Celebrating Thanksgiving on the Ketogenic Diet

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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

 

 

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Talking to Young Children about Epilepsy and the Medical Ketogenic Diet

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explaining epilepsy and ketogenic diet to young childrenWhen your child has seizures and is starting a medical 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. This post provides some tips and resources to help you explain epilepsy and the medical 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 many children’s books about special diets or epilepsy. Here are some that you might find useful:

Reassure Them That They Are Not Alone

Even at an early 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 medical 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 medical ketogenic diet to your child? What advice would you give to other parents in your shoes?

The medical ketogenic diet should be used under medical supervision.

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“What Are Ketones Anyways?”

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When your child is on the medical 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?”

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 medical 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.

  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.
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