Before you Begin…
/By: Keto Mom Melanie
I used to think I knew about the ketogenic diet. I focused on not eating carbs and finding fat bomb recipes. Then Dravet Syndrome, a type of genetic epilepsy that begins in early life characterized by temperature-sensitive/febrile seizures and often treatment resistant, entered the picture. I realized I had only dipped my toes into the shallow end. My husband, Joe, introduced me to the ketogenic diet with a version he follows for weight management. He adopted a ketogenic lifestyle over 10 years ago but before embarking on his lifestyle change, he did some digging. After learning about the history of the ketogenic diet, it was important for him to understand the mechanism of the diet. He discovered that a more precise version of the ketogenic diet is used to help control seizures, particularly in people with drug resistant epilepsy. Joe is the reason we advocated for Ketogenic Diet Therapy, or KDT, for our daughter. As I dove in, it hit me-this should be documented! So here I am... My daughter, Rosie, started KDT in September 2021. We waited 3 months for the appointment. I was at an advantage because Rosie had just started eating and was transitioning off formula. That weighed heavily on me. I tried to wrap my head around what it would be like going into KDT without any of the information I had already learned about ketogenic diets. Or trying to convince a toddler that their diet had to change overnight. That just seemed so unfair. So, before you start using all the math you thought you would never need, I have put together some modifications you might consider before your KDT appointment.
Switch from dairy milk to unsweetened coconut, almond, or other nut-based milk. If your child is not loving the taste, try a few brands because there seems to be a significant taste difference between brands. Also, consider that unsweetened vanilla flavors are often allowed on ketogenic diets. If after trying different brands, your child still does not like the taste, try adding a pump of sugar-free flavor syrup (I have found the sugar-free syrups at TJ Max for under $5) and/or a squirt of zero sugar whipped cream. With so many flavors, your child may find a few favorites. Coconut milk has more fat than almond milk and is around a 3:1 ratio depending on the brand, which means you do not have to add extra fat to be KDT compliant. However almond milk can easily be altered to be higher in fat by adding some heavy cream to it. Try adding 1 Tablespoon of heavy cream to 8 ounces of almond milk to increase the fat by about 5 grams and get you to a 4:1 ratio. Redi-Whip, Great Value, and Land O Lakes brands both have sugar-free versions.
Start making sandwiches on low-carb tortillas. Choose the option with the lowest net carbohydrates. I stock up when they are BOGO at the grocery store. La Banderita brand, street taco size, is an excellent option with 0 net carbs. Mission Tortilla Carb Balance, La Tortilla, and Lavash all offer low-carb options as well.
Select sugar-free versions of all beverages. This is important. You will want to know what your child will enjoy drinking. Hydration is a critical part of KDT. Minute Maid has 4 zero sugar flavors: fruit punch, mango passion, lemonade, and pink lemonade. Some other options are Mio flavoring drops, Powerade Zero, Propel Fitness Water, Hint Water, and ICE Sparkling water. Many carbohydrate-free beverages are available but always double-check the nutrition label to assure that it reads 0 grams of carbohydrate per serving. Please note that these products may be sweetened with artificial sweeteners such as sucralose, aspartame, and erythritol. Tolerance to these ingredients may vary so please use with caution and in moderation.
Add a few avocado slices at mealtime or snack time. Avocados are an amazing source of high-quality fat. I keep single-serve guacamole or plain mashed avocado on hand. It is easy for a grab-and-go snack, plus you can find frozen avocado chunks at some grocery stores which is a wonderful way to prevent food waste-we have all seen how quickly fresh avocados can go bad.
Substitute zucchini noodles, shirataki noodles, or spaghetti squash for pasta. If your kiddo loves pasta, as most kids do, the shirataki noodles are a good substitute. They work in everything from spaghetti with tomato sauce to macaroni and cheese. Rinse them off and toss them in a frying pan to “dry” them a bit.
Update your scrambled egg recipe by adding 2-3 tablespoons of zero carb-heavy cream per egg or cook them in 1-2 tablespoons of butter. Trust me, I know! It seems like a lot of fat because it is! Make sure the nutrition label shows 0 carbs, not <1. Trace amounts of carbs add up! Natural by Nature, Organic Valley, Clover, Sonoma, Stonyfield Organic, and Publix Heavy Whipping Cream (label below) are brands that are 0 carbs.
For snacks, be creative. Are cheese and crackers a go-to? Try swapping the cracker for cucumber slices. Are chips and pretzels a favorite? Introduce pork rinds. A great base for a dip is sour cream and mayo. Add in your fresh or dried herbs and you have a delicious KDT compliant treat.
My goal is to make this manageable for your family. When you slowly incorporate some of these modifications before your official start date, you will be much more ready to dive into Ketogenic Diet Therapy under the guidance of your medical team. Good luck!
