprinkle on top (keto sprinkles!).

Jell-O® eggs, made using egg-shaped molds (such as this one), are popular Easter treats for kids. You can make a keto version using our KetoCal gelatin recipe.

If your family typically serves ham on Easter, you can make your little one a delicious Ham & Cheese Tart (one of my personal favorite keto recipes).

If carrot cake is a tradition in your home, KetoCook has a great recipe for keto carrot cake.

For more ideas, check out the Easter recipe ideas that Matthew’s Friends recently shared on their Facebook page (please keep in mind that these recipes are calculated using the program used in the UK so work with your dietitian to adjust).

Passover:

The Epilepsy Foundation has a very helpful article all about managing the ketogenic diet over Passover. It includes many tips for substitutions that can be made to traditional Passover foods to make them more keto-friendly.

Matzo is a typical Passover food, but the high carb content usually makes it off limits for keto kids. If Matzo Ball Soup is a favorite in your family, you can make a keto-version for your child using the Charlie Foundation’s “No Matzo-Ball” Soup Recipe.

Macaroons are another common food consumed during Passover. Matthew’s Friends has a recipe idea for keto-friendly macaroons made of shredded coconut, egg whites, corn flour and artificial sweetener (please keep in mind that these recipes are calculated using the program used in the UK so work with your dietitian to adjust). If corn flour is not allowed, you could try substituting with almond flour.

 

Whether your family is celebrating Easter or Passover this week, we hope that you have an enjoyable holiday with your family!

-Mallory

Ket-O’Cal St. Paddy’s Day Milkshake!

Ket-O'Cal ShakeSt. Patrick’s Day is tomorrow and what better way to celebrate than with a minty, green Ket-O’Cal milkshake! You can make your keto kid his/her very own shamrock shake with a few simple ingredients:

Add the flavored syrup to your KetoCal LQ to reach your desired level of minty chocolate goodness, then add it to your blender with some ice. Blend until smooth, pour, and enjoy!

Optional: Top your Ket-O’Cal shake with homemade whipped cream (whipped heavy cream with artificial, carb-free sweetener).

Happy St. Patrick’s Day!

For more fun keto recipes, visit MyKetoCal.com.

Happy Registered Dietitian Nutritionist Day!

Did you know that today is Registered Dietitian Nutritionist Day? Each year on the second Wednesday of March, the Academy of Nutrition and Dietetics honors the many contributions of Registered Dietitian Nutritionists (RDNs).  The expertise and dedication of RDNs has a great impact on the health and well-being of their patients and community. If you have a child on the ketogenic diet, you know just how important and valuable it is to have a knowledgeable and committed RDN. If you are grateful for your ketogenic dietitian (a RDN with special training and expertise in implementing the ketogenic diet), today is the perfect day to let them know!

We’d like to give a special recognition to the many dedicated ketogenic dietitians out there, especially our five awesome Keto Ambassadors. Your contributions make a difference in the lives of your patients and the entire ketogenic diet community! Read more about our Keto Ambassadors here: http://www.myketocal.com/ambassador.aspx.

Check out this YouTube video to learn more about the many ways that RDNs make a difference.

KetoCal Supports Rare Disease Day 2015!

KetoCal is a medical food used by individuals with intractable epilepsy who are on a ketogenic diet. Within the category of intractable epilepsy, there are many different seizure disorders, many of which are rare diseases. KetoCal is also used by individuals with rare metabolic disorders that are managed with a ketogenic diet, including GLUT1 Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency (PDHD). Many individuals in our KetoCal community are living with rare disease, so we wanted to take this opportunity to show our support for Rare Disease Day 2015rdd-logo

Below is a list of just some of the rare diseases within the ketogenic diet community. Please note that this list contains only the rare diseases that we are aware of from talking with caregivers and healthcare providers of individuals living with these diseases; If we are missing one that is important to you, please let us know. If you get a chance, please take a moment to click on the links to learn more about these rare conditions.

Rare Disease Day 2015 is on February 28th. To learn more about Rare Disease Day, and how to get involved, visit http://www.rarediseaseday.org/.

Rare Disease:Numbers:Learn more:
GLUT1 Deficiency SyndromeAbout 500 cases have been diagnosed worldwidehttp://www.g1dfoundation.org/
Pyruvate Dehydrogenase Deficiency (PDHD)Several hundred cases reportedhttps://www.rarediseases.org/rare-disease-information/rare-diseases/byID/413/viewFullReport
Myoclonic-Astatic Epilepsy (Doose Syndrome)Estimated 1 in 10,000http://doosesyndrome.org/
Tuberous Sclerosis ComplexEstimated 1 in 10,000http://www.tsalliance.org/pages.aspx?content=2
Rett SyndromeEstimated 1 in 10,000 females (very rare in males)https://www.rettsyndrome.org
Severe Myoclonic Epilepsy of Infancy (Dravet Syndrome)Estimated 1 in 30,000http://www.dravetfoundation.org/
Infantile Spasms (West Syndrome)Estimated 2-3.5 in 10,000http://www.infantilespasmsinfo.org/index.php
Lennox-Gaustaut SyndromeEstimated  1 in 50,000-100,000http://www.lgsfoundation.org/
Angelman SyndromeEstimated 1 in 15,000http://www.angelman.org/
Landau Kleffner SyndromeUnknownhttp://www.epilepsy.com/learn/types-epilepsy-syndromes/landau-kleffner-syndrome
Alternating Hemiplegia of ChildhoodEstimated 1 in 1,000,000http://ahckids.org/ or http://cureahc.org/

Fiber and the Ketogenic Diet for Epilepsy

By Ellen Sviland Avery, MS, RD, LD, CNSC

As many of you know, the ketogenic diet is a very high fat, moderate protein and low carbohydrate diet. Since carbohydrates are limited, this can also limit an important nutrient in the diet: fiber. In today’s KetoConnect post, registered dietitian Ellen Sviland Avery answers your questions about fiber and why it’s important for children on the ketogenic diet for epilepsy.

Why is fiber important?

Fiber is important in a healthy diet to maintain gut health.  It is recommended that children older than 2 years of age consume a minimum amount of dietary fiber equivalent to their age plus 5 grams of fiber per day. For example, a 4-year old child should consume at least 9 g of fiber per day (4+5=9). A safe range of dietary fiber intake for children is suggested to be their age plus between 5-10 grams of fiber per day. 1 Research has also shown that up to 55% of children don’t meet fiber needs with an oral diet. 2,3

How does this affect my child on the ketogenic diet?

As previously stated, fiber may be limited in the ketogenic diet. Fiber is primarily found in fruits, vegetables and grain products. Due to the low carbohydrate intake of the ketogenic diet, these foods are typically consumed in small quantities, limiting the amount of fiber consumed. Because of the lack of fiber and bulk in the diet, constipation is a common side effect. 4,5 Gastrointestinal symptoms, especially constipation, are seen in ¾ of all ketogenic diet patients.6

So how do I improve these side effects?

To help prevent or alleviate constipation with the ketogenic diet, talk to your child’s doctor or dietitian to ensure your child is receiving adequate fiber and fluid. Speak with the dietitian about foods that may be higher in fiber that will fit in your child’s ketogenic ratio. Sometimes just increasing the amount of fiber consumed by small amounts will help with constipation. If needed, the doctor or dietitian may also prescribe a fiber supplement or even a carbohydrate-free laxative. Do not give your child any laxative without first consulting with the medical team.

How can KetoCal help with fiber needs?

KetoCal 4:1 contains fiber to help meet your child’s fiber needs while on the ketogenic diet. One drink box of KetoCal 4:1 LQ contains 2.6 g fiber. The great thing about the fiber found in KetoCal is that it comes from a patented blend of six different types of fibers, rather than just one type. This helps to better resemble the blend of fiber one would get from eating a healthy diet. Talk to your dietitian to see how KetoCal fits into your child’s meal plan!

-Ellen

  1. Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics. 1995;96(5 Pt 2):985-8.
  2. Butte NF, Fox MK, Briefel RR, et al. Nutrient Intakes of US Infants, Toddlers, and Preschoolers Meet or Exceed Dietary Reference Intakes. Journal of the American Dietetic Association. 2012;110(12):S27-s37.
  3. Hampl JS, Betts NM, Benes BA. The ‘age+5′ rule: comparisons of dietary fiber intake among 4- to 10-year-old children. J Am Diet Assoc. 1998;98(12):1418-23.
  4. Dahl WJ, Niebergall EJ, Owen RJ. Implications of fiber inadequacy in the ketogenic diet: a case study. ICAN: Infant, Child, & Adolescent Nutrition. 2011;3(5):3.
  5. Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009;50(2):304-17.
  6. Bergqvist AG. Long-term monitoring of the ketogenic diet: Do’s and Don’ts. Epilepsy Res. 2012;100(3):261-6.

Tips and Recipes for Making Valentine’s Day Fun for Your Keto Kid

valentinesdayLike most holidays and special occasions, Valentine’s Day can be tricky when you have a child on the ketogenic diet for epilepsy. Most valentine celebrations involve candy and other sweets not allowed on the ketogenic diet, which can make it stressful for parents trying to ensure that their child does not consume any non-allowed foods.  Parents may also find it challenging to make the day fun despite the dietary restrictions. Fortunately, little things go a long way when it comes to making special occasions fun for kids. For today’s KetoConnect Blog Post, we have some tips and ideas for small ways to make Valentine’s Day fun and special for your keto kid.

Add a Festive Touch!

You can make any meal more festive with a cute Valentine’s Day-themed straw, cup, plate, etc.

Decorate Your KetoCal!

Replace your child’s regular KetoCal with pink, strawberry-flavored KetoCal. Simply add a sugar-free, carb-free strawberry flavoring, such as DaVinci Gourmet’s strawberry syrup, to the KetoCal LQ Vanilla. Add your festive straw and voila!–You have a Valentine’s treat!

Another idea is to actually decorate the KetoCal LQ drink box. We found some cute ideas on Pinterest, such as these. You can find more ideas on our “Valentine’s Day on the Ketogenic Diet board on Pinterest! (Please note- these ideas use juice boxes, so you would just use your KetoCal LQ boxes instead).

Make Everything Heart-Shaped!

Another easy way to make Valentine’s Day special is to make your child’s favorite foods in the shape of a heart. Below are a few ideas:

  • Make your KetoCal pancakes into hearts by pouring the batter into a cookie cutter on the pan.
  • Make a heart-shaped KetoCal pizza by spreading the pizza dough into the shape of a heart before topping and cooking (you could do this by hand or using a larger-sized cookie cutter–just place the cookie cutter on the parchment paper and spread the dough inside of it to shape the pizza).
  • Make heart-shaped muffins or cupcakes using heart-shaped silicone baking cups, such as these.

Embrace Pink!

Celebrate Valentine’s Day by making recipes that are naturally festive by color! Here are some recipe ideas that are pink and perfect for Valentine’s Day.

Rasstrawberry_smoothiepberry or Strawberry Smoothie:

Our KetoCal Raspberry or Strawberry Smoothie recipes are naturally pink in color and perfect for Valentine’s Day. Optional–Top with whipped heavy cream sweetened with carb-free sweetener and serve with a festive straw!

KetoCal Cherry Float:

Add scoops of KetoCal Vanilla Ice Cream to any sugar-free, carb-free cherry-flavored soda, such as Zevia® Black Cherry or Professor Fizz (please note, these sodas are not carb-free but the carb comes from erythritol, which some dietitians do not count towards total carbohydrate– check with your dietitian first). Usually, the carb-free cherry soda is red in color but if the brand you use is not, you could add a small amount of red food coloring. Optional- top with whipped heavy cream sweetened with carb-free sweetener and serve with a festive straw!

Strawberry Panna Cotta:panna-cotta

Panna Cotta is a creamy Italian dessert. Our KetoCal Strawberry Panna Cotta recipe is tasty and perfectly-colored for a Valentine’s Day treat!

Make Awesome Non-Food Valentines!

Many valentines involve candy, but there are many other options for non-food valentine treats which are just as much fun for kids. We found some awesome ideas for non-candy valentines on Pinterest. You can check them out on our “Valentine’s Day on the Ketogenic Diet” Pinterest board. If your child’s school is having a Valentine’s Day celebration, send along some non-food valentine treats for your child and the rest of the children to enjoy. If you are friends with other parents of children in the class, you could share some non-food Valentine ideas with them as well. There are likely other children in the class with food restrictions, such as those with food allergies, and many parents try to minimize their children’s sugar intake, so you might find that other parents embrace the awesome non-food valentine idea too!

-Mallory

2015 Epilepsy and Ketogenic Diet-Related Event Calendar

2015 CalendarFor today’s blog post, we created a calendar of epilepsy and ketogenic diet-related events taking place throughout 2015. This includes various conferences, fundraisers and patient group awareness days. These are only the events that we are aware of, so we hope that you can help us add on to this calendar. If we are missing your group’s event, please let us know so that we can include it. Please add a comment below this post or send us an email at myketocal@nutricia.com.

January

February

March

April

  • Keto University (for dietitians)
    April 27th- 29th
    San Diego, CA

May

June

July

August

September

October

November

December

Top Five Books for Parents Learning About the Ketogenic Diet for Epilepsy

If you are considering the ketogenic diet for your child, or perhaps your child is already scheduled to begin the ketogenic diet, you are likely seeking all the information that you can find to educate and prepare yourself. Even after your child starts the ketogenic diet, you will likely continue searching for information and resources to support you in managing your child’s diet. Many parents find books to be helpful, so for today’s KetoConnect blog post, we rounded up a list of five of our favorite books for parents learning about the ketogenic diet for epilepsy.

For more resources for parents learning about the ketogenic dietfor epilepsy, check out our list of helpful YouTube videos and infographics.

ketodietsbookKetogenic Diets

This book, by the ketogenic diet team at Johns Hopkins Hospital, is a must-have for both parents and health care professionals.

The Keto Cookbookketocookbook

This ketogenic diet cookbook is co-authored by a mother of a child on the ketogenic diet and a ketogenic  dietitian. It provides a variety of tasty ketogenic recipe ideas.

Keto Kid: Helping Your Child Succeed on the Ketogenic Dietketokid

This book is written by a physician who is also the mother of a child on the ketogenic diet. It provides helpful tips for everyday management of the diet.

Fighting Back with Fatfightingback

This book is written by two mothers of children on the ketogenic diet for seizures. It provides practical tips for parents managing the Classical Ketogenic Diet or the Modified Atkins Diet.

Diet for Seizures: One Child’s Journeydietforseizures

In this book, a father tells about his daughter’s experience with the Modified Atkins Diet for epilepsy. This is a great read for parents, especially those interested in the Modified Atkins Diet.

Do you have feedback about these books or know of another useful book to add to this list? Please share in the comment section below!

No Bones About It: Questions and Answers About Nutrition, Epilepsy and Bone Health

By Ellen Sviland Avery, MS, RD, LD, CNSC

Why should I be worried about my child’s bones?

Bone health is important for men and women, children and adults. As children, it is important to get enough calcium and Vitamin D starting during infancy. Inadequate calcium and Vitamin D during childhood can affect proper bone development.

Where can I find calcium and Vitamin D in my food?

Good sources of calcium include dairy products, calcium fortified orange juice and milk substitutes, sardines, dark green leafy vegetables (kale, spinach, collard greens) and calcium fortified cereals. Good sources of Vitamin D include salmon, tuna, shrimp, egg yolks, beef liver, mushrooms and Vitamin D fortified foods. Of note, Vitamin D can also be made in the liver from sunlight!

How much calcium and Vitamin D does my child need daily?

The Recommended Dietary Allowance for calcium for children aged 1-3 years is 700 mg/day, 4-8 years is 1000 mg/day, and 9-18 years of age is 1300 mg/day. For Vitamin D, the RDA for children aged 1-18 years is 600 international units (IU) per day.

How do I know if there’s a deficiency?

If you are concerned about a deficiency, be sure to discuss it with your child’s health care provider.

What does this have to do with my child with seizures?

Many common anti-epileptic drugs (AED) can cause disturbances with Vitamin D absorption. In a recently published study, decreased bone mineral density was seen more often when a child was on more than one AED (Vestergaard 2015). As we mentioned already, Vitamin D is necessary for good bone health. It is important to talk to your physician about ensuring your child is receiving adequate Vitamin D and calcium.

Now you might ask why we are focusing on bone health and the ketogenic diet. Typically, the ketogenic diet can be low in high calcium and Vitamin D foods as many of them contain carbohydrate, which is restricted in the ketogenic diet. The effect of diet on bone health is just one of the many reasons why it is so important to use the ketogenic diet only under medical and nutritional supervision. Your physician and dietitian that are helping you to manage your child’s ketogenic diet will help to ensure they are meeting the recommended dietary allowance’s (RDA’s) for calcium and Vitamin D. Most often, they will recommend a calcium and Vitamin D supplement to make up for any gaps in the diet. They may also check blood levels to look out for deficiencies in calcium or Vitamin D.

Again, if you have any concerns about your child’s diet and bone health, be sure to discuss it with your child’s health care team.

-Ellen

1. Vestergaard P. Effects of Antiepileptic Drugs on Bone Health and Growth Potential in Children with Epilepsy. Paediatr Drugs. 2015.

Ketogenic Diet Myths and Misconceptions Series: Heart Disease

myths2

One of the most common misconceptions about the ketogenic diet for epilepsy is that it will lead to heart disease, also known as cardiovascular disease. It is true that consuming high amounts of certain types of fats (including cholesterol, saturated fats and trans fats) can lead to high levels of lipids in the blood, which may increase an individual’s risk for developing heart disease. It is also true that high lipid levels are a common side effect of the ketogenic diet. However, when the ketogenic diet is used under proper medical and nutritional supervision, lipid levels can typically be controlled.

When an individual is on a ketogenic diet for epilepsy, their health care team will regularly monitor their blood lipid levels. If high lipid levels are found, adjustments can be made to the diet in order to bring the levels down to a safe level. This is just one of the many reasons why it is so important to only do the ketogenic diet under close medical and nutritional supervision.

A 2008 study from Johns Hopkins Hospital found that about a third of children developed high lipid levels after starting the ketogenic diet[1]. Interestingly, the researchers noted that in many cases, the high lipid levels were only temporary. As the children’s bodies adjusted to the high fat diet, their blood lipid levels often normalized and returned to near pre-diet levels within 6-12 months[2].

As mentioned above, the ketogenic health care team can make certain adjustments to the diet in order to help prevent or manage high lipid levels. For one, the ketogenic dietitian can help caregivers to incorporate more healthy fats into the diet and reduce the intake of unhealthy fats. The Children’s Hospital of Philadelphia (CHOP) published a report in 2009 about six children who developed high lipid levels on the ketogenic diet[3]. The children’s caregivers were encouraged to reduce foods with high levels of saturated fat and cholesterol (such as heavy cream, butter, egg yolks, etc.) and to incorporate more healthy fats into the diet (such as vegetable oils, nuts, etc.). These simple diet adjustments led to improved lipid levels for all six of the children observed.

It’s important to note that high lipid levels may be less of a concern for children on the ketogenic diet who are tube-fed or who otherwise consume a formula-only ketogenic diet. The previously mentioned 2008 Johns Hopkins study found that children on formula-only ketogenic diet were much less likely to develop high lipid levels in comparison to children who consumed a solid food ketogenic diet. This may be because ketogenic diet formulas have relatively low levels of saturated fat (20%) in comparison to the amount of saturated fat in a typical solid-food ketogenic diet (60%).

In summary, the belief that a ketogenic diet for epilepsy will lead to heart disease is a common misconception. Although high lipid levels can increase an individual’s risk for developing heart disease, lipid levels can usually be managed with close monitoring and guidance from the ketogenic diet health care team. As always, be sure to discuss any questions or concerns with your health care provider.

 

  1. Nizamuddin, J., et al., Management and risk factors for dyslipidemia with the ketogenic diet. J Child Neurol, 2008. 23(7): p. 758-61.
  2. Kossoff, E.H., et al., Ketogenic Diets: Treatments for Epilepsies and Other Disorders. Fifth ed. 2011, New York, NY: Demos Medical Publishing.
  3. Fenton, C., C.M. Chee, and A.G.C. Bergqvist, Manipulation of Types of Fats and Cholesterol Intake Can Successfully Improve the Lipid Profile While Maintaining the Efficacy of the Ketogenic Diet. ICAN: Infant, Child, & Adolescent Nutrition, 2009. 1(6): p. 338-341.

Ketogenic Diet Infographics

Information graphics, better known as infographics, are visual representations of information. Infographics provide a quick and clear way to learn about a topic without having to read a large amount of text. They are a popular way to share information via social media.

Given the current popularity of infographics and their usefulness for sharing complex information in an easier-to-understand way, we searched the web for the best infographics about the ketogenic diet for seizures and epilepsy. Below is our list of the top five infographics that are helpful for learning about the ketogenic diet.

If you are a parent considering the ketogenic diet for your child, we hope that you find these infographics useful for learning more about how the diet works. If your child is on the ketogenic diet and you are already familiar with how it works, these may be useful for explaining the diet to friends, family, teachers, etc.

  1. Our favorite infographic about the ketogenic diet is from Lurie Children’s Hospital of Chicago. It does a great job of explaining the basics of how theketogenic diet works.

    info

    Click to view full image

  2. We may be biased about this infographic since it’s ours, but we think it’s useful for spreading awareness about intractable epilepsy and how theketogenic diet may help for some individuals.

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    Click to view full image

  3. This infographic from Duke Children’s Hospital provides a nice visual comparison of the percentage of fat, carbohydrate, and protein in a typical diet, classical ketogenic diet, modified Atkins diet, medium chain triglyceride (MCT) ketogenic diet, and low glycemic index treatment (LGIT).

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    Click to view full image

  4. Here is another infographic from our website, which we think is useful for explaining the difference between the classical ketogenic diet and the newer variations (modified Atkins Diet, MCT ketogenic diet, and LGIT).

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    Click to view full image

  5. Lastly, here is an infographic shared on Facebook by Gillette Children’s Hospital with holiday tips for parents of children on theketogenic diet. The winter holidays may be over, but these tips are useful for managing special occasions allyear long, such as birthday parties, Valentine’s Day, Easter, etc.
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    Click to view full image

     

Do you know of a helpful infographic about the ketogenic diet for epilepsy? Please share a link in the comments below!

Keto Highlights of 2014

2014 Highlights

As we finish the final days of 2014, today’s KetoConnect blog post looks back at the highlights of 2014 for the ketogenic diet community.

International Conference:

The highlight event of 2014 was undoubtedly the International Symposium on Dietary Therapies for Epilepsy & other Neurological Disorders, which was hosted by Matthew’s Friends in Liverpool, England. Around 270 healthcare professionals, scientists, and parents attended the first International Symposium on Dietary Therapies for Epilepsy & Other Neurological Disorders, which was held in 2008 in Phoenix, AZ. This year’s symposium had nearly double the attendance with roughly 500 attendees from 27 different countries.

Global Growth:

The use of the ketogenic diet continued to expand geographically in 2014. As mentioned in the paragraph above, this year’s International Symposium had attendees from 27 different countries! In the August 2014 issue of Keto News, Dr. Eric Kossoff discussed the global growth of the ketogenic diet, which is now offered in at least 60 countries!

More Research:

Research interest in the ketogenic diet has increased tremendously in recent years and the trend continued into 2014. There were more scientific articles on the ketogenic diet published in 2014 than ever before. The graph below shows the steadily increasing number of publications on the ketogenic diet, with a whopping 172 articles published in 2014 (along with 13 articles e-published ahead of print in 2015)! As Dr. Eric Kossoff discussed in his recent Keto News article, there has never been more research interest in the ketogenic diet. It is a very exciting time for our community!

Source: Pubmed.gov

Source: Pubmed.gov

Increased Online Interest:

In addition to the trend for increasing research interest, there is also a trend for increasing online interest in the ketogenic diet. Google Trends allows you to compare online interest in certain topics over time based on how many people search the Web for that topic. As you can see from this graph comparing online search trends over the last 10 years (below), there were many people searching for the ketogenic diet online in 2014!

Source: Google Trends

Source: Google Trends

Loss of Dr. John Friedman:

The ketogenic diet community mourned the loss of Dr. John Freeman in 2014. Dr. Freeman was an internationally renowned neurologist from Johns Hopkins University who revived the use of the ketogenic diet for epilepsy. Dr. Freeman’s contributions live on in the many patients that he helped.

New Keto Ambassador Program:

Nutricia North America launched a new “Keto Ambassador” program in 2014, connecting expert ketogenic dietitians with less experienced dietitians for support and guidance. In 2015, the Keto Ambassadors will host the first ever “Keto University” for dietitians!

 

For more 2014 highlights from our friends across the pond in the UK, check out the 2014 project summary from Matthew’s Friends.

Happy New Year, everyone! We’ll see you in 2015.

-Mallory

Holiday Tips and Recipes Roundup

Today’s KetoConnect post is a collection of posts from around the web with helpful tips and recipe ideas for celebrating the holidays with a child on the ketogenic diet. Please comment if you know of any other helpful posts that we should add to the list. Best wishes for a happy, healthy, keto-friendly holiday!

Tips for Celebrating Winter Holidays (Epilepsy Foundation)

Christmas:

Tips for Managing Your Child’s Ketogenic Diet over the Holidays (KetoConnect)

Christmas Survival Guide (Matthew’s Friends)

KetoCal Christmas Recipe Ideas (KetoConnect)

Holiday Baking (KetoCook)

Hanukkah:

Celebrating Chanukah on the Ketogenic Diet (KetoConnect guest blog post)

KetoCal Hanukkah Recipe Ideas (KetoConnect)

KetoCal Christmas Recipe Ideas

Earlier this week we posted tips for celebrating the holidays with a child on the ketogenic diet. If you missed it, be sure to check it out! To go along with these tips, today we have some KetoCal recipes for making keto-friendly Christmas treats and Christmas morning breakfast ideas. If your family celebrates Hanukkah, be sure to check out our previous blog posts on celebrating Hanukkah with a child on the ketogenic diet and KetoCal Hanukkah Recipe Ideas.

As always, consult with your child’s health care provider to adjust these recipes to meet your child’s ketogenic ratio and calorie requirements.  The ketogenic diet for epilepsy should only be used under medical supervision.

Making cookies at christmas time

Favorite Christmas Treat Recipe Ideas:

KetoCal Christmas Cookies:

Make Christmas cookies using our KetoCal Almond Coconut Cookie recipe. These are your keto-version of basic “sugar” cookies (sans sugar of course). They are easy to make and a favorite around the office (people often describe them as tasting like shortbread cookies). You can make these cookies festive by adding carb-free food coloring to the batter before cooking. I like to divide the recipe in half and add red carb-free food coloring to one batch and green carb-free food coloring to the other. Another idea is to add red or green “sprinkles” to your cookies by mixing a small amount of carb-free food coloring into the Truvia before adding it on top of the cookies. You could also use small, Christmas-themed cookie cutters to make different shapes.

KetoCal Gingerbread Cookies

KetoCal Hot Chocolate

Our KetoCal Chocolate Smoothie Recipe can be used to make tasty hot chocolate by simply omitting the ice and serving it warm. This easy recipe uses 3 simple ingredients: KetoCal LQ Vanilla, unsweetened cocoa powder, and vegetable oil. Optional carb-free sweetener can be added to taste. We like to use KetoCal LQ Vanilla for this recipe but you could also use KetoCal LQ Unflavored with additional carb-free sweetener.

Other Christmas dessert ideas:

KetoCal Blackberry Crumble

KetoCal Crème Brulee

Christmas morning breakfast ideas:

KetoCal Cinnamon and Blueberry Toast

KetoCal Pancakes

KetoCal Chocolate Muffins

KetoCal Bacon & Cheese Muffins

KetoCal Blueberry Muffins

KetoCal Cheesy Ham Tart

KetoCal Cheesy Tomato Tart

 

Merry Christmas and happy holidays everyone!

-Mallory

Tips for Managing Your Child’s Ketogenic Diet Over the Holidays

The holiday season is officially upon us! Hanukkah starts today, Christmas is just over a week away, and Kwanzaa starts the following day! This time of year tends to be very food-focused, which can make it challenging for parents of children on restrictive diets. For today’s blog post, Robyn Blackford, a ketogenic dietitian from Ann & Robert H. Lurie Children’s Hospital of Chicago, helped us to come up with some tips for managing the holidays with a child on the ketogenic diet.

Plan Ahead for Meals & Treats

  • Talk to your child’s dietitian for any recipes that you may need well before the time you need them.
  • Make the recipes in advance to ensure that they taste good and travel well.
  • For holiday meals, if possible, find out what will be served ahead of time so that you can find keto-variations to match what everyone else will be eating.
  • Make a few batches of keto treats to have handy over the holidays so that you can provide them for your child at school parties, family get-togethers, etc. when other kids are enjoying treats.

Prepare for Holiday Meals & Get-Togethers

Preparing your child:

  • It’s important to prepare your child for holiday meals, get-togethers, and parties. Talk to your child ahead of time about what to expect and practice saying “No, thank you” if offered any foods other than the foods that you bring.
  • For holiday meals, some kids may enjoy a smaller, kid-friendly, holiday-themed dinner plate. Smaller, sectioned plates can be helpful for making keto meals more appealing to children and also make it less obvious that their meal is smaller in size than a typical meal. On the other hand, some kids may prefer to have the same dinner plate as everyone else so that they don’t feel different. Talk with your child ahead of time to find out which option he or she prefers. If you go with the small, child-friendly plate, you might also bring some for all of the children attending to enjoy!

Preparing friends & family:

  • Let family members and friends know ahead of time about your child’s special diet so that they know not to offer foods other than the food that you bring for your child. By letting everyone know ahead of time, you can avoid having the conversation in front of your child, which might make your child feel self-conscious.

Preparing your child’s school:

  • If there will be a holiday party at your child’s school and food will be provided, remind your child’s teacher(s) that your child cannot have any food except for the food that you send. If there will be treats provided, send a special keto treat for your child so that he or she doesn’t feel left out. You might also send along non-food, holiday-themed treats like stickers, pencils, etc. for all of the children to enjoy.

Embrace Non-food Variations of Favorite Holiday Traditions

A lot of holiday traditions involve foods that are not allowed on the ketogenic diet, but you can still enjoy them by taking a new, non-food spin on favorite traditions.gingerbread house

  • If your family enjoys making gingerbread houses, you can make a non-food gingerbread house this year using a cardboard box, paper, cotton balls, jewels, glitter, puff balls, stickers, etc. Here’s one that we made as an example. They are just as much fun to make and they last longer!
  • Rather than filling your child’s Christmas stocking with candy, fill it with non-food treats like small toys, stickers, markers, fun socks, etc.

We hope that you find these tips helpful for managing your child’s ketogenic diet over the holidays.  With a little creativity, improvising and planning ahead, you can make your child’s holiday as normal as possible. Try to remember that although food seems like such an important part of holiday celebrations, most of our best childhood memories of the holidays have nothing to do with the food.

Happy Chrismakwanzika everyone!

-Robyn & Mallory

KetoCal Hanukkah Recipes

Earlier this week we posted a guest blog with tips and recipe ideas for celebrating Hanukkah on the Ketogenic Diet. If you missed it, be sure to check it out! To go along with these tips and ideas, we have some KetoCal recipes for popular Hanukkah foods to share today. As always, consult with your child’s health care provider to adjust these recipes to meet your child’s ketogenic ratio and calorie requirements.

KetoCal Latkes with Sour Cream Topping:

latkeLatkes are potato pancakes often enjoyed during Hanukkah. These delicious keto latkes are made with low carb vegetables, zucchini and cauliflower, instead of potatoes.

Recipe makes two medium-sized latkes.

Ingredients:

  • 25 g Cauliflower, raw
  • 65 g Zucchini, with skin – raw
  • 1 g Garlic Paste
  • 16 g Egg (raw, mixed well)
  • 12 g Sour Cream – cultured (not low-fat)
  • 12 g Mayonnaise
  • 16 g Oil, Olive
  • 21 g KetoCal 3:1 Powder

Directions:

  1. Shred raw zucchini (I used a cheese grater), then measure (raw).
  2. Chop cauliflower florets, then measure (raw).
  3. Steam cauliflower a bit to soften, either on the stove or in the microwave. Briefly mash them with a fork or mini spatula.
  4. After measured, place shredded zucchini on a plate and sprinkle a small amount of salt on top. Allow to sit for a few minutes, then blot it with a paper towel (this removes excess water from the zucchini so that the latke batter is not too watery).
  5. Mix vegetables, egg, garlic paste, olive oil and KetoCal 3:1 powder in a bowl.
  6. Heat a pan with olive oil.
  7. Pour latke batter into pan, making two “pancakes”. Cook until brown on edges, then flip and brown on the other side. If some of the latke falls apart at the edges, just use your spatula to reshape it as it cooks.
  8. Remove from heat and place on a plate to cool, Do not place on a paper towel since this will remove some of the fat.
  9. To make the sour cream topping, mix the sour cream and mayonnaise together. Spoon the mixture onto the latkes.

Nutrition Information (for entire recipe; 2 latkes):

Calories: 445
Fat: 44.4 g
Protein: 6.8 g
Carbohydrate: 4.3 g
Ratio: 4:1

KetoCal Sufganiot:

donut1Recipe makes two mini doughnuts.

Sufganiot are jelly-filled doughnuts often enjoyed during Hanukkah. You can make a keto doughnut by preparing the KetoCal Pancake recipe and pouring the batter into a doughnut mold pan (thanks to our past guest blogger, Dana, for sharing her keto doughnut creation with us!).

Ingredients:

  • 26 g KetoCal 4:1 Powder
  • 8 g butter
  • 7 g cream, 40%
  • 4 g olive oil
  • 28 g eggs, raw, mixed well
  • 4 g (mL) water

Directions:

  1. Preheat oven to 375°F.
  2. Melt the butter.
  3. Stir in the egg, cream, oil, and optional carb-free sweetener into the butter and mix well.
  4. Mix the KetoCal 4:1 powder and water, and then add into the mixture.
  5. Spray a mini doughnut mold pan with oil.
  6. Pour batter into doughnut molds (depending on the size of your molds, it should make about 2-3 mini doughnuts)
  7. Cook for 20-25 minutes, until golden brown.

Optional: To add a jelly filling to your doughnuts, stir a small amount of prepared sugar-free, carb-free fruit-flavored gelatin to reach a jelly-like consistency, then spoon it into the middle of the doughnut. Note that the doughnut recipe is for a 4:1 ketogenic ratio. Adding carb-free, sugar-free gelatin will affect the ratio slightly, so work with your dietitian to balance the ratio with an additional source of fat if needed.

Nutrition Information (for entire recipe, not including optional “jelly”):

Calories: 341
Fat: 34.0 g
Protein: 7.5 g
Carbohydrate: 1.1 g
Ratio: 4:1

Celebrating Chanukah on the Ketogenic Diet

zahavaChanukah begins a week from today and we are excited to welcome a guest blogger for today’s post on celebrating Chanukah while on the ketogenic diet for epilepsy. Zahava Turner, RD CSP LDN, is a ketogenic dietitian at the Johns Hopkins Ketogenic Diet Clinic in Baltimore, MD. Zahava looks forward to celebrating Chanukah with her family each year so she is happy to share some tips for families celebrating Chanukah with a child on the ketogenic diet so that they can have an enjoyable holiday too.


hanukkahChanukah and the Ketogenic Diet

The holiday season is fast approaching! Chanukah or Hannukah is a Jewish holiday that celebrates the triumph of light over darkness and spirituality in a materialistic world. The Holy Temple which had been destroyed was rededicated  in Jerusalem. It begins on the 25th of the Jewish month of Kislev. Chanukah is observed by lighting the Menorah every night for eight days in honor of the single vial of olive oil that was found in the rubble that lasted for eight days.

As with most holidays, there are special foods that are eaten during Chanukah. Popular Chanukah foods include latkes, which are potato pancakes, and sufganiot, which are doughnuts. These foods are traditionally cooked in oil to commemorate the miracle of the olive oil that lasted for eight days. The heavy use of oil during Chanukah makes it the perfect holiday for children following a ketogenic diet for epilepsy!

As a ketogenic dietitian, I know how important it is to parents for their child’s life to be as normal as possible while on the ketogenic diet. Parents may be concerned that their child will have to miss out on favorite Chanukah foods but with some creativity and help from your dietitian, you can create ketogenic versions of almost any dish. Below are some ideas for making ketogenic latkes and sufganiot for your child to enjoy during Chanukah.

Latkes:

Although potatoes are traditionally used for latkes – any shredded vegetable like zucchini, beets, kale, or spinach can be mixed with egg to bind it together and then fried in oil.

Sufganiot:

One of the families that I work with came up with this recipe for a ketogenic donut! These keto donuts make a great substitute for sufganiot during Chanukah.

Keto-donut Recipe – Created by the Lynch family

Work with your dietitian to adjust the amounts of each ingredient to meet your child’s ketogenic ratio and calorie needs.

Ingredients:

  • Egg whites
  • Cream (whipped)
  • Macadamia nuts (finely chopped)
  • Butter and
  • Peanut butter

Directions:

Spray mini bunt pan well with nonstick cooking spray.  Mix egg whites, whipped cream and nuts together – set aside.  Melt butter and peanut butter together – mix well and pour into egg mixture.  Mix together and pour into bunt pan.  Bake in the oven at 350°Fon the lowest rack until golden brown (about 35 min. for a 300 kcal meal).  Cover with aluminum foil the last 10 minutes or so of baking to prevent top from burning before completely cooked through.

Happy Chanukah everyone!

-Zahava

 Find more recipe ideas for keto Chanukah foods here.

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Warm Keto Soups for Cold Days

Cold weather calls for warm soup! Try one of our tasty KetoCal® soup recipes. These recipes use KetoCal LQ Unflavored, which is unsweetened and perfect for making savory recipes. We made samples of these soup recipes for our office and everyone still raves about them. The crowd favorites were the Mock Baked Potato Soup and the Taco Soup.

Note- These recipes are for a 4:1 ketogenic ratio. We also have soup recipes for a 3:1 ketogenic ratio and the Modified AtkinsDiet. As always, consult with your health care provider to ensure recipes are appropriate.

KetoCal Mock Baked Potato Soup


 

KetoCal Taco Soup

Cream of taco soup

 

KetoCal Mushroom Soup

 

 

KetoCal Tomato Basil Soup

Tomato basil soup

 

 

KetoCal Green Pepper & Tomato Soup

Roasted Tomato Soup

 

 

 

 

 

 

-Mallory

 

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YouTube Videos for Parents Learning About the Ketogenic Diet for Epilepsy

ParentslaptopIf your child’s health care provider has recommended that you consider the ketogenic diet to help manage your child’s seizures, you likely have many questions. Your health care team can recommend various books and websites that provide helpful information for parents learning about the ketogenic diet for epilepsy. While these resources are valuable, sometimes the best information comes from other parents who have been in your shoes and can share their family’s experiences.

Thankfully, the Internet makes it possible for parents to share their stories with other parents anywhere in the world.  For today’s KetoConnect blog post, I’ve collected some of my favorite YouTube videos of parents sharing their family’s ketogenic diet stories. I hope that these families’ experiences will be helpful for you in learning more about life on the ketogenic diet for epilepsy.

Do you know of a helpful parent video to add to this list? Please share a link in the comment section below! And if you haven’t already, be sure to subscribe to KetoCal’s YouTube page for videos with mixing instructions, recipe demonstrations, and other helpful tips for managing the ketogenic diet for epilepsy.

-Mallory

Note: These videos were created by the YouTube users and are available for public view on YouTube.com.


Meet Monica’s Family

Monica’s older brother created this video to share his sister’s story with the ketogenic diet for epilepsy. Monica’s parents offer their invaluable tips and advice to other parents.

 


Meet Tyler’s Parents

In this video from Johns Hopkins Children’s Center, you’ll meet Tyler’s family and learn about their experience with the ketogenic diet for Infantile Spasms.

 


Meet Max’s Parents

In this video from the Mayo Clinic, Max’s parents share their story with intractable epilepsy and the ketogenic diet.

 


Meet Matthew’s Family

Emma, from the U.K., shares her family’s experience with Dravet Syndrome, intractable epilepsy, and the ketogenic diet. Her experience led her to create Matthew’s Friends Charity, whose mission is improve awareness and access to the ketogenic diet.

 


Meet Kate’s Parents

In this video from the Charlie Foundation, Kate’s mom and dad share their daughter’s experience with epilepsy and the ketogenic diet. Kate’s story is a great example of an older child for whom the ketogenic diet was helpful.

 


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Special Post for Epilepsy Awareness Month

As many of you know, November is National Epilepsy Awareness Month, so today’s KetoConnect blog post is a special Epilepsy Awareness edition. Read below for an overview of Nutricia’s Purple Day for Epilepsy Awareness and to view our new infographic to help spread awareness about epilepsy and the ketogenic diet.

Nutricia North America Purple Day for Epilepsy Awareness:

Last Friday was “Purple Day” here at Nutricia North America. The KetoCal team committed to donate $5 for every Nutricia North America employee who wore purple to work for epilepsy awareNNAPurple2014ness. It was a sea of purple in the office and our internal social media site was flooded with photos of employees across the US and Canada sporting purple. We were so impressed by everyone’s enthusiasm that we decided to double the funds raised.

Friday’s fundraiser will be used to sponsor a child to attend Camp Great Rock, a camp specifically for children and teens with epilepsy. Great Rock campers get a chance to experience the joys of summer camp in a safe environment, under the medical supervision of the Neurology team from Children’s National Medical Center, our local children’s hospital here in Washington D.C.

Epilepsy and Ketogenic Diet Awareness Infographic:

Also in recognition of National Epilepsy Awareness Month, we created this Infographic to help spread awareness about epilepsy and the ketogenic diet as an option for those with intractable seizures. Please feel free to share, pin, post, and spread the word!

How are you recognizing Epilepsy Awareness Month?

-Mallory

 

Ketogenic Diet jpeg

Celebrating Thanksgiving on the Ketogenic Diet

ThanksgivingCan you believe that Thanksgiving is just 9 days away? If you have a child on the ketogenic diet for seizures, you may be feeling stressed about managing the diet on such a food-focused holiday. For today’s post, I’ve compiled some recipes and tips to help you ensure that your little one has an enjoyable, keto-friendly Thanksgiving.

Preparing a Keto-Friendly Thanksgiving Meal:

Many parents like to prepare their child keto versions of the dishes that the rest of the family eats so that their child feels like they are eating the same thing as everyone else. If your family will celebrate Thanksgiving at a family member or friend’s house, consider talking to them about the menu ahead of time so that you have time to prepare similar keto dishes for your child.

Once you have some ideas of the dishes that you want to prepare, ask your child’s dietitian for help adjusting the recipes to your child’s ketogenic ratio and calorie needs, if necessary. If you are making a dish that you haven’t made before, you may want to try making it before Thanksgiving to make sure that it looks and tastes how you expect. If you will be making your child’s meal at home, then traveling to a friend or family member’s home for your Thanksgiving feast, make sure that the meals are transportable.

Some parents like to serve their child’s meals on smaller, kid-friendly dishes to make keto meals look more appealing and to make it less obvious that keto meals are smaller in size than regular meals. Consider getting a fun, colorful kid’s plate for your child’s Thanksgiving meal. You might even pick some up for all of the young children attending your Thanksgiving feast. Your child will feel like “one of the gang” and the other children might enjoy the special, kid-friendly dishes too!

Recipe Ideas:

KetoCook has created a wonderful Thanksgiving menu for keto kids. You can find their Thanksgiving recipes on the Charlie Foundation website or through the links below.

Desserts:

Dessert is the highlight of the Thanksgiving meal for many people. Check out our KetoCal recipe ideas for delicious Thanksgiving desserts.

Festive Formula:

If your child is mostly formula-fed, you can make Thanksgiving special by giving their KetoCal a festive twist. For example, you could dress up their KetoCal LQ into a turkey (see this example of a decorated drink box on Pinterest) or make a KetoCal Pumpkin Spice Shake.

Foodless Fun at the Table:

You can take the focus off of food altogether by creating an awesome kid’s table or kid’s place at the adult table with fun activities to enjoy during Thanksgiving dinner. This might be especially helpful if you are planning to feed your child before the group meal or if your child is tube-fed. Pinterest is full of free, printable, Thanksgiving-themed placemats and activity sheets for kids. We’ve collected some of our favorites on our holiday pinboard.  If you are feeling crafty, you can even make these cute pilgrim hat crayon holders for the table! We absolutely love this idea of making a faux pumpkin pie, filled with non-food treats and toys to keep your little one entertained at the dinner table.

 

Celebrating Thanksgiving on the ketogenic diet will take some extra effort but with some advanced planning and creativity, you can ensure that the whole family enjoys the day. I hope everyone has a wonderful Thanksgiving! What are you most thankful for this year?

-Mallory

 

 

Talking to Young Children about Epilepsy and the Ketogenic Diet

When your child has seizures and is starting a ketogenic diet, it’s important to help him or her to understand and cope as much as possible. But it can be challenging to discuss complex medical information with young children in ways that they can grasp. For today’s post, I’ll provide some tips and resources to help you explain epilepsy and the ketogenic diet to your little one.

Keep It Simple

Try to keep things as simple as possible. You want to be open and honest but too many details can be confusing and create unnecessary anxiety for a young child. Remember that you know your child best so you are the best judge of how much they can understand. It may be helpful to let your child guide the conversation. Provide basic information and encourage your child to ask questions. Let the questions guide you with how much information to provide.

Use Kid-Friendly Terms

Sometimes children need kid-friendly analogies to understand a concept. For example, you might tell your child “You’re starting a magic diet (or a superhero diet, or a princess diet) because it helps some kid’s brains to feel better so that they don’t have seizures. You won’t be able to eat some of your favorite foods for a while but we’ll make special magic (or superhero, or princess) foods just for you that are just as tasty.” Using terms like these can help you to communicate to your child that he or she will be eating different foods and that they can do it because he or she is strong like Spiderman (if interested in superheroes) or determined like Cinderella (if interested in princesses). Again, you know your child best so tailor your explanation to his or her interests.

Use Children’s Stories

Some parents find storybooks are helpful in communicating complicated information to children and fortunately, there are several children’s books about special diets or epilepsy. Here are some of my favorites.

Reassure Them That They Are Not Alone

Even at a young age, children are very sensitive to feeling different from their peers. Reassure your child that they should not be embarrassed about having seizures or eating differently. Point out that many people have health issues and that they come in many forms. Some kids have breathing problems, others have tummy troubles, and others have seizures. Similarly, many kids have conditions that require them to follow a special diet. For example, some children have food allergies that limit the types of foods that they can eat and others are on a ketogenic diet for epilepsy, which also limits the types of foods that they can eat.

For more information on talking to your child about epilepsy, check out some of these useful sites:

How did you explain epilepsy and the ketogenic diet to your child? What advice would you give to other parents in your shoes?

-Mallory

 

 

“What Are Ketones Anyways?”

When your child is on the ketogenic diet for seizures, the word “ketone” is a part of your everyday vocabulary. Not only do you talk about them, chances are that you measure them regularly as well. Despite this, you may find yourself wondering, “What are ketones anyways?” In today’s post, I’ll try to answer all of your questions about ketones.

Ketones, sometimes referred to as “ketone bodies”, are water-soluble compounds (meaning that they dissolve in water) that are produced as “byproducts” when the body burns fat for energy [1]. Normally, the body produces only small quantities of ketones but ketone production increases when the body is using fat as a primary source of fuel. This happens during starvation, when the liver burns stored body fat for energy, and on a ketogenic diet, when the liver burns large quantities of dietary fat for energy.

As the liver burns fat, ketones build up in the blood and the body is said to be in “ketosis”.  Ketones are transported from the liver through the blood to the brain, heart, and skeletal muscles where they can be used for energy[2].

Types of Ketones:

There are 3 different types of ketones: beta-hydroxybutyrate, acetoacetate, and acetone. Beta-hydroxybutyrate and acetoacetate are the most abundant ketones[3]. Acetone is produced in much smaller quantities, making up just a small proportion of the total ketone levels. While beta-hydroxybutyrate and acetoacetate are transported through the blood to provide energy to other parts of the body, acetone is not. Instead, it is exhaled through the lungs, which is why individuals on the ketogenic diet may have a characteristic smell to their breath.

Measuring Ketones:

When the body is in ketosis, ketones can be detected in the blood, urine and even in the breath.

Health care providers typically measure a patient’s ketone levels using blood or urine tests. Blood tests measure the blood levels of beta-hydroxybutyrate specifically. Urine tests, on the other hand, measure the levels of acetoacetate primarily. Although blood tests are generally viewed as more reliable measures of ketosis, urine testing is more practical for caregivers. Health care providers may use blood tests to evaluate ketone levels during diet initiation and at follow-up appointments but most families will measure ketones at home using urine test strips. Ketones can also be measured in the breath, although this is not a commonly used method [4, 5]. Breath testing of ketones specifically measures the level of acetone exhaled.

The Role of Ketones in Seizure Control

Because ketones can pass through the blood-brain-barrier, they are able to enter the brain to provide fuel[1]. There are many theories about how the ketogenic diet works to reduce seizures. One theory is that the ketones have an antiepileptic effect on the brain. However, we still don’t know exactly what role ketones play. Although ketone levels are good indicators that the body is in ketosis, the level of ketones do not always correlate with the degree of seizure control[6]. In other words, some individuals may have high levels of ketones but poor seizure control while others have low ketones but good seizure control. Because of this, some researchers believe that ketone levels may just be a sign that the body is in ketosis and that perhaps there is some other factor associated with ketosis that is responsible for the effect on seizures.

Thanks for reading today’s post on ketones. I hope that I answered your questions but if not, feel free to ask questions in the comment section below. We’ll see you next week!

-Mallory

  1. Kossoff, E.H., et al., Ketogenic Diets: Treatments for Epilepsies and Other Disorders. Fifth ed. 2011, New York, NY: Demos Medical Publishing.
  2. Nelson, D.L. and M.M. Cox, Lehninger Principles of Biochemistry. Third ed. 2000, United States of America: Worth Publishers.
  3. Qiao, Y., et al., Breath ketone testing: a new biomarker for diagnosis and therapeutic monitoring of diabetic ketosis. Biomed Res Int, 2014. 2014: p. 869186.
  4. Musa-Veloso, K., S.S. Likhodii, and S.C. Cunnane, Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. Am J Clin Nutr, 2002. 76(1): p. 65-70.
  5. Musa-Veloso, K., et al., Breath acetone predicts plasma ketone bodies in children with epilepsy on a ketogenic diet. Nutrition, 2006. 22(1): p. 1-8.
  6. Danial, N.N., et al., How does the ketogenic diet work? Four potential mechanisms. J Child Neurol, 2013. 28(8): p. 1027-33.

Medium Chain Triglcyerides (MCTs) and the Ketogenic Diet

coconutoilIf you are new to the ketogenic diet, you may be wondering about the term “MCT” you keep hearing about. MCT stands for medium chain triglyceride. Some of you may already be using MCTs, but perhaps you are wondering what makes them different from regular fats and oils. In today’s post, we’ll teach you all about MCTs, what makes them unique, and how they are sometimes used with the ketogenic diet for epilepsy.

Dietary Fat

To understand MCTs, it helps to know a little about dietary fat in general.  Dietary fat is made up of fatty acids, often referred to as the “building blocks” of fat. Fatty acids can classified as short, medium, or long-chain, depending on their length.

Most of the fat in the foods we eat is in the form of triglycerides, which are made up of 3 fatty acids. A triglyceride can be classified as short, medium, or long-chain depending on the length of the fatty acids that it contains. A long chain triglyceride (LCT) contains 3 long chain fatty acids, a medium chain triglyceride (MCT) contains 3 medium chain fatty acids and a short chain triglyceride (SCT) contains 3 short chain fatty acids.

How the Body Processes MCTs

Now that you understand the structure of dietary fat, let’s move on to the differences in how the body processes MCTs in comparison to LCTs.

  1. Digestion & Absorption: Because of their shorter length, MCTs are more easily digested and absorbed in the gastrointestinal tract than LCTs.
  2. Transportation: Once dietary fat is absorbed by the gastrointestinal tract, the body must then transport it to the liver where it is metabolized to produce energy. MCTs are transported directly from the gastrointestinal tract through the bloodstream to the liver.  In comparison, LCTs must take a longer route through the lymphatic system then through the circulatory system before finally reaching the the liver. The analogy I like to use is that LCTs and MCTs have the same origin (GI tract) and destination (liver) but LCTs take the longer, slower scenic route and MCTs take the expressway.
  3. Metabolism: In addition to the differences described above, the metabolism of MCTs is unique as well. Fat metabolism occurs in the mitochondria of the liver. LCTs require a substance called carnitine to enter the mitochondria, however MCTs can enter mitochondria freely so they are not limited by the presence of carnitine.

How Is MCT Used with the Ketogenic Diet?Liquigen

Remember that the ketogenic diet works by switching the body’s metabolism from using glucose for energy to using fat for energy, which produces high amounts of ketones in the body. The unique features of MCTs make it useful with the ketogenic diet because MCTs are capable of producing more ketones than regular fat (which is mostly LCT). Although a small number of foods contain a percentage of MCTs (such as coconut oil, palm kernel oil, and butter fat), pure MCT oil is not found naturally. However, there are specially-produced MCT oils available, such as Liquigen®.

The MCT Ketogenic Diet (MCTKD) was first introduced in the 1970s. This diet is a variation of the Classical Ketogenic Diet and is based on the percentage of calories coming from MCTs (usually between 30-60%), rather than a ketogenic ratio. The idea is that because MCTs produce more ketones than regular fat (which consists of mostly LCTs), incorporating high amounts of MCTs into the diet allows patients to stay in ketosis while consuming relatively higher amounts of protein and carbohydrates. This makes the MCTKD appealing to individuals who might have trouble complying with the protein and carbohydrate restrictions of the Classical Ketogenic Diet.

High amounts of MCTs can cause gastrointestinal disturbances in some individuals, such as vomiting or diarrhea, so the amount of MCTs that can be used depends on each patient’s tolerance. When used, the ketogenic dietitian will usually recommend introducing MCT oil gradually to help ensure tolerance. Like the Classical Ketogenic Diet, the MCTKD is initiated in the hospital under medical supervision and all foods must be weighed using a gram scale.

The MCTKD is frequently used in Europe and Canada. Although the MCTKD is less common in the U.S., MCT oil is often incorporated into the Classical Ketogenic Diet and Modified Atkins Diet. MCT oil may be added to the diet to help boost ketone production or to help maintain ketosis with a lower ketogenic ratio with more protein and carbohydrates allowed.

As always, consult with your health care provider before introducing MCT oil or any other new item into your child’s ketogenic diet.

Do you use MCTs? If so, how do you use them?

-Mallory

 

 

Photo attribution: Flickr user Mattie Hagedorn

Halloween on the ketogenic diet

Celebrating Halloween on the Ketogenic Diet

Children in halloween costumesHolidays and special occasions often include food and treats. When on a ketogenic diet, it can be tricky to participate in the celebration since foods are limited. For today’s blog post, I compiled some tips and recipe ideas to help you to ensure that your little one has a happy and keto-friendly Halloween.

School Parties:

If your child’s school is celebrating Halloween, be sure to remind your child’s teacher(s) of food restrictions. If there is a class party and candy will be involved, you may want to send some keto-friendly treats (see recipes below) or non-food treats (like Halloween-themed stickers, pencils, temporary tattoos, etc.) for your child to enjoy.

Trick-or-Treating:

As you might expect, commercial candy is off limits for children on the ketogenic diet. Even low sugar or sugar-free candies will contain far too many carbohydrates. However, there is more to trick-or-treating than the candy, so many families allow their child to trick-or-treat without actually eating the candy that they collect. The Epilepsy Foundation recently posted an article about celebrating Halloween on the ketogenic diet and interviewed two keto moms about how they manage. One mom said that her son enjoyed trick-or-treating, then giving away the candy he collected to other trick-or-treaters in the neighborhood. Another mom said that her son likes to bring home the candy he collects to his sister or take it to school to share with his classmates. Another idea is to let your child trade the candy he or she collects for special keto treats, non-food Halloween treats, coins, or even a small toy.

Recipe Ideas for Keto Halloween Treats:

As always, consult with your child’s health care professional to ensure that these recipe ideas are appropriate for your child’s ketogenic ratio and calorie requirements. If needed, your dietitian may be able to help you modify these recipes to reach a different ketogenic ratio.

You can prepare these treats ahead of time, then store them in little Halloween-themed treat bags (for example, these that I found at my local party store) that you can send to school or put in their trick-or-treating bag.

The following recipes are less transportable, but might be a tasty treat to enjoy at home on Halloween.

Read more tips for celebrating Halloween on the ketogenic diet from the Epilepsy Foundation.

How does your family celebrate Halloween on the ketogenic diet? Please share your experiences and tips for other families in the comment section below.

Have a safe and happy Halloween everyone!

-Mallory

Recipe: KetoCal Pumpkin Spice Shake

yogurt with spiced pumpkin puree

In case there was any doubt, the surplus of pumpkin-flavored foods confirms that it is officially fall. Like many, I look forward to pumpkin lattes, pumpkin cheesecakes, and anything else pumpkin all year long. I decided that we needed to come up with a pumpkin KetoCal recipe, so I set out to create one. I must say that this delicious KetoCal Pumpkin Spice Shake exceeded my expectations. I hope that your keto kids enjoy it as much as I did!

-Mallory

As always, consult with your health care provider to ensure that this recipe idea is appropriate for your child’s diet and calorie requirements. The instructions for preparing this recipe at a 4:1 and 3:1 ketogenic ratio are provided, along with the instructions for preparing this recipe for the Modified Atkins Diet. Be sure to use the appropriate version for your child. If your child is on a different ratio, your dietitian may be able to help you adjust it by changing the amount of oil used. Note that the nutrition values were calculated using KetoCalculator, so if you are in another country or using a different system, the recipe may need to be adjusted.

Ingredients:

4:1 Version:

  • 120 g Vanilla KetoCal 4:1 LQ (you could also use Unflavored KetoCal LQ but you may want to add a carbohydrate-free sweetener if you do)
  • 15 g pumpkin, canned, unsweetened
  • 1 g ground cinnamon or unsweetened pumpkin pie spice
  • 5 g canola oil

3:1 Version:

  • 120 g Vanilla KetoCal 4:1 LQ (you could also use Unflavored KetoCal LQ but you may want to add a carbohydrate-free sweetener if you do)
  • 15 g pumpkin, canned, unsweetened
  • 1 g ground cinnamon or unsweetened pumpkin pie spice

MAD Version:

  • 1/2 cup (120 mL) Vanilla KetoCal 4:1 LQ (you could also use Unflavored KetoCal LQ but you may want to add a carbohydrate-free sweetener if you do)
  • 1 tablespoon pumpkin, canned, unsweetened
  • 1/2 teaspoon ground cinnamon or unsweetened pumpkin pie spice

Directions:

  • Add ingredients to a blender and blend until smooth.
  • Once prepared, serve immediately or store in a refrigerator for up to 24 hours.

Serving ideas:

  • Blend with ice for a cold treat!
  • Serve warm for a comforting treat on a cold day!
  • Freeze into pumpkin spice popsicles or ice cream!

Nutrition Information:

4:1 Version:

Ratio: 4:1
Calories: 228
Fat: 22.8 g
Protein: 3.9 g
Carbohydrate: 1.8 g

3:1 and MAD Versions:

Ratio: 3.1:1
Calories: 183
Fat: 17.8 g
Protein: 3.9 g
Carbohydrate: 1.8 g

The Liverpool waterfront
Gallery

Summary of the 2014 Global Symposium for Ketogenic Dietary Therapies

We’ve just returned from Liverpool, England where we attended the 4th Global Symposium for Ketogenic Dietary Therapies for Epilepsy and Other Neurological Disorders, hosted by Matthew’s Friends. Our brains are full of new and exciting information, so for this week’s blog post, I thought I’d share an overview of the conference with you.

As mentioned, this year’s Global Symposium was held in Liverpool, UK and hosted by Matthew’s Friends. For those of you not familiar with Matthew’s Friends, it is a charity based in England dedicated to spreading awareness and providing access to the ketogenic diet. It was started by Emma Williams, mom to Matthew, whose seizures and quality of life improved on the ketogenic diet. The mission of Matthew’s Friends is very similar to that of the Charlie Foundation here in the US, and the two groups often work together (The Charlie Foundation hosted the last Global Symposium, held in Chicago in 2012).

The Global Symposium consisted of 4 days of presentations for health care professionals, followed by a family day for families of children on the ketogenic diet, some adult patients on the ketogenic diet, and some individuals who are just interested in learning more about it. There were 5 of us from the US KetoCal team who attended the symposium, in addition to our KetoCal colleagues from the UK, Germany, Netherlands, and Spain. KetoCal had a booth in the exhibitor’s hall and as always, Chef Neil wowed visitors with his KetoCal recipe creations. We were excited to see our fellow US buddies from the Glut-1 Deficiency Foundation in the booth right across from us!

Day 1:

The conference kicked off on Tuesday with a dietitian’s meeting in the morning, followed by the opening sessions for the professional program in the afternoon. After the close of the sessions, Matthew’s Friends hosted a Welcome Reception where everyone could catch up with old friends and meet new members of the global keto family.

Matthew’s Friends created awesome video overviews of each day of the conference. Here is the video of Day 1.

Day 2:

Wednesday morning covered utilization of the ketogenic diet for specific epilepsy syndromes, including Dravet Syndrome, Doose Syndrome, Infantile Spasms, Status Epilepticus, FIRES, Angelman Syndrome, and Tuberous Sclerosis. In the afternoon, we heard presentations about the possible “mechanisms of action” of the ketogenic diet (or for those of us who are not doctors, we learned a little about how and why the diet is thought to work). That evening, we got to visit the Museum of Liverpool for the poster session. This was one of my favorite parts of the conference- Researchers from all over the world displayed posters presenting their brand new research on the ketogenic diet.

Watch the Matthew’s Friends’ video summary of Day 2 here.

Day 3:

On Day 3, researchers discussed secondary effects of the ketogenic diet, such as the diet’s effects on cognition, learning, behaviors, and bone health. Dr. Kossoff, who some of you may know from the Ketogenic Diet Center at Johns Hopkins University, talked about the long term use of the ketogenic diet. Next, a group of ketogenic dietitians talked about the clinical implementation of the ketogenic diet. The afternoon sessions focused on “optimizing utilization” of the diet. The presenters talked about utilizing the diet in specific age groups, including infants and adults, and in specific situations, such as for patients in status epilepticus. Emma Williams presented on ways to better support families and prepare them for managing their child’s ketogenic diet. That night, we had the privilege of attending the Matthew’s Friends Charity 10th Anniversary Gala Dinner. We enjoyed some great food and an awesome Beatle’s cover band (when in Liverpool!).

View the video summary of Day 3 here.

Day 4:

We started Day 4 of the professional conference with presentations on using the ketogenic diet across different cultures and settings. Next, we learned about the ketogenic diet for patients with mitochondrial disease and specific metabolic conditions, including pyruvate dehydrogenase deficiency and Glut-1 Deficiency. In the afternoon sessions, we learned about research being done on the ketogenic diet for cancer, a new and exciting topic for the ketogenic diet community. We ended the day with discussions about the future of the ketogenic diet and the announcement of the 2016 Global Symposium, which will be held in Banff, Canada!

Watch the Day 4 video summary here.

Family Day:

Family Day is always my favorite part of the Global Symposium. It’s exciting to meet families and learn about their ketogenic diet stories. In the morning, presenters gave families an overview of the presentations from the professional sessions. In the afternoon, we broke up into workshops for specific areas of interest. Between sessions, Chef Neil made some amazing KetoCal recipe creations for families to try, including some popular British foods, Scotch Eggs and Yorkshire Pudding! The UK KetoCal team launched some new KetoCal recipe books. There’s one for a 4:1 ratio, 3:1 ratio, Modified Atkins Diet, and MCT Ketogenic Diet.  Families got to take one home and they were a huge hit. We are in the process of putting some US versions of the recipe books together so keep an eye out for them in the next few months!

See the video summary of Family Day here.

Well done, Matthew’s Friends, on a very successful, informative, and fun Global Symposium. We are already looking forward to seeing everyone in Banff in 2016!

-Mallory

Below are some photos from the week.

The Modified Atkins Diet for Epilepsy

The Modified Atkins Diet: What is it, How does it compare to the classical ketogenic diet and when is it used

Since the Classical Ketogenic Diet was developed in the 1920’s, several variations have emerged, including the Modified Atkins Diet. If you are considering the ketogenic diet for epilepsy management for your child or yourself, you may have come across the “Modified Atkins Diet” and wondered what it is and how it’s different from the Classical Ketogenic Diet. In today’s blog post, KetoCal Medical Advisor and registered dietitian Ellen Sviland-Avery will explain.
ketochart3

Comparison of the Classical Ketogenic Diet, Modified Atkins Diet, and other variations

The Modified Atkins Diet (MAD) is a less-restrictive variation of the Classical Ketogenic Diet. Although it may not have quite the same success rates seen with the Classical Ketogenic Diet, MAD can be very helpful in managing seizures for some individuals. MAD is still a high fat/low carbohydrate diet but has some key differences from the classical diet.

Differences Between the Modified Atkins Diet and the Classical Ketogenic Diet:

  • Protein is not restricted
    The Classical Ketogenic Diet is designed to provide “adequate protein”, meaning that patients eat enough to sustain their body mass, but no extra. The Modified Atkins Diet does not restrict the amount of protein in the diet.
  • No gram scale required
    While the Classical Ketogenic Diet requires that foods be weighed on a gram scale, foods are measured using household measurements (like cups, tablespoons, etc.) on the Modified Atkins Diet.
  • Not designed according to the ketogenic ratio-
    As you may recall from our previous post on the ketogenic ratio, the Classical Ketogenic Diet is designed according to a ratio, usually 4:1 or 3:1 (grams of fat: carbohydrate + protein). The Modified Atkins Diet is not designed according to a ratio, but is simply based on limiting carbohydrates, usually to 10-20 grams/day. However, if you were to calculate the ketogenic ratio of a typical MAD, it would come out to about a 1:1 ratio.
  • Outpatient initiation
    While hospital admission is usually required when starting the Classical Ketogenic Diet, the Modified Atkins Diet is usually initiated in an outpatient setting.

Similarities Between the Modified Atkins Diet and the Classical Ketogenic Diet:

  • Carbohydrates are restricted-
    Like the Classical Ketogenic Diet, carbohydrates are restricted on the Modified Atkins Diet, usually to 10-20 grams/day. Hidden sources of carbohydrate must still be monitored to ensure that patients are not consuming more than the recommended amount. Label reading is a must for all OTC products as well. See the previous post on sources of hidden carbohydrates.
  • Fat consumption is encouraged-
    Fat consumption is encouraged on the Modified Atkins Diet. It can be difficult for patients on the MAD to get enough fat to remain in ketosis, so sometimes dietitians will recommend supplementing with KetoCal to boost daily fat intake.  A 2010 study found that consuming KetoCal daily helps to improve the efficacy of the Modified Atkins Diet.
  • Supplements are usually required-
    Although the Modified Atkins Diet is less restrictive than the Classical Ketogenic Diet, nutritional supplements are usually still required to ensure your child is meeting 100% of nutrition needs. Work with your dietitian to determine what, if any, supplements are necessary. All versions of the ketogenic diet can be deficient in vitamins and minerals, including Vitamin D, B vitamins and calcium, to name a few. This is one of many reasons why it is so important to only use the ketogenic diet and MAD under close medical supervision.

When is the Modified Atkins Diet Used?

The Modified Atkins Diet may be used to extend the use of dietary management of seizures to patients who are not candidates for the Classical Ketogenic Diet. Below are some examples of situations where the MAD might be used:

  • As a stepping stone to the Classical Ketogenic Diet-
    Families might use the Modified Atkins Diet in preparation for starting the traditional diet or as a trial to see if dietary management is likely to be helpful.
  • As a transition from the Classical Ketogenic Diet-
    Some patients may follow the Modified Atkins Diet when transitioning off of the Classical Ketogenic Diet. Some health care providers and families prefer to wean gradually from the Classical Ketogenic Diet, so they may switch to a MAD before coming off the ketogenic diet completely.
  • Families with limited time and resources-
    Some families may not be able to commit to the requirements of initiating and managing the Classical Ketogenic Diet, so the outpatient initiation and less restrictive nature of the Modified Atkins Diet may be more appropriate.
  • Older children, teenagers, and adults-
    Older children, teenagers, and adults may have trouble complying with the Classical Ketogenic Diet, so the Modified Atkins Diet may be easier for them to maintain. Also, because these patients have larger body masses, they may have trouble meeting their protein needs on the Classical Ketogenic Diet.

These are just some examples of when the Modified Atkins Diet might be used. If you are considering dietary management of epilepsy, you will work with your doctor and dietitian to determine whether the Classical Ketogenic Diet, Modified Atkins Diet, or another variation works best for you and your family.

-Ellen

Birthday Cakes for Children on the Ketogenic Diet: Part 2

How to Create an Awesome Pretend Birthday Cake for Your Tube-Fed Keto Kid

Last week, we talked about keto-friendly birthday cakes for children on the ketogenic diet. In today’s post, I’ll share some ideas for making non-food, pretend birthday cakes for keto kids who are tube-fed or exclusively formula-fed.

My younger sister, who has epilepsy, has been tube-fed for many years. However, up until a few years ago, she was able to eat some food by mouth and always enjoyed tasting her birthday cake. After she became strictly NPO due to swallowing problems, I worried she would be disappointed by a lack of a birthday cake so I made her this pretend pink and purple princess cake out of cardboard, felt paper, ribbon, tissue paper and glitter paint. I poked little holes in it and inserted candles for her to blow out (you could also use flameless candles for a more fire-safe option). Her favorite part of celebrating her birthday is everyone singing “happy birthday” to her (seriously, the amount of joy she gets from a single song is unparalleled) so she didn’t seem to miss eating cake at all. In fact, I think she loved the foodless cake even more because she could keep it and we could relight the candles and sing over and over again, all year long (she’s really confused about her age now).

To make the pretend cake, I cut two big circles (about 12 inch diameter) out of cardboard to be the top and bottom of the cake, along with one long thin piece of poster board that I wrapped in a circle and taped to be the middle of the cake (the diameter of this circle should be about the same as the two big circles you cut). I taped one of the big circles on top of the wrapped poster board and the other on the bottom.  Then I covered the whole thing with paper mache and let it dry overnight. After it was dry, I covered it with colored felt paper that I cut to match the size of the top of the cake and the sides. Last, I decorated it with different colored ribbon (wrapped around the sides to look like layers), glitter paint, fluff balls, and balled up white tissue paper to look like frosting. I used a glue gun to attach the decorations, but super glue would probably work fine if you don’t have one.

If you are crafty, you can find some awesome sewing patterns and craft tutorials for making more elaborate pretend birthday cakes. We’ve collected some of these on our Pinterest page. Some of the ideas require fairly advanced sewing skills but others are more basic.

Another idea is to make a birthday cake piñata (such as this one) and fill it with non-food treats like stickers, pencils, toy cars, necklaces, etc. You can use it as a pretend cake to sing happy birthday, then use it as a piñata afterwards. Alternatively, you could make a piñata-like box cake made of decorated boxes with gifts inside that your little one can “open”. Here is a great example shared by the FPIES Foundation: cake with gifts inside and cake with gift boxes opened (Note- FPIES is not related to epilepsy or the ketogenic diet but children with this condition also must follow very restricted diets).

If your child is really into a certain theme, you can make a themed pretend birthday cake. Party supply stores and grocery stores usually sell cake topper kits of popular kids’ interests and movies (I found some Frozen and Despicable Me 2-themed options in my local grocery). For a pretend cakes, you can just glue them on. You can choose colors for the pretend cake according to the theme you are doing, then glue the toppers on last.

If you are looking for a fun activity for the party, you could even let each child make their own pretend birthday cake. You could prepare basic white “cakes” out of boxes covered with white paper, then let the kids decorate it with paint, tissue paper, glitter, jewels, etc.

Like we talked about last week, food restrictions don’t have to keep you from throwing your child an awesome birthday party. Creating a fun foodless birthday cake is a great way to make your little one feel special and to celebrate another year and milestone.

-Mallory

Birthday Cakes for Children on the Ketogenic Diet: Part 1

How to Create a Ketogenic Birthday Cake That Your Keto Kid Will Love!

Birthday cakeBirthday cakes are so much more than just the ingredients that go into them. They are symbolic of accomplishment, milestones, and the gathering of loved ones to share a treat with the birthday girl or boy. Because of their significance, parents of children on a ketogenic diet may worry that their child will have to miss out on a birthday cake. Thankfully, that is not true!

Although a typical store-bought birthday cake is simply not an option for a child on the ketogenic diet, rest assured that there are ways to provide a tasty and keto-friendly birthday cake that your child will love. It may take some homework, trial & error, and creativity, so be sure to plan ahead. We’ve collected some ketogenic diet cake recipe ideas that you can choose from. You could use these recipes to make a regular cake or cupcakes. Cupcakes work especially well because you can make a special keto cupcake for the birthday boy or girl and non-keto cupcakes for the rest of the party guests.

Keep in mind that you may need to adjust the recipe to accommodate your child’s ketogenic ratio and calorie requirements, so ask your ketogenic dietitian for help. If the recipe that you want to use is for a 3:1 ketogenic ratio but your child needs a 4:1 ratio, your dietitian may be able to make it work by tweaking the recipe or by adding a side of heavy cream, Liquigen®, or another source of fat to raise the ratio. If you do end up adjusting the ratio, be sure to try out the recipe prior to the big day to make sure it comes out as expected.

Ketogenic Diet Birthday Cake & Frosting Recipes:

  • Chocolate Cupcake & Chocolate Cream Frosting: If your little one is a chocolate lover, our KetoCal® Chocolate Cupcake with Chocolate Cream Frosting Recipe is a great option! This recipe is for a 3:1 ratio but as mentioned above, your dietitian may be able to help you make it work by adjusting the recipe or serving it with an additional fat source.
  • Chocolate Cupcake: The Matthew’s Friend’s KetoCal Chocolate Muffin recipe can be converted to a cupcake by adding frosting (see frosting recipes ideas below). We have recipes for making it at a 3:1 or 4:1 ratio, along with a Modified Atkins Diet recipe.
  • Sprinkle Cake: Keto Cook has this amazing Sprinkle Birthday Cake recipe, a keto-version of the popular “Funfetti” cakes. This recipe is  for a 3:1 ratio, but again, your dietitian may be able to help you make it work.
  • Buttercream Frosting: The Charlie Foundation and Keto Cook collaborated on this awesome recipe for Buttercream Frosting, which can be used with the Sprinkle cake recipe or whichever recipe you are using. Best of all, they have instructions for making it at a 2:1, 3:1, or 4:1 ratio.
  • Whipped Cream Frosting: This recipe for Whipped Cream Frosting is another creation of Keto Cook and the Charlie Foundation. The great thing about this option is that the frosting is a 6.88:1 ratio, so it can be used to bring down the ratio of the cake if needed (ask your dietitian to help you come up with the exact amount required).

Cake Decorations:

Once you have decided on a recipe for the cake and frosting, you can move on to decorating and personalizing it. Party supply stores usually sell cake decorations with kid-friendly themes. You will want to select non-food decoration options (rather than edible decorations made of icing), such as themed baking cups, birthday candles, cupcake picks, figurines, etc. Once you select the theme, you can use keto-friendly food coloring to make matching colored frosting. 

As Dana explained in her recent parent guest blog post on making the ketogenic diet fun for kids, the key is to focus on what your child is interested in at the time. Her daughter wanted a Barbie cake, so Dana used her creative powers to create amazing keto Barbie cupcakes (pictured right). She used miniature Barbie figurines and keto-friendly food coloring to create Barbies with pink and purple cupcake bodices!

Normalcy:

I love that Dana made matching non-keto Barbie cupcakes for the other children so that her daughter didn’t feel like she was eating something different than everyone else.  Whenever possible, try to provide your child with keto-versions of the foods that everyone else eats because it helps them to feel normal. If you provide party guests with food (for example, pizza), you could make your child a keto version (for example, our 3:1, 4:1 or MAD keto pizza recipes) so that they feel included in the pizza party. Note- you can make the pizza ahead of time and freeze it so that you just have to warm it on the day of the party.

I am always amazed by the measures that parents take to provide a suitable birthday cake for their child. The moral of the story is that food restrictions don’t have to stop you from giving your little one a happy birthday. When it comes down to it, the cake itself is less important than the effort that goes into making your little one feel special on their day. With a little creativity, everyone can have a great time celebrating another year and milestone.

Thanks for reading Part 1 of my post on ketogenic diet birthday cakes. Next week I’ll post Part 2, which is on making non-food birthday cakes for keto kids who are tube-fed!

-Mallory

The Ketogenic Ratio Explained

If your child’s physician has recommended a ketogenic diet for epilepsy management, you likely have many questions, which may have led you to this post. As you collect information online and educate yourself on the topic, you may come across the term “ketogenic ratio” and wonder what it means. I’ll try to clear things up in today’s post.

Infographic by Lurie Childrens Hospital

The classical ketogenic diet for epilepsy is designed according to a ratio. This ratio, often referred to as the “ketogenic ratio”, represents the amount of fat in the diet, in comparison to the amount of protein plus carbohydrate. If you are a visual person like me, this infographic to the right, which was created by the awesome keto team at Lurie’s Children’s Hospital, will help explain the concept better.

If the last paragraph didn’t trigger long-forgotten memories of middle-school math class, the remaining paragraphs surely will. Don’t worry if math is not your thing- the fundamentals will come back to you quickly. Many keto parents will tell you that managing their child’s ketogenic diet revealed math and cooking skills they never knew they had! Also, keep in mind that the ketogenic dietitian who you work with will very carefully design and calculate your child’s diet, helping you to manage it at every step along the way, so you are by no means on your own.

The most commonly used ketogenic ratios are 4:1 and 3:1. A 4:1 ketogenic ratio describes a ketogenic diet that is made of 4 grams of fat for every 1 gram of protein plus carbohydrate. In other words, for every 5 grams of food consumed, there are 4 grams of fat and 1 gram of protein and/or carbohydrate. Therefore, a 4:1 ketogenic diet contains 80% fat (4÷5=80%) and 20% protein plus carbohydrate (1÷5=20%). Likewise, a 3:1 ketogenic diet contains 75% fat (3÷4=75%) and 25% protein plus carbohydrate (1÷4=25%).

Notice that the ketogenic ratio compares the amount of fat, protein, and carbohydrates in grams, a measure of weight. This is because the diet is calculated in grams, since foods are measured by weight using a gram scale.

If you compared fat, protein and carbohydrates according to the number of calories provided from each (rather than the number of grams of each), the ratio would be a little different because fat provides more calories per gram than protein and carbohydrates do. Each gram of fat provides the body with 9 calories, while each gram of protein or carbohydrate provides the body with 4 calories.

For example, let’s say that you need to consume 360 calories. To provide 360 calories from protein and/or carbohydrate (which both provide 4 calories per gram), you would need to eat 90 grams of protein and/or carbohydrate (360÷4=90). However, to get the same amount of calories from fat, you would need to eat just 40 grams of fat (360÷9=40). Fat provides the same number of calories with much less mass because it is more calorically dense than protein and carbohydrates.  For this reason, ketogenic meals tend to look smaller than standard meals, even when they provide the exact same amount of calories.

If a child is on a 4:1 ketogenic ratio, 90% of the calories in their diet comes from fat. Did I lose you there? This part confused me
at first because I thought “how can it be both 80% fat and 90% fat?”. The answer is that it is 80% fat if you are measuring by weight and 90% fat if you are measuring by calories.  Remember that a 4:1 ketogenic ratio represents 4 grams of fat for every 1 gram of carbohydrate plus protein. Four grams of fat (which provides 9 calories per gram) provides a total of 36 calories (4 x 9 = 36). One gram of protein or carbohydrate (which provides 4 calories per gram) provides a total of 4 calories (1 x 4 = 4). The ratio of calories from fat to calories from protein plus carbohydrate is 36:4. This means that for every 40 calories consumed, 36 come from fat and 4 come from protein and/or carbohydrate. Thus, 90% of the calories comes from fat (36÷40=90%), and 10% comes from protein and carbohydrate (4÷40=10%). On a 3:1 ketogenic diet, about 87% of the calories comes from fat, and 13% comes from protein plus carbohydrate. For comparison’s sake, a typical American diet contains about 35% of calories from fat and about 65% from protein and carbohydrate.

3-1typical

I hope that this post helped to explain the ketogenic ratio and the basic design of the ketogenic diet, but if you have any questions or need anything clarified, please comment and we’ll do our best to help!

-Mallory

 

 

Parent Guest Blog: Tips for Making the Ketogenic Diet Fun

We are delighted to welcome our very first guest blogger to KetoConnect. Dana is a mother of two adorable little girls, one of whom is on the ketogenic diet. We want to thank Dana for sharing her family’s keto story and for these wonderful tips for making the ketogenic diet fun for kids.

 

5 Tips for Making the Ketogenic Diet Fun

Two years ago, my daughter’s doctor recommended that we put her on the ketogenic diet as a way to help curb her uncontrolled seizures. As a busy mother of two, I felt overwhelmed at the possibility that I might have to add yet another thing to the laundry list of items that had consumed my life up to that point. I was scared that I would not be able to follow the diet as strictly as it required. I was worried that I would not have time to devote to it. Most of all, I was questioning whether it would work for my daughter.

Then we took the leap and put her on it. Within days, we noticed improvements in her behavior and her seizure control. She was having status seizures every 6 weeks, and was not yet potty trained (at nearly 4). After starting the diet, she was fully potty trained within a week and went 6 months without seizing. She also seemed happier. Now, she tends to seize only when overheated or very sick.

It took about 6 months before I started creating my own recipes. I eventually made it my mission to make her food that other kids would want. My goal is to cook meals that my daughter will not only like, but that she will be proud to eat. Here are my top 5 ways of making the ketogenic diet fun:

  1. Listen to your child– if they are able to verbalize what they want, then try to make it work. – One day my daughter said she wanted carrots and cucumbers. Up to that point, I had not yet created a recipe that included these items. I knew she liked hot dogs, so I made her a meal that included hot dogs, cream, oil, and a side of carrots and cucumbers.
  2. Keep their favorites handy – sometimes they want to eat the same meal all the time. –Back to the carrots and cucumbers. One day, I asked my daughter what she wanted for breakfast. Her response, “sausage, carrots and cucumbers.” I asked her again for lunch. Again, “sausage, carrots and cucumbers.” I think you know where I am going with this. Needless to say, I always keep hot dogs, sausage (each nitrate-free and filler-free), carrots, and cucumbers in the fridge.donut
  3. Be creative – you do not always have to follow recipes word-for-word. – I like to make my daughter the pizza from the keto cookbook, but I do not always like having to whip egg whites, so I bought several shapes of silicone molds. I simply add unwhipped egg whites to the mix and make her “pizza bread” or “pizza bagels”. It actually takes less time. – Another time, she asked for a donut. I did not have a recipe for donuts, but I had a recipe for pancakes. So I poured pancake batter into a donut mold, and voilà, she had a keto donut that she loved!
  4. Make them feel awesome – “Geez, I wish I could eat princess food.” – The fact of the matter is that, as parents we feel guilty about many things that are out of our control. We do not realize how food-based our culture is until we are presented with huge limitations. I was afraid that I would be depriving my daughter. No more Happy Meals. No more cookies and ice cream. She would be forced princess cupcakesto eat food that looked unappetizing and tasted bad. That does not have to be the case. It does not take that much more time to make their food look delicious. Keto-friendly food coloring and flavoring can make something simple look and smell divine. – For my daughter’s 5th Birthday, she wanted to have a Barbie cake. Well, I did some research and reached out to my keto-related support groups. I made it happen. Not only did I make her a Barbie “cupcake” but I also made her friends cakes that looked identical to hers.
  5. Not all accidents are bad – the frozen Ketocal story. – Sometimes my daughter loves a Ketocal shake and sometimes she does not. We use the Ketocal shakes a lot when we travel or when we do not have time to cook. We were visiting my mother and had to leave to attend an event. My mother thought she would just stick a Ketocal drink into the freezer to chill it. Well, she forgot about it until my daughter mentioned she was hungry. My mother pulled a very frozen Ketocal out and panicked. Then she thought, “Why don’t I serve it as ice cream?” And it was a huge hit. My daughter asks for it to this day. “I want my ice cream.”

So in the end, my suggestion to parents who are new to the diet is to take a deep breath. It can be overwhelming and daunting, but if the diet works, there are more benefits than drawbacks. It does not have to be expensive or overly time-consuming. You just have to focus on what your child is interested in at the time. Eventually you will find your groove.

-Dana

Top Five Kitchen Essentials for the Ketogenic Diet Chef

When a child goes on the ketogenic diet, his mom and dad become experts of many trades.  After a few months, parents will be math whizzes (measuring food to the tenth of a gram), they’ll learn to spot hidden carbs a mile away, and most impressively, they’ll become absolute magicians in the kitchen. Keto cooks quickly learn that there are some kitchen supplies that you simply can’t live without.

Although we’re not nearly as skilled as some keto parents we know, we do spend quite a bit of time creating and testing new KetoCal recipes, so we’ve come across some tools that we’ve found to be especially helpful. Below is our list of the top 5 kitchen essentials for the ketogenic diet chef.

1. Silicone spatulas:

Silicone spatulas, especially the mini ones, are perhaps our most cherished keto cooking utensils. They work great for getting every last drop out of a dish (which is critical in keto cooking).

2. Parchment paper:

We find that parchment paper is a must for the ketogenic baker. Use it to line baking pans and cookie sheets so that foods don’t stick to the pan. Another perk is that it saves time cleaning up! Note that parchment paper and wax paper are not the same thing- Parchment paper is oven-safe and wax paper is not (Yes, we learned that the hard way!).

3. Silicone bakeware:

Silicone bakeware is awesome for cooking keto recipes because it a) makes it super easy to remove food from the pan, b) keeps food from sticking to the pan and c) keeps all of the oil in the finished product. If you allow the food to cool before removing from the pan, the excess oil will absorb back into the food so you don’t have to worry about losing some of the fat.

4. Mini prep bowls (lots of them):

When preparing keto meals, you need small bowls to weigh each ingredient before combining them. Stocking up on mini prep bowlswill save you time because you won’t have to wash bowls in between weighing multiple ingredients.

5. Mini whisks:

We find these most helpful for recipes involving eggs. Usually the recipe will call for a given amount of eggs, raw, and well-mixed. To prepare this,  you crack an egg into a mini prep bowl (see above), mix it well, then measure the amount that you need for the recipe. The regular size whisk doesn’t fit into the mini bowl and we find that a fork just doesn’t mix quite as evenly. The mini whisk works great for this!

You can usually find these kitchen tools in kitchen supply stores or online department stores.

Keto parent chefs- Which kitchen tools can’t you live without? Please share your top 5 in the comment section below!

-Mallory & Ellen

Tube-Feeding and the Ketogenic Diet

feeding_tubes_bannerThe ketogenic diet can be much easier to manage when your child is tube-fed since the diet can be given with a special ketogenic formula. In addition, research suggests that an all-liquid ketogenic diet may even be more effective, perhaps because there is less room for errors with measuring foods[1].

Tube-feeding can be given in a variety of ways. Whether given via a bolus, syringe, or feeding pump, the ketogenic diet can easily be given with a feeding tube. Ideally, the feeding schedule should be similar to the way your child was previously fed, just with the new formula.

As usual, the ketogenic diet will be started in the hospital under close medical supervision. You will work with your doctor and dietitian to determine the appropriate ketogenic diet ratio and amount of formula you should give to your child daily. Oftentimes your child will be gradually transitioned from their previous formula to the new ketogenic formula over a period of a few days. While in the hospital for diet initiation, your ketogenic diet health care team will teach you everything you need to know about preparing, administering, and managing your child’s new ketogenic diet when you go home.

KetoCal is a nutritionally-complete ketogenic formula that can be used to provide the ketogenic diet for tube-fed children. It comes in a 3:1 or 4:1 ratio, and as a ready-to-feed liquid or easy-to-prepare powder. KetoCal is milk-based so it may not be appropriate for children who have milk protein allergies. However, your dietitian can put together a modular ketogenic tube-feed with a variety of ingredients that are safe for your child’s food allergies. The KetoCal 4:1 powder and KetoCal 4:1 LQ are both low in lactose, so they are usually okay for children with lactose intolerance.

Tips for Tube-Feeding KetoCal:

  • KetoCal LQ Unflavored is the ideal formula for tube-fed children because it is ready-to-feed. No need to mix! Just shake and administer the formula! In some cases, your child’s dietitian may recommend adding extra water or other ingredients to the formula, so be sure to follow these instructions carefully.
  • If your child is using the KetoCal powder, be sure to mix your formula per the instructions given by your child’s dietitian. For best results, be sure to mix with the correct temperature of water to allow the formula to dissolve fully. It is recommended to use water between 113-122 °F. For more information and tips on mixing KetoCal powder, check out our KetoCal mixing video on YouTube!
  • Once the powdered formula is mixed, store in a closed container in the refrigerator and use within 24 hours. Discard after 24 hours and mix a new batch. Be sure to mix or agitate the formula just prior to feeding since some settling may occur.
  • Once the KetoCal 4:1 LQ has been opened, it can be stored in a closed container in the refrigerator for up to 24 hours.
  • For both the KetoCal Powder and KetoCal LQ, the recommended hang time is 4 hours. The hang time refers to the amount of time the formula can safely remain at room temperature after preparation.
  • Some settling of Ketocal may occur in the feeding bag which is a normal feature of the product. This settling should not block the feeding tube, however, it is recommended that the tube is flushed with water between each feed. It may also help to occasionally agitate the feeding bag.

If you have any questions or concerns, contact your child’s health care team for assistance. For questions about KetoCal, you can also call our Nutrition Services support line at 1-800-365-7354, Option 2.

For assistance with getting insurance reimbursement for KetoCal, contact our Nutricia Product Coverage Navigator program.

-Ellen

[1] Kossoff EH, McGrogan JR, Freeman JM. Benefits of an all-liquid ketogenic diet. Epilepsia. 2004 Sep;45(9):1163.

 

Hidden Carbohydrates in Non-Food Products

Toothpaste can be a source of hidden carbs

Toothpaste can be a source of hidden carbs

When your child is on the ketogenic diet, you have to count and limit the carbohydrates (carbs) in everything consumed, not only in foods but also in non-food items. The term “hidden carbs” refers to carbs in products that are easily overlooked because you may not expect these products to contain carbs, or because carbs are listed on the ingredient list in unfamiliar names. Even a small amount of extra carbs can affect the ketogenic ratio, so it’s important to watch out for carbs that may be hiding in unexpected places. In today’s post, we’ll talk about some common non-food items that may be sources of hidden carbs.

Medications

Medications are often made with fillers that may contain carbs. When your child is started on the ketogenic diet, the neurologist and dietitian will assess the carb content in your child’s prescribed medications and switch to carb-free or lower-carb versions if possible. The ketogenic dietitian will account for any carbs coming from medications when calculating your little one’s total daily carb intake.

If your child needs a new medication while on the ketogenic diet (for example an antibiotic for a new ear infection or an antihistamine for seasonal allergies), be sure to contact the neurologist or ketogenic dietitian. If the medication contains carbs, they may be able to recommend a keto-friendly alternative, or if not, adjust the diet to account for the additional carbs coming from the new medication. This applies to situations where you are just switching brands of medications or switching from a brand to generic version and vice versa. Different brands and generic versions can have different ingredients and fillers, so never assume that one version is safe because the other was.

The Charlie Foundation provides a helpful list of Carb-free or Low-Carb products, including common over-the-counter medications, such as:

This list is a great guide for keto-friendly products but as always, consult with your health care team before introducing any new medications.

Personal Care Products:

It’s also important to look out for hidden carbs in personal care products because they may be absorbed through the skin. Be especially careful with dental care products, like toothpaste and mouthwash, as well as skin care products that are applied in large amounts, like sunscreen or body lotion.

Before using personal care products, check the ingredient lists closely to check for hidden carbs and consult with your health care team. Unfortunately, identifying carb sources on the ingredient list can be tricky since they are usually listed in unfamiliar names, like “glycerol” or “propylene glycol”. The Charlie Foundation provides this list of carbohydrate and non-carbohydrate ingredients, which is a great resource because it lists the names of carb sources as they might appear on the ingredient list.

Your health care team may be able to recommend certain brands or varieties of personal care products that are keto-friendly, along with varieties to avoid. The Charlie Foundation’s list of Carb-free or Low-Carb Products includes a broad collection of keto-friendly personal care products, such as:

Remember, if you are ever unsure if a product is keto safe or not, hold off on using it until you check with your health care team.

Keto parents- Have you ever discovered hidden carbs in an unexpected place? Please share your experiences and tips with other parents in the comment section!

-Mallory

 

Photo: Flickr

Back to School on the Ketogenic Diet: Part 3

ketoschoollunchFor the final post in our Back to School on the Ketogenic Diet Blog Series, we’ll talk about getting KetoCal through the National School Lunch Program. We’ll also share some school lunch recipe ideas incorporating KetoCal LQ. In case you missed them, be sure to read Part 1 on notifying the school about the ketogenic diet and Part 2 on packing the ketogenic diet lunchbox.

KetoCal and the National School Lunch Program

If your child attends a U.S. public school, you may be able to get KetoCal LQ provided by the school for the cost of the standard lunch meal. The Rehabilitation Act of 1973, the Individuals with Disabilities Education Act, as well as the regulations governing the National School Lunch Program (NSLP) stipulate that substitutions to the regular school meal must be made for children who are unable to eat school meals or have special dietary needs due to a qualified disability, such as epilepsy, when that need is certified by a licensed physician. Best of all, our Nutricia Product Coverage Navigator can guide you through the steps to request KetoCal from the school. For more information, visit our Epilepsy and the School Lunch Program webpage.

Quick & Easy KetoCal School Lunch Recipe Ideas

Speaking of KetoCal and school, we are excited to share some ketogenic school lunch recipe ideas that incorporate KetoCal LQ. If your child gets KetoCal LQ provided by the school, you can just send the additional ingredients to go along with it. We hope that your keto kids love the recipes and we hope they save you precious time in the morning!

As always, be sure to consult with your child’s health care provider about all meal ideas to ensure that they work for your child’s specific ketogenic ratio and calorie requirements.

Thanks for reading our Back to School on the Ketogenic Diet Blog Series. We hope everyone has a happy and healthy school year. We’d love to see photos of your little ones and their keto lunches on the first day back, so please share on our Facebook page!

Be sure to check back next week for our post on Common Sources of Hidden Carbs!

-KetoConnect Team

Back to School on the Ketogenic Diet: Part 2

Continuing with our “Back to School on the Ketogenic Diet” blog series (see Part 1), today we’ll provide some tips and meal ideas to help you pack a school lunch that your keto kid will love.

Packing the Ketogenic Lunchbox

Many parents face a daily cLunch bagshallenge when it comes to packing their child’s lunch box. It can be difficult to come up with lunch ideas that are transportable, nutritious, and that your child will actually eat. When your child is on a ketogenic diet for epilepsy, this task is even more daunting. Not only does the meal need to be carefully weighed and prepared, but oftentimes your child must eat the entire meal to maintain the ketogenic ratio. This is challenging enough at home but it can be even more difficult in the school cafeteria when you aren’t there to supervise. We’ve put together some tips and ideas to help you come up with keto-friendly school lunches that your child will enjoy.

Before school starts, ask your child’s dietitian to help you come up with some transportable meals that can be sent along to school. Find out from the school whether there is access to a refrigerator or a microwave since this will determine the types of meals that will work.

Presentation is Key

Because the ketogenic diet is high in fat and fat is denser in calories than carbohydrates and protein, ketogenic diet meals appear smaller than regular meals even though they provide the same amount of calories. Many parents find that small, fun food containers help to make ketogenic meals look more appealing and kid-friendly. Bento boxes are very popular right now and are perfect for packing keto school lunches. If you’re not familiar with them, bento-style food boxes have multiple compartments to hold small amounts of different foods that can be packaged in clever, kid-friendly ways. You can find Bento-style and other kid-friendly food containers at major department stores, kitchen goods stores, or online.

  • Meal Inspirations:

If you are looking for some lunchbox inspiration, check out these creative Bento school lunch ideas on Pinterest. Once you get some ideas, you can work with your child’s dietitian to make keto-friendly versions of Bento meals by substituting the ingredients in the compartments with low-carb, high fat foods like olives, pepperoni, or macadamia nuts.

  • Accessories

If the Bento-style boxes weren’t cute enough, there are additional accessories to make meals even more kid-friendly. For example, there are these adorable Bento food picks to hold foods together and Bento forks to send in place of utensils (keep in mind these could be a choking hazard for very young children). Then there is my personal favorite accessory, the Bento vegetable cutter. You can use these to cut low-carb vegetables (such as cucumbers or zucchini) into fun shapes that can be eaten with mayonnaise or other high-fat keto dips.

Mind the Ratio

For younger kids, it may be a good idea to send meals that have a consistent ratio regardless of how much is eaten since you can’t be there to ensure your little one eats the entire meal. For example, tuna salad that has all ingredients combined vs. a hot dog with a side of mayonnaise that must be eaten in entirety. With combined meals, you don’t have to worry that the ketogenic ratio will be off if your child doesn’t finish it all.

KetoCal LQ can be very handy for school lunches since it is ready-to-drink, nutritionally complete, and has a 4:1 ratio regardless of whether your little one takes a sip or drinks the whole box. Plus, if your child gets distracted by all the commotion in the school cafeteria, it may actually be easier for him or her to drink a meal at lunchtime. Kids love the KetoCal drink boxes since they look like the juice boxes all the other kids are drinking. Consider keeping a few boxes of KetoCal LQ at school as a back-up lunch in case the one you pack is left on the school bus or accidentally spilled on the cafeteria floor.

As always, be sure to consult with your child’s health care provider about all meal ideas to ensure that they work for your child’s specific ketogenic ratio and calorie requirements.

For those of you who have already mastered the art of packing your child’s ketogenic diet lunchbox, which meals are your child’s favorites? What tips would you offer other parents who are new to this?

-Mallory

For more information on this topic, read Part 1 and Part 3 of the Back to School on the Ketogenic Diet series.

 

Photo: Flickr

Back to School on the Ketogenic Diet: Part 1

It’s hard to believe that summer is almost over. If your child started the ketogenic diet over the summer, you might be anxious about the thought of sending your little one back to school. Today’s post, “Informing the School About Your Child’s Ketogenic Diet” is Part 1 of the “Back to School on the Ketogenic Diet” blog series. This series will provide tips and resources to help make the transition back to school go smoothly.

Informiback to school busng the School About Your Child’s Ketogenic Diet

First, be sure to let the school know about your child’s ketogenic diet before school starts. If possible, arrange a meeting with your child’s teacher and everyone else that may care for him or her to educate them about the diet and how to manage it at school.

If your child has an Individualized Education Program (IEP), request an IEP review meeting so that accommodations associated with the diet can be added. Prior to the meeting, have your child’s physician provide a letter explaining the ketogenic diet and the requirements during school hours.  Here is a helpful example letter, developed by the authors of Keto Cook, which your child’s neurologist can fill out for the school.

If there have been any changes to your child’s epilepsy medications, be sure to notify the school about these as well. Consider providing an updated Seizure Action Plan to reflect these changes.

Lastly, there are many celebrations at school that involve food so make sure that your child’s teachers and aides understand that your child cannot have the same treats that the other children get.  Ask them to let you know when celebrations are planned so that you can send a ketogenic diet treat for your child to enjoy. You might consider leaving a shelf-stable keto snack, such as a box of KetoCal LQ, at school just in case of an unexpected celebration.

Stay tuned for next week’s post where we’ll continue the “Back to School on the Ketogenic Diet” series with some tips on packing the ketogenic diet lunchbox!

If you have already mastered sending your little one to school on the ketogenic diet, what advice would you offer other parents?

-Mallory

For more tips & resources on this topic, read Part 2 and Part 3 of the Back to School on the Ketogenic Diet Series.

Photo: Flickr

Big News: We Have a Blog!

BlogWe are so excited to announce our blog, KetoConnect, an online resource for parents of children on the ketogenic diet for epilepsy. The purpose of KetoConnect is to keep keto moms and dads informed of the latest news and events, while sharing useful tips, recipe ideas and resources to support you in managing your child’s ketogenic diet. We hope KetoConnect will provide support for parents at various stages of their child’s ketogenic diet journey, from the time they start considering  and researching it, to the time their child is weaned off of the diet.

KetoConnect is written by a team from Nutricia North America, the makers of KetoCal®, so we will provide parents with useful information, tips and recipe ideas related to KetoCal. However, the goal of the blog is to provide support for the ketogenic diet in general so our posts will cover a broad range of topics. We’ll even have parents and health care providers as guest bloggers to provide a variety of perspectives. Please let us know if you are interested in contributing!

Starting next Tuesday, look out for our weekly blog posts. We hope you’ll join the conversation and welcome your questions, comments, topic suggestions, and feedback!

-The KetoConnect Team

Photo: Flickr user xioubin low