Keto Introduction

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Since the last few years, the popularity of the Keto diet has increased considerably. Often accompanied by intermittent fasting, this diet encourages the body to enter a metabolic state called ketosis, hence its name.  The ketogenic diet is a high fat diet that is low in carbohydreates, moderate proteins, and mimics the fasting state. This type of macronutrient consumption results in fats being converted into ketone bodies in the liver.  These ketone bodies are then utilized as the main energy source as opposed to gucose. The Ketogenic diet was first used in 1924 to treat epilepsy. The diet was used then for paediatric patients but lost its popularity due to the introduction of antiepileptic drugs.

This style of nutrition is focused on the macronutrient distribution, having very low levels of carbohydrates (usually <30 gr per day), a moderate amount of protein, and a high amount of fats.

The macronutrients are often divided into 60% fats, 30 to 35% protein, and 10% carbohydrates (or less).

Examples of food often consumed in the keto diet include eggs, bacon, butter, avocado, nuts, meat, cheese, oil, etc. In contrast, foods that are eliminated include rice, grains, potatoes, some types of fruits, sweets and some high carb vegetables.

Different types of ketogenic diets

Classic Ketogenic Diet

This is the strictest version of the diet.  More common for younger children with seizures who’ve been admitted to the hospital and under a doctors care.  The diet ratio is 4 parts fat for every 1 part of protein and net carbohydrates. This results into a diet of 90% fats, 6% protein, and 4% carbohydrates.  

Modified Ketogenic Diet

This diet has a lower ratio that allows for more carbohydrate consumption and less fats. This lower ratio has less side effects and higher compliance but diet efficacy can be reduced.  The ratio for this option is 82% fat, 12% protein, and 6% carbohydrates. 

MCT Oil Diet

This ketogenic diet includes the use of medium chain triglycerides (MCT).  MCT oil is absorbed fairly quickly and the individual on the keto diet can usually achieve a higher level of ketosis but at the same time allows for more carbohydrates in the diet.  This is our preferred ketogenic diet as it allows for consumption of more vegetables.  The ratio for this option is 73% fat, 10% protein, and 17% carbohydrates.  

Seizure-frequency reduction over 12 months on the ketogenic diet. From a prospective study of 150 children treated at Johns Hopkins Hospital.

Source: Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358-63.