A support blog for parents of children on the medical ketogenic diet for intractable epilepsy. KetoCal® is a medical food for the dietary management of intractable epilepsy and is intended for use under medical supervision. Talk to your healthcare provider to determine if KetoCal is right for you.
Medical ketogenic diet chef, Rachel Finn, came up with these
kid-friendly recipe ideas that your little ones will love. From chocolate
donuts to pizza bites, these are sure to please even the pickiest of eaters. As
always, talk with your child’s healthcare provider to determine if these
recipes are appropriate for your child.
KetoCal is a medical food for the dietary management of
intractable epilepsy and is intended for use under medical supervision. Talk
with your healthcare provider about whether KetoCal is right for you.
The classical medical ketogenic diet for the management of intractable epilepsy was created in the 1920s at the Mayo Clinic. It became popularized in the 1990s thanks to the launch of the Charlie Foundation and the release of the movie First Do No Harm. With the recent popularity of the keto diet for weight loss purposes, many people may wonder how it is different from themedical ketogenic diet that is used to manage intractable epilepsy. While both have the same basic premise: low carbohydrates and high fat, there are many distinctions. In today’s post, we’ll describe the key ways that the medical ketogenic diet for the management of epilepsy is different from the mainstream keto diet that is used for weight loss.
One major difference between the medical ketogenic diet and the keto diet for weight loss is that the medical ketogenic diet must be designed and monitored by a medical team, usually a neurologist and a ketogenic dietitian (a registered dietitian who is trained to manage medical ketogenic diets for epilepsy). Not only is the medical ketogenic diet typically initiated in the hospital, it is also monitored by the medical team on a regular basis to look out for side effects, to ensure nutritional needs are being met, and to assess the diet’s effect on seizure control.
One of the key differences between the medical ketogenic diet for epilepsy and the keto diet for weight loss is the way the diets are designed. The classical medical ketogenic diet is designed according to theketogenic ratio, that is, the ratio of the amount of fat (measured in grams) to the amount of combined carbohydrates and protein (also measured in grams). The exact amount of carbs, fat, and protein allowed on a classical medical ketogenic diet depends on:
The amount of protein required to sustain the patient’s specific goal body mass
Therefore, no two
patients on a medical ketogenic diet will have the exact same daily carb,
protein, and fat requirements. In comparison, the keto diet for weight loss typically
limits carbohydrates to a given amount or aims for a certain percentage of
calories coming from carbs, protein, and fats. If you were to compare the two
diets according to the number of daily carbs and protein allowed, the medical
ketogenic diet will typically be much lower in carbs and protein, and much
higher in fat. Note that there are less strict variations of the classical
medical ketogenic diet, such as the modified Atkins diet, but even these versions
of medical ketogenic diets will be much lower in carbs and higher in fat
compared to a keto diet for weight loss.
Another difference between the two diets is that the classical medical ketogenic diet restricts protein in addition to carbohydrates. As described above, the amount of protein allowed in the medical ketogenic diet depends on the patient’s goal body mass. In other words, they are allowed just enough protein to sustain their body’s muscle mass but no extra. A keto diet for weight loss typically focuses more on limiting carbohydrates, with less restriction to protein intake.
Unlike the keto diet for weight loss, the medical ketogenic diet for epilepsy is generally initiated in the hospital under close medical supervision. Because of the very strict limitation of carbohydrates and protein, the level of ketosis reached on the medical ketogenic diet is much higher compared to a keto diet for weight loss. Therefore, it is essential that a medical ketogenic diet is initiated under medical supervision.
To monitor for and treat potential side effects like low blood glucose or vomiting
To allow the medical team to make adjustments to the diet as needed
This hospital time
is also used to train the patient or their caregiver how to manage the diet
once they go home.
Precision of Food Measurement
Another difference between the two diets is the precision with how foods must be measured. On the classical medical ketogenic diet, all foods and drinks must be measured to the tenth of a gram using a gram scale. For example, a meal may call for 29.2 grams of chicken breast, 50.5 grams of mayonnaise, etc. Every single bite of the meal must be consumed to ensure that theketogenic ratio of the meal is accurate. With a keto diet for weight loss, foods can typically be measured with household measurements like cups, ounces, and tablespoons, and there is less concern about finishing the entire meal.
Sticking to the Diet
For patients following a medical ketogenic diet for epilepsy management, breaking the diet, even just a bite, can result in breakthrough seizures. Therefore, having a “cheat meal” or taking a week off for the holidays is simply not an option. Individuals following a keto diet for weight loss may lose weight-loss progress if they fall off the diet for a while, but the consequences are not so serious.
Accounting for Medications & Non-Food Products
With the medical ketogenic diet, the carbohydrate allowance is so specific that trace amounts of carbohydrates from medications need to be accounted for. Typically, when a patient starts the medical ketogenic diet, they are switched to variations of their anti-seizure medications with lower carb amounts (for example, switching from liquid form to tablet form). If there are still carbohydrates coming from medications, the carbohydrate allowance from foods will have to be adjusted to account for them. Oftentimes, the medical ketogenic diet team will recommend specific brands of self-care products that are lower or without carbohydrates (yes, the body can absorb trace amounts of carbs through the skin!). This may be especially important for items that go in the mouth (like toothpaste) or that are applied to large areas of the skin (like moisturizer or sunscreen). Individuals following a keto diet for weight loss generally don’t have to be this precise or careful about trace carbohydrates.
Length of Time
People who follow a keto diet for weight loss may follow the diet for a certain amount of time to lose weight or they may follow a keto lifestyle permanently as a method to maintain weight. On the other hand, patients on a medical ketogenic diet for epilepsy management will usually follow the diet for a specific period of time. In most cases, if a patient’s seizures are controlled on the medical ketogenic diet for 2 years, the medical team will recommend weaning off of the diet with the hope that they can come off the diet and maintain seizure control. However, with certain medical conditions, like Glut-1 Deficiency Syndrome, the medical ketogenic diet must be maintained for longer periods of time or even for life.
Hopefully this post gives you a better idea of what makes the medical ketogenic diet for epilepsy different from the more widespread keto diet used for weight loss purposes. For more information on the medical ketogenic diet for epilepsy, visit www.ketogenicdietforepilepsy.com.
This blog post is brought to you by Nutricia North America.
The medical ketogenic diet should be used under medical supervision.
My name is Rachel Finn, and I am a chef at a children’s hospital where I help create recipes for children following a medical ketogenic diet for the management of intractable epilepsy. Working with Nutricia North America, I created a new, versatile dough recipe, KetoCal® 2:1 Dough, and it has become the go-to keto dough for almost everything! It is made with the KetoCal® 3:1 Powder, which is unflavored and works nicely for a savory dough. I’ve used this dough as the base to create a variety of other keto-friendly recipes – check them out below! These recipes were shared at our most recent Keto University for professionals administering the ketogenic diet in the medical field, and they were a big hit!
Carbohydrate-heavy foods like pasta and fries are undoubtedly the basic foods patients understandably miss the most when being on the classic, modified ketogenic or modified Atkins diet. My new KetoCal Dough recipe is at a 2:1 ratio. It can be used for various dishes from pocket sandwiches, to faux French fries, to even pizza rolls that resemble what the rest of the family might be eating. If you’re a bit more adventurous, you can also use this dough recipe to create samosas with cilantro chutney, crab rangoons, or empanadas. Serve these recipes with high fat sauces or with a high fat drink on the side (such as KetoCal or heavy cream) to reach your needed ketogenic ratio. Ask your healthcare provider for help to modify these recipes to reach your specific requirements.
KetoCal 2:1 Dough is found as an ingredient in MyKetoPlanner. Using the dough as the base, you can individualize recipes to fit into specific ratios. The following recipes each use 40 grams of dough that will provide a large enough portion to work with and make a filling meal or snack.
Once made, KetoCal 2:1 Dough can be
stored for 24 hours wrapped in plastic in the refrigerator. You can also freeze these recipes if you
prefer to make your ketogenic meals ahead of time. However, for best results, making,
baking, then eating immediately is recommended.
Ingredients are weighed in grams for
consistent results. For each of these recipes, the dough is weighed (40 grams)
prior to baking.
Tools You Will
Parchment paper and a rolling pin
are essential tools for rolling this dough.
For small helping hands, a 1-inch dowel rod cut into 12-inch section is
easy to grasp and roll. Send us pictures
of your keto kids helping to create these recipes!
To download a PDF of these recipes for print, click here.
This KetoCal 2:1 Dough is
surprisingly easy to whip up! It
is versatile and can be used for many different ketogenic recipes. Be creative and let us know what dishes you
come up with!
Please be sure to individualize
recipes for your specific diet plan with the help of your healthcare provider.
I was paid by Nutricia
North America for my time to create this blog post, however, my opinions are my
KetoCal® is medical
food for the dietary management of intractable epilepsy and is intended for use
under medical supervision. Talk to your healthcare provider about whether
KetoCal is right for you.
*Hellmann’s® and Best
Foods® are registered trademarks of the Unilever Group of Companies. Kikkoman®
is a registered trademark of Kikkoman Corporation. Philadelphia® is a
registered trademark of Kraft Foods Group Brands LLC. Unilever, Kikkoman
Corporation, and Kraft Foods Brands LLC are not affiliated with Nutricia North
America and have not endorsed the proposed use of their products in this
recipe. Specific brand names are referenced to ensure consistent nutritional
composition necessary to maintain the medical ketogenic diet. KetoCal is a
registered trademark of SHS International Ltd.