Keto Super Stars: Meet Fuad

By: Keto Mom Tito

What was your main reason for pursuing the ketogenic diet?

Our son was diagnosed with periventricular grey matter heterotopia at the age of 2. A friend told us about the ketogenic diet for seizures and after doing some research, we decided to try it and see if it would work for him. At the age of 3, he was put on the Modified Atkins Diet (MAD) as it is more flexible than the “classic” ketogenic diet. We initially started with a carbohydrate restriction of 20 grams a day, but he is now on 50 grams of carbs a day and still maintaining good seizure control. We check his ketones every morning and before bed to assure he is in ketosis. 

What other treatments have you tried and stopped in the past?

Initially after his diagnosis, he was put on Keppra (levetiracetam) to help manage the seizures. Unfortunately, this medication led to irritability and fatigue. The seizures also got progressively worse over time increasing from monthly to every two weeks. We did not want to keep adding medications to manage his condition so seven months after his diagnosis and after trying and failing Keppra, the MAD was started. 

What are some of the difficulties you encounter with the ketogenic diet and how have you been overcoming them? 

In the beginning, finding recipes he would enjoy was very difficult. It was mostly a matter or trial and error. Also sticking to the extremely low level of carbs allowed daily was a challenge but over the years, we have been able to create multiple meals that are our go to while also trying to create new meals and snacks to try. Our go-to- meals include keto pancakes and turkey sausage, Two Good™ yogurt with berries, and fathead dough pizza crust which is made with cheese, cream cheese, egg and some type of low carb flour.  Kitchen staples in our lives include measuring spoons, cups, spatulas and lots of mixing bowls. 

What has been the best thing you have seen as a result of the ketogenic diet?

The seizures stopped right away, and he has not had a seizure episode for almost 3 years now. He is thriving and is back to being the curious, fun-loving boy dad and I love. 

What do you wish you had known at the beginning that you know now?

I have to say that the Ketogenic clinic team at University of Chicago Hospital is a godsend. The team was with us every step of the way from the beginning. My questions were always answered promptly and thoroughly. I cannot thank his dietitian Stephanie Schimpf enough, she made the whole process bearable for us because she was always there to encourage us, provide ideas with his meals and was there for us as needed. 

What is a piece of advice that you would give to families who are thinking about starting the diet or who have just started?

My advice for families who are thinking about it and those who have started would be to please give this diet a shot. It is very challenging, but the rewards are immeasurable. Our son has a chance at a great quality of life because of this diet.

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!

Keto Super Stars: Meet Charlotte

By: Ashley Oldaker (Keto Super Mom)

While we have just begun our Keto journey earlier this year, our journey to get here has been a little longer. Our daughter, Charlotte (5), had her first tonic-clonic seizure at 9 months old. We rushed her to the ER where they ran tests on her and everything came back fine. A few months later she had her second tonic-clonic seizure and we again took her into the ER. This time around we were referred to a pediatric neurologist at our Children’s Hospital, here she was diagnosed with generalized epilepsy.

We weren’t fully convinced it was just generalized epilepsy, we started to compare the two, thinking it was maybe tied to being sick/on medication or something to do with food. When we looked back at the first one, she was getting over croup, this time she was getting over an ear infection. We also realized both happened right before mealtimes. We thought we were onto something, but then a few months later she had her third tonic-clonic seizure. This time she wasn’t getting over an illness or on medication, however it was right before breakfast. We were convinced these seizures were tied to when/what she was eating. Since this seizure didn’t fully present itself like the other two, we decided it was time to put Charlotte on an anti-seizure medication, so at around 15 months old she was on Keppra with regular follow up appointments with her pediatric neurologist. 

The Keppra was working, we didn’t see any more tonic-clonic seizures, however Charlotte would have these odd episodes where she would say she was dizzy and was clearly out of it. We would give her a little juice or some fruit snacks, or she would take a 15 minute nap and she would perk up. We brought this up at each of our follow up appointments with her neurologist. We would either run more tests, or up her Keppra. After upping her Keppra, Charlotte would be good for a couple of weeks and then these dizzy spells would come back. During this time, we also noticed Charlotte was developmentally behind on her milestones. We were starting to wonder if she was just doing things on her own time/terms or if the medicine was causing issues. 

Throughout the years of regular pediatric appointments and routine follow ups with her neurologist we had MRI’s, EEG’s and bloodwork done. Each time, everything would come back normal. This was great news, but also frustrating to us because we knew something else was going on. She shouldn’t be having these dizzy spells as often as she was. During her routine follow up with her neurologist in November of 2021, we went back to the drawing board and started from the beginning. At this time, we decided to do some genetic testing. We were hopeful, but scared about the can of worms we could be opening with doing this testing. In December we got a call from her doctor, she had good news for us, we finally know why Charlotte is having seizures and her little episodes, and she was diagnosed with Glut1 Deficiency. 

Glut1 Deficiency is a rare genetic disorder that impairs brain metabolism. Essentially, Charlotte’s brain isn’t able to process glucose properly which prevents it from growing, developing and functioning as it should. With a diagnosis, we finally had answers, and we could get her on the right treatment plan. Currently, there is no cure for Glut1, however, a medically supervised Keto diet can help improve most symptoms. What is Glut1 Deficiency?

Right before Charlotte’s 5th birthday, we decided to start the Keto diet, under the guidance of her new Keto team, we started the diet from home and eased her into it. The first week, we swapped out one meal to be a keto meal. The second week, we did two meals as keto. The third week, all three meals were keto, but her snacks were still regular. Finally the fourth week we were full blown keto. To be honest, we were very overwhelmed and scared during this transition. We were worried she was going to want her usual snacks and meal options of chicken nuggets, goldfish crackers, yogurt, etc. We tried to explain to her the best that we could, that she would need to go on this special diet to help her brain and body grow and feel better, she wouldn’t be able to eat some things she used to anymore. At first it was a little bit of a struggle, but by the time we were full blown Keto, she was realizing she can still eat a lot of food she likes, but things have to be made special just for her. She thinks she is pretty cool because at school she has her own special tray with her own food. 

We are only on our fourth month of being on the ketogenic diet, but so far it seems to be working. We did have one trip to the ER during the transition, but other than that we have seen improvements with Charlotte. We aren’t getting calls weekly from school about her having dizzy episodes or seizures, she has more energy, and she is doing better in school. We are still pretty new to this, but it isn’t as overwhelming as it once was and I know as we continue on it will become second nature. Charlotte has been a rock star during this, she doesn’t ask for sugary treats, and knows she can’t just eat anything she wants. She loves to help me make her breakfast every morning (she will even correct me if I miss something), and enjoys making her snacks as well. Her little sister recently tried to give her a Cheerio and Charlotte told her “no thank you, I can’t have that, it isn’t on my diet.” It can be heartbreaking to hear your five year old say, “I’m on a diet,” since the word “diet” is traditionally thought of negatively, but it makes my momma heart proud. She is aware that the keto diet makes her body feel better and it is helping her not have seizures, and what other diet allows you to lick the butter clean off your plate? ;)

Keto Super Stars: Meet the Lewis Family

By: Laura Lewis (aka Super Mom)

In April of 2019, my daughter Stella was found unresponsive in her crib at the age of 2 years old. She was completely stiff. After an ambulance ride and an ER visit to the children's hospital, we were told that she had a febrile seizure. Months later, in August, September, and October it happened again. After the seizure in October, she was diagnosed with epilepsy and put on Keppra. Within 3 days she stopped being able to walk properly…this is where our journey began. Over the next 2 years we did every genetic test, MRIs, countless EEGs with no answer as to why Stella was having seizures. We tried 9 different medications and cannabidiol (CBD). Stella officially was diagnosed with intractable epilepsy. We asked 3 different neurologists about the ketogenic diet and were told that her situation was not severe enough and it would not help her, until we met Dr Koh. We began our keto journey in January of 2022.

What was your main reason for pursuing the ketogenic diet?

After 9 failed medications for various reasons (side effects, increased seizures, etc), we were told that Stella would be a candidate for the modified Atkins diet (MAD). We were referred to the ketogenic diet clinic at Children’s Healthcare of Atlanta (CHOA) and met with the physician and dieticians. 

What other treatments have you tried and stopped in the past?

Stella has been on the following medications in various combinations and dosages to attempt to control her seizures. 

• Keppra

• Trileptal

• Klonopin

• Zonegran

• Vimpat

• Depakote

• Cannabidiol (CBD) 

What is Stella’s ketogenic diet prescription?  

We aim for 150 grams of fat a day and no more than 35 grams of net carbs. Stella averages between 1500-2000 calories/day. 

What is a typical day of eating for Stella on her ketogenic diet plan? 

 She loves the Birch Bender Keto Toaster Waffles so she usually starts with those and some bacon. I also give her berries and add heavy whipping cream.  

Lunch can be her keto pizza, keto ratio yogurt with some MCT oil added in, cucumbers and mayo and then some berries. She loves fruit - it’s her favorite thing so I usually give her around 10 raspberries or blackberries. 

Dinner is usually whatever we eat with a lot of added butter, or I order from Factor 75 because they have keto meals and it’s so easy. Everything is grass fed, no preservatives, no refined sugar and she loves them. She 

What are some of Stella’s favorite ketogenic meals/foods? 

 Stella loves a keto pizza! I get the cauliflower pizza crusts from Trader Joe’s, put butter on it, add 2 tablespoons of Rao’s Marinara Sauce, loads of full-fat mozzarella cheese, pepperoni and bacon on it and bake it. It’s a total of 4 grams net carbs and she feels like she is eating pizza. 

She has always been a good eater and has always loved veggies and “dip” so I give her cucumbers with mayo and ranch seasoning. She loves that! Plus to make it easy I buy the Kirkland Signature Guacamole single serve cups and add 1 tbsp of solid butter to it. She eats it right up with a spoon. 

How often do you check ketones and what level of ketosis is Stella in on her ketogenic plan? 

Stella ranges anywhere between small/low ketones (mostly in the morning) to the large/high ketones later in the day. She mostly hovers around the moderate level. 

 We check ketones twice a day now. When we first started we checked a lot more frequently, but since she’s been consistently on the diet and in school, we have reduced the frequency of checks.

What are some of the difficulties you encounter with the ketogenic diet and how have you been overcoming them? 

The most difficult thing for us is that Stella has a little brother who is 2 years old and a super picky eater. She sometimes wants what he has or at school if someone has birthday treats, she wants to be able to have it. Ultimately, the biggest challenge is planning ahead and being prepared before the event arrives. Another challenge was focusing not just on lowering carbs but also dramatically increasing her fat intake. At first, I did not realize that the fat intake was the most important part. 

What has been the best thing you have seen as a result of the ketogenic diet?

After meeting with the doctor and dietitian at CHOA in January, we started the diet in mid-February. The biggest change we are now just starting to see is her cognitive awareness. I had read on many Facebook groups, and so many other places that the diet would change cognition immediately. This was not the case for us. It took us a good 8 weeks until we started to see a difference. Stella was always extremely active. She never wanted to sit down and now she seems a lot calmer and her sleep is better. 

What do you wish you had known at the beginning of your epilepsy journey that you know now?

In the beginning of this whole epilepsy journey, I wish I would have known to fight harder to try the ketogenic diet. I wish I would have challenged the doctor’s opinion and asked to be referred to the keto clinic instead of believing that it would never help. In the beginning of the diet therapy, you may see an increase in seizures but do not let this discourage you. Keep in mind that it’s important to tweak the diet for your specific person or child. There is no one size fits all!

What is a piece of advice that you would give to families who are thinking about starting the diet or who have just started?

GIVE THE DIET TIME TO WORK! Be prepared that you will be in the kitchen more often and you need to plan. My husband and I were always on the same page about starting her on the diet, but I do not think that we approached it realistically. We were looking for an immediate change and would get frustrated when that was not the case. While she is still seizing periodically, it has only happened while she has been sick, which is typical for epilepsy. 

It's not a one size fits all, some people need to be on a dose of medication and the diet, which for us is the case. She is on a minimal dose of medication, and we feel like we are getting our kiddo back. Give yourself grace while figuring it out. It is a huge adjustment and change of lifestyle so try to be patient and kind with yourself while going through it. If you're willing to give the meds with all the crazy side effects a good try, why not do something that is a more natural route. The effort is worth it. 

If you would like to be featured on our blog and/or social media, please reach out to us at info@ketohope.org! We are always looking for inspiring and amazing stories! 

If you would like to chat with the Lewis family for recipe ideas or support, please contact Laura at Laura.Lewis07@gmail.com or follow her on Instagram @lauralewis07.  Also check out our Family Support page to be paired with a knowledgeable and supportive parent on your ketogenic journey!

Keto Hiking Adventure

by Jen Westbrook

No granola bars? No oatmeal? No baked beans? How can any legitimate backpacker survive without these time-tested staples? With the right amount of preparation, patience, and determination – any hiking trip can become the MAD/Keto hiking adventure of a lifetime. In Spring of 2021, my family of 5, trail name The Wandering Westbrooks, hiked 275 Appalachian Trail miles over 6 weeks. And we maintained 35 grams of net carbs/day.

My son, Roman, had a stroke at birth which damaged his brain. He’s been defying the odds ever since with his

indominable spirit and clever mind. We were told he would not lift his head, talk, or be able to interact with

us on a meaningful level. He’s accomplished all of that, and much more! Living with Cerebral Palsy, Hemiparesis, and Epilepsy have proven challenging, but this family of mine is special. We are not known to sit and accept limitations. Here’s how we prepared and executed, what at first seemed impossible, but turned out to be a wonderful family experience full of exciting memories. (Sans granola bars.)

First, the appropriate food prep equipment. Our list includes the Gourmia 5 rack dehydrator, Ziploc bags of various sizes, Wallaby mylar food storage bags, Food Saver BPA free bags, Weston vacuum seal bags, oxidizer packets Food Saver heat sealer, Jetboil, and cardboard boxes (The trail traverses through towns from time to time. We took advantage of the opportunity and mailed ourselves food. We retrieved the boxes at a post office or hostel.)

Next, you need the correct food, in the correct volume. My boys are hungry. They’re adventuresome and full of energy. I knew providing them with enough calories whilst keeping Roman in ketosis would be challenging, but we were undaunted. We planned for 8 weeks on the trail (which was the outer limit of our available time). So, 5 people, 3 meals a day, and snacks for 8 weeks amounts to exactly a bazillion servings. 😊 This was the most tedious part of our preparation. Yes, we portioned out every meal (with all the seasoning), every snack, for every person.

What follows is our list of food (keep in mind all food was carried dehydrated, then rehydrated at mealtime with the exceptions of the bars and nuts/nutbutter pouches). This list includes only our food. I did not include our hiking and camping gear.

(On trail food list) chicken, broccoli, blueberries, strawberries, flax meal, hemp seeds, nutritional yeast,

Keto Cal 3:1, egg powder, heavy cream powder, PB Fit, MCT oil, Fat Bombs, extra virgin olive oil pouches,

Parm Crisp Snack Mix, mixed nuts, pumpkin seeds, beef, spinach, French beans, cheddar cheese, pepper jack cheese, sardines, salmon, anchovies, Good To Go bars, Love Good Fats bars, LMNT electrolyte powder, Justin’s peanut butter or almond butter pouches, Superfats pouches, green bell peppers, jerky, kale. Some meals included Lakanto Monkfruit sweetener, or for a savory flavor we added salt, pepper, garlic powder, or a no carb Jamaican jerk seasoning.

(Off trail food list) About once a week, we would come off the trail and stay at either a hostel or a hotel so we could wash our clothes and bodies and pick up our box of food. On these “zero days” as they are called, we would buy food from a grocery store. Those meals usually consisted of a low carb salad paired with a fatty fish like sardines or salmon, olives, and cheese. Typically, we would also purchase Rebel Ice Cream, which was a nice keto treat after traversing mountains. One food failure: my attempt at making Pemmican. This would have been a great energy packed, no carb food choice if I had some more time to practice making it correctly. Mine fell apart and was more like crumbs. We did not take it along with us.

A typical day of meals looked like this:

Breakfast: flax, PBfit, blueberries, heavy cream powder, Keto Cal, monkfruit.

Lunch: chicken, broccoli, oil (MCT or olive), cheddar cheese or nutritional yeast.

Dinner: Beef, spinach, oil (MCT or olive), cheddar or pepper jack cheese, blueberries or strawberries.

Snacks: Parm Crisp Snack Mix, Super Fat pouch and 2 bars. (Good to Go, Love Good Fats, or Keto Ratio)

Drinks: Water mostly, but on especially hot or humid days and on days the terrain was challenging, or we hiked longer, we would drink no carb LMNT electrolyte mixed in our water.

Supplements: Garden of Life raw vitamin C, Caltrate minis calcium, Pure Encapsulations L-Carnitine, Bio Kult Probiotic.

Planning, portioning, assembling, and mailing all takes time. We began our prep about a month and a half before our trip. Luckily, dehydrated vacuum sealed food lasts a very long time unrefrigerated. As you can see from the pictures, my home became a temporary storing facility for 900 servings of meals, 600 keto bars, 300 Parm Snack Mix servings, and innumerable packets of oil and nut butter pouches. We also pre-counted the supplements and carried only what we needed to save weight. We ate a good amount of food on this trip, and although my children claimed to be “ravenous” at mealtime, they didn’t ask to eat any more than they do at home. Everyone had plentiful energy as after videnced by their antics at our tent sites. After hiking with a heavy pack all day, they still had energy to skip rocks on a stream and climb trees. We even had morning and evening yoga sessions.

Adventuring in the woods whilst dealing with Epilepsy is not without risks, of course. Although we ensured he received ample sleep, adhered to the diet, and kept him healthy, we still took along Roman’s daily and emergency medications to be safe. He , thankfully, was seizure free the entire trip. As hectic as it was to prepare for this trip, food was the easiest part of the whole adventure. Our planning and preparation paid off and I am so grateful my family didn’t skip this experience on account of our special diet. I didn’t even miss the granola bars.

Kitchen Kiddos: Easy Keto Recipes Even Kids Can Master

By: Laura Dority MS RD LD

As the “kitchen manager” in my household, my kids know that most weekends they will find mom busy meal prepping in the kitchen. We are a busy family of 4 with lots of weekly activities- baseball, work, playdates, gymnastics and the list goes on and on. To keep the family functioning smoothly Monday-Friday, I have become a well-oiled meal prepping machine on the weekend.  

Oftentimes my kiddos want to jump in and help me out in the kitchen…or maybe they are just on the hunt for a fresh cookie…either way they have become my big helpers! This weekend I decided to change it up a bit and focus on 4 keto friendly recipes that my 6-year-old could master almost entirely by himself. I managed anything that involved heat but he did the rest including weighing food on a gram scale, measuring foods using household measures, mixing, blending and of course taste testing. 

Check out these simple keto recipes that we made together and try getting your little keto hero in the kitchen to help!  I have linked to a few of the more unique and harder to find ingredients to make your shopping easier!

Recipe #1: Keto Pancakes

Recipe Credit: Charlie Foundation 

Ingredients: 

•30 grams macadamia nuts- roasted 

•6 grams pecan or macadamia nut oil 

•28 grams egg, raw (mixed well)

Optional: 3 drops vanilla extract

Directions: Grind macadamia nuts in a blender until finely chopped. Mix egg and oil into chopped macadamia nuts and add vanilla extract (if desired). Spray a nonstick skillet with oil-spray and drop batter into desired size circles. Cook until light brown around edges.

Kiddo Tasks: For this recipe, my son weighed all the ingredients, ground the nuts, whisked the egg and handled all the blending. With my supervision, he also successful flipped the pancake (something he was very proud of)! This recipe made about 1 decent size pancake – we went ahead and made a second batch so his little brother could have one too!

Nutrition Information (for entire recipe): 4:1 ketogenic ratio, 300 calories, 30 grams fat, 6 grams protein, 1.5 grams net carbs

Recipe #2: Spice Muffins

Recipe Credit: Functional Formularies® The Keto Recipe Cookbook 

Ingredients: 

1 package (226 grams) Functional Formularies® Keto Formula 

•2 large (100 grams) fresh eggs

•½ cup (114 grams) butter, melted

•1 cup (112 grams) almond flour

•¼ cup (30 grams) coconut flour

•2 teaspoons (8 grams) konjac root flour

•2 tablespoons (12 grams) pumpkin spice blend

•1 teaspoon (4 grams) baking soda 

•Pinch of salt

•Stevia to taste

Directions: Preheat the oven to 300 degrees F. Line a muffin tin with parchment paper liners. Combine the formula, eggs, and melted butter in a large mixing bowl and stir to combine. Sift together the almond flour, coconut flour, konjac root flour, pumpkin spice blend, baking soda and stevia. Add dry ingredients to the wet and stir well to combine. Scrape the sides of the bowl once. Fill each parchment liner halfway and bake for 25-30 minutes until done. 

Kiddo Tasks: For this one, my little dude was responsible for preheating the oven, melting the butter in the microwave in 20-30 second increments and measuring out the ingredients using household measures which turned into a great way for him to understand the difference between teaspoons, tablespoons and different cup sizes. He also helped mix all the ingredients together and spoon the mixture into the muffin tins. 

Nutrition Information (for 1 muffin- recipe makes ~12): 2.4:1 ketogenic ratio, 192 calories, 18 grams fat, 5 grams protein and 2 grams net carbs

Recipe #3: Hummus

Recipe Credit: Functional Formularies® The Keto Recipe Cookbook 

Ingredients: 

•1 clove (3 grams) garlic

•1 cup (132 grams) macadamia nuts, dry roasted

•1 package (226 grams) Functional Formularies® Keto Formula

•1 tablespoon (15 grams) olive oil

•1 tablespoon (15 grams) lemon juice

•2 teaspoons (3 grams) oregano, dried herb

•Salt/pepper

Directions: Using a food processor, add the garlic clove then pulse several times until it is finely chopped. Scrape the sides if needed. Add the remaining ingredients to the garlic. Pulse until the macadamia nuts are pureed. Scrape the hummus into a glass bowl with a tight-fitting lid.  Refrigerate for at least 1 hour before serving. 

Kiddo Tasks: He did this recipe 100% himself. I supervised, checked the weighing, and helped him with some of the scraping but otherwise he is a hummus creating extraordinaire! This recipe makes a pretty good amount of hummus- enough for likely a few days and we paired with cucumbers! 

Nutrition Information (1 serving – recipe makes ~8 servings): 4:1 ketogenic ratio, 214 calories, 21 grams fat, 4 grams protein and 2 grams net carbs

Recipe #4: Keto Chocolate Chip Cookies

Recipe Credit: Charlie Foundation 

Ingredients: 

•1 large (50 grams) egg

•1 tablespoon (7 grams) flaxseed meal

•1 cup (100 grams) almond flour 

•½ teaspoon (2 grams) baking powder

•½ teaspoon (2 grams) baking soda

•¼ cup (30 grams) coconut flour

•1 stick (114 grams) butter, room temperature

•½ cup (56 grams) avocado oil

•2 tablespoons (30 grams) Lily’s semi-sweet chocolate chips

•Sweetener of choice

Directions: In a small bowl, whisk together the egg and flaxseed meal. Set aside. In a food processor, combine the almond flour, coconut flour, baking powder, baking soda and sweetener. Pulse several times to combine the dry ingredients. Add the remaining ingredients, including the chocolate chip. Pulse until well combined. Refrigerate the dough until you can roll into balls and place on a parchment lined baking sheet. Flatten the balls and bake at 350 degrees F for about 9 minutes. Avoid overbaking. 

Kiddo Tasks: At this point in our kitchen adventure, whisking, measuring, and mixing were all mastered skills. He also helped roll the dough into balls and really loved flattening them (rather aggressively) with a spoon! This recipe made about 13 cookies and we used a few drops of Stevia as our sweetener. 

Nutrition Information (for entire batch): 3:1 ketogenic ratio, 2193 calories, 214 grams fat, 38 grams protein and 29 grams net carbs

As you can see, little brother joined us for the taste testing part of our kitchen time! I hope you have as much fun as we did making these recipes together! Remember involving your keto kid in the creation of new meals and recipes can help them play a more active role in their keto journey and improve compliance!

Tell us about your favorite easy keto recipe in the comment section so we can continue to expand our options! Oh right, I almost forgot….in terms of the kids helping me clean up…haha…that didn’t happen….that was a mom only step!

Keto Cereals: Kid-Tested, Keto-Dietitian Approved (almost)

By: Sarah Metzger MS, RDN, LD, CDCES

We were all taught that breakfast is the most important meal of the day, and for many Americans, cereals are their top choice. Cereals are even more popular amongst breakfast for kids. And for parents, cereal provides the obvious quick and easy set-up and clean-up, plus a lot of variety. So, can we use this super-convenient food for kids on a ketogenic diet? The short answer is yes, but… Depending on your child’s specific needs, some keto cereals/granolas will be able to work on the ketogenic diet and you can say goodbye to scrubbing a crusty egg pan at 10 PM every night. However, there are a few contingencies. I sought to answer this question by exploring some of the top keto cereals and granolas out on the market. I ran a taste test to assess “yummy-ness” and “yucky-ness” from the perspective of kids and delved into the nutritional qualities from my perspective as a ketogenic dietitian. I recorded over 60 taste tests done by children from my son’s daycare, ranging from 1 to 6 years old, some of whom were deemed picky eaters by their parents (when they were out of earshot).  

On the positive side, the keto cereal called Magic Spoon (fruity flavor in particular) was a huge hit among all the kids who tasted it, finishing their whole sample! Wonderworks Keto and Catalina Crunch brands were a close second in the ranking overall. Not too surprisingly, the granolas were less favorable, with 50% of the kids not wanting to even try it in the first place unless it was an adventurous kid who liked nuts. This brings us to the homemade granola, which I created by blending ingredients very finely to mask the visible nuts and create more of a ‘bar’ that can be broken up into a cereal. My own 2-year-old, who is currently surviving on animal crackers and cheese sticks alone these days, ate 3-4 pieces of my homemade granola for dinner - I was shocked!

The first barrier I came across was the price of the keto cereals. A typical cereal box (not on sale) is around $4, yet all the keto options average $8 per box. One reason for the high cost is because regular sugar is $0.60/lb vs. substitute sugar like monk fruit, for example, is $7/lb. 

The second challenge is that keto cereals, although they are lower in carbs and regular sugar, are also high in protein and low in fat. This leads to the keto cereals not having a ketogenic ratio suitable for stricter/classic ketogenic diets on their own. The granolas, however, have a much higher ketogenic ratio, around 2:1. One way around this is to add a high fat “milk” substitute like heavy cream to the meal. You can then add further volume with an unsweetened nut-based milk such as almond or coconut which will not change the ratio significantly. But regardless, always make sure to talk with your dietitian and make note of any changes in ketone levels if any of the sugar-substitutes in the cereals are new to your child’s diet.  

Bottom line: Shop the sales, talk to your dietitian about making the cereals fit into your kids’ specific diet plan, and go with the fruity or chocolate flavors first. And, if you have some spare time, try a homemade, super-versatile granola the whole family will love as a meal, snack, or even just as an activity. 

Up First: Cereals

Magic Spoon

Nutrition per serving: 170-180 calories, 7-9 grams fat, 4 grams net carbs, 13-14 grams protein

Ratio: <1:1

Sweetener: Allulose & monk fruit

Price: $11.00/7oz. box from Amazon; $10.00/7 oz. box Magicspoon.com ($7.50/box with subscription)

Kids’ Take:

Fruity and chocolate flavors were biggest hits.

Peanut butter was also well-liked.

100% of the kids went back for more!

Pros: Very kid friendly & gluten free

Cons: Expensive, small box & contains dairy

Wonderworks Keto Friendly Cereal

Nutrition per serving: 150-160 calories, 6 grams fat, 3 grams net carbs, 15-17 grams protein

Ratio: <1:1

Sweetener: Allulose, erythritol & stevia extract

Price: $8.60/10oz. box from Target; $8.00/10oz. box from Kroger; $7.67/10oz. box from Walmart

Kids’ Take:

100% of the kids loved the chocolate flavor.

Peanut Butter was a close second.

Cinnamon was the least popular.

Pros: Very kid friendly & bigger box compared to Magic Spoon.

Cons: Contains dairy & gluten

Catalina Crunch

Nutrition per serving: 110 calories, 6 grams fat, 5 grams net carbs, 11 grams protein

Ratio: <1:1

Sweetener: Stevia & monk fruit

Price: $9.00/9oz. box from Kroger; $7.00-10.00/9oz. box from Walmart; $8.33/9oz box from Amazon

Kids’ Take:

Top 3 flavors the kids loved were cinnamon toast, chocolate and maple waffle.

100% of kids who tried them liked it.

Pros: Possibility for sale prices. Gluten-free & no outright dairy/nuts.

Cons: Processed on a plant that also does nuts and dairy.

Remember you can make any of these cereals more keto friendly by adding 1/3 cup of heavy cream which adds ~275 calories, 29 grams fat, 2 grams net carbs and 1.5 grams of protein. This brings the overall ratio of the cereals plus heavy cream to ~1.75 to 2:1. If your kiddo needs more liquid in the cereal, add unsweetened nut-based milks to desired volume. Most of the unsweetened nut milks contain minimal net carbs and protein.

Next Up: Granola

NuTrail Keto Nut Granola (Cinnamon Pecan)

Nutrition per serving: 160 calories, 16 grams fat, 2 grams net carbs, 4 grams protein 

Ratio: 2.5:1

Sweetener: Erythritol & monk fruit 

Price: $11.00/11oz. bag from Walmart (must buy pack of 6); $13.00/11oz. bag from Amazon ($10.00/bag in pack of 6); $12/11 oz. bag from NuTrail website ($10/bag in pack of 3)

Kids’ Take: ~40% of kids liked it 

Pros: Gluten-free

Cons: Contains nuts and dairy

The Granola Bakery: Keto Granola (Cinnamon Crunch)

Nutrition per serving: 200 calories, 19 grams fat, 2 grams net carbs, 5 grams protein

Ratio: 2.7:1

Sweetener: Monk fruit

Price: $9.00/11 oz. bag from Amazon

Kids’ Take: ~40% of kids liked it

Pros: Gluten & dairy free

Cons: Contains nuts

Homemade Granola (recipe below)

Nutrition per serving: 250 calories, 23 grams fat, 5 grams net carbs, 6 grams protein

Ratio: 2:1

Sweetener: Erythritol (or your choice)

Price: ~$10.00 a batch which makes ~12 ½ cup servings

Kids’ Take: ~83% of kids liked it

Pros:

Own choice of sweeteners

Ingredients can be on sale or in bulk

Nut-free recipe options

Dairy and gluten-free

Cons: Time required for cooking/cleaning & messy to eat.

Sarah’s Keto Granola

Ingredients: 

• 1 cup Pecans

• 1 cup Almonds

• 1 cup Cashews

• (1 nut should be salted or add 1 tsp of salt)

• ⅓ cup Sunflower seeds or pumpkin seeds

• ½ cup Ground Flaxseed Meal

• 1 large egg white

• 6 Tablespoons Erythritol sweetener

• ¼ cup Coconut oil measured in solid form

• 1 tsp vanilla extract (optional)

Directions: 

1. Preheat oven to 350 degrees.

2. Line a large cookie sheet with tin foil or parchment paper and spray well with cooking spray. 

3. Pulse harder nuts in a food processor (almonds, hazelnuts, peanuts), add in softer nuts (cashews, pecans, walnuts) and pulse another few times.  Measure and add in the remaining ingredients into the food processor and pulse only 1 or 2 more times.  Mix with a spatula to have all ingredients incorporated without it becoming too fine. Or you can make it finer to create more of a cohesive granola vs. larger nuts sticking out. A cohesive granola with smaller pieces tends to be more kid-friendly. 

4. Spread out the granola dough onto cookie sheet as thin as you can make it.

5. Bake at 350 degrees for 15-18 minutes or until edges start to brown noticeably. 

6. Remove from the oven and let cool for a full 60 minutes.

7. Break into pieces and enjoy with your choice of diluted heavy cream or milk alternatives as cereal, or as a topping on keto yogurt, or of course as a snack. 

8. Store in an airtight container away from moisture. 

Variations: You can choose different nuts, seeds, add-ins (e.g. coconut flakes) and different sweeteners. 

Nutrition information: 250 calories, 23 grams fat, 5 grams net carbs, 6 grams protein 

Disclaimer: This blog post is NOT sponsored. Pricing listed and availability or products at retailers is subject to change. 

Going MAD one gift at a time

By Daisy Argudin

This is the gift giving time of the year. Whether you are the parent or a family member of someone on a version of the ketogenic diet, this gift guide is for you. You may not think of MAD (modified Atkins diet) or Keto as the inspiration for a gift list, but the reality is that this treatment should be celebrated as a life saver for many. There are items that can make things easier. There are things that are considered must haves. Best of all there are things that while not necessary can make meals more fun and life a little easier for everyone. Here are a few of our favorites. I haven't included specific brands as I find that for many of these items it’s more a matter of preference than any one brand being superior to another.

Measuring cups and spoons 

On MAD these are the single most used item in our house. I prefer stainless steel spoons and cups as they are easy to clean and durable.  I suggest you Have an extra set in your car. Car? Yes. I've been out and unavoidably delayed around lunch time with a hangry 6-year-old. I had to make up a meal on the fly in a grocery store and needed to buy an extra set to figure out the correct servings.  You may never use them but if you need them, you’ll be glad I suggested it if you ever do.   

Digital Scale 

On MAD you may not have been told to use a scale to portion food but they are very useful.  My 7-year-old can help prep many of his meals with supervision using the scale.  When we buy premade food or mixes it makes figuring out correct portion sizes so much easier.  On the nutrition label they normally list the serving size in a form that can be weighed, often OZ (ounce) or G (grams) in the US.  it is very useful in figuring out portions of 1 pot meals. When eating out or traveling it is easier to use than measuring cups or spoons. You can put a small plate right on the scale to keep it clean and they are very portable.  

Silicone liners 

This simple little tool is a workhorse. They are very easy to clean and reuse.  Silicone liners are my top choice for baking.  Unlike the paper liners you don’t lose any of the oil you use in your recipes.  They are useful for holding pills. They can be used in lunch boxes to keep food separated. I use them on my scale to keep it clean when weighing different items.  They can be used as molds for fat bombs.

Rubber spatulas 

I never knew how useful a rubber spatula would be till we started MAD.  They are great for getting every single drop into your little one.  I like having several types because they serve different purposes. The longer thin one is useful for getting waffles out of the waffle maker and getting every bit of nut butter out of the jar. They are great for cooking, mixing, frosting and, more

Oil containers

Not every child will drink their oil but if yours does having these is so much easier than carrying around oil bottles and spoons. There are many options on oil containers. Some prefer a jar style. Some like the syringe style with a cap.  We like these squeezable ones because they are the easiest to use.  We have bigger ones that can be filled with a couple of doses and portioned out at meal time with a small measuring cup. We also have smaller ones that can be pre portioned and placed into a lunch box.

Fun kid plates and cups 

Being a kid on a diet of any kind can be very hard.  For many, they eat similar meals most days and they can begin to refuse food and meal time can become a struggle. Having a few plates and cups they can pick from allows them to feel like they have choices and some control. I know in our case when I offer dinner and tell my son to pick whatever plate he wants he gets excited, even if the meal isn't his favorite.  We prefer the kind with different sections, some are even made to be like a board game. 

Lunch box 

Whether your child is in school or not you'll need some way of transporting food. A thermos is a great way to transport heavy cream. I suggest you get the one with the wide mouth, it will be easier to clean. Lunch boxes seem to be one of those items where quality and cost go hand in hand. It may seem like an investment but some lunch boxes will last several years and are worth it. 

Spiralizer 

Some may think that these are only for zoodles, which are a great spaghetti substitute, but that’s not all. Vegetables are often a struggle for kids but making them fun can sometimes make them more tolerable. Zucchini is a good example; did you know it can be eaten raw? We often make salads with spiral zucchini and cucumber; the dressing provides necessary oils in a yummy way.  Carrots, jicamas, turnips and, broccoli stems can also be spiraled and eaten raw or cooked.

Silicone mold 

These molds have many uses. They are great for making fat bombs and chocolates.  I use them with plain gelatin and flavored water for treats. You can make ice cubes with flavor enhancers for when your little ones are sick.  The smaller molds can be used to make gummy candies treats that can be premade and enjoyed anytime. You can get them in many shapes and sizes which gives you many options on uses. 

Mini waffle maker  

I didn’t think I would use this as much as I have. Low carb waffles are just the beginning.  Chaffels, waffles made with just eggs and cheese, are very popular. People use them as a bread alternative and as pizza crusts.  You can make low carb hash browns with turnips; I've seen some use cauliflower but haven't tried it myself. You can make eggs with bacon crumbles and cheese for a super-fast and yummy breakfast. 

Frother  

I use this little gem at least once a day. It works well at emulsifying fats and liquids, so they do not separate in your drinks.  It makes whipped cream with very little clean up. It will give you the fluffiest scrambled eggs. If you add protein to your drinks, it makes them creamier.  You can use it to make beautiful dressings. My keto kid loves Capuchinos with extra foam and cream. 

We hope this guide has given you some ideas. If your still not sure which item your keto loved one could use most, a gift card is always useful. Our social media this month will feature recipes that use all the tools we have included in our gift guide for inspiration, so keep an eye out. Share this with anyone you may know currently on or considering the ketogenic diet or modified Atkins for epilepsy, they may not realize how many useful tools are available to them.    

If you also love these item's, please share how they have been useful to you. If there is any item you feel we’ve missed please share them with us. We always look forward to your comments. 

I have not been compensated in any way for these items. My opinions are my own and honest. 

Urine, Blood, Breath Ketones: Which is Best?

Author: Laura Dority MS RD LD

Ketones, ketones, ketones! At every appointment, your keto dietitian is likely asking you about ketones…like a broken record.  What is the level? How often are you checking? Do you notice a difference in levels between “good” or “bad” seizure days? 

And maybe sometimes you are asking yourself, do ketones really help guide treatment?  Are we checking enough? Too much? Are we using the best form of ketone monitoring?   

Let’s dig into some of these questions. Please keep in mind that a lot of this blog is going to be strictly my opinion and personal experience with treating ketogenic diet patients. It doesn’t mean that if your keto program does it differently – that it’s wrong!  

Are Ketones Important?  

The easy answer – yes of course they are! However, you must always keep in mind that the ketogenic diet is treating seizures NOT ketone levels.  If someone walks into my clinic with a low level of ketones but not having any seizures, that’s awesome! I’m not going to change anything just because of a low ketone level or trace or even negative. I’m going to make my changes based on seizure control as well as all other clinical data which MAY include the ketone level!   

Some forms of ketogenic diet therapy – looking at you low glycemic index treatment –don’t even produce ketones in certain patients.  Something to keep in mind!  

Overall for most patients ketones are important but are not the end all be all.  

What is the Ideal Ketone Level?  

It’s 100% individualized. I have patients that do fantastic at a small ketone level while I have other patients that absolutely have to be in the large range. Why the difference? It’s really hard to say – maybe related to the specific cause of the epilepsy? Age? Weight? Metabolism?  Thankfully researchers are looking into this exact question!  

I certainly have some patients that need to be at a specific ketone level to have ideal seizure control. I have seen this situation specifically with GLUT 1 deficiency patients and Dravet Syndrome. Based on my observations these 2 subgroups of the epilepsy population tend to do best at higher levels of ketones.  

While I have other patients that the level of ketones do not seem to directly correlate with seizure control. For example, they may have a “good” seizure day at small ketones and then a “bad” seizure day with large ketones one week and then it completely flip-flops the next week.   

What is the Best Way to Check Ketones?  

There are three different ways to check ketone levels – each actually measuring a different ketone body. Let’s learn more about each and when I may recommend one over the other.

Option 1: Urine ketones

• Measures acetoacetate 

• Generally measured in trace, small, moderate or large but can also have a number associated with the reading (see photo above)  

  • Trace = 5 mg/dL   

  • Small = 15 mg/dL   

  • Moderate = 40 mg/dL  

  • Large = 80-160 mg/dL  

• Advantages:  

  • Inexpensive  

  • Simple  

  • Non-invasive  

  • Many different brands (including available on Amazon) 

• Disadvantages:  

  • Least accurate  

  • Shows the ketone level that WAS available for use (past by-product not a real time test) 

  • Impacted by hydration and other factors  

Option 2: Blood ketones

• Measures betahydroxybutyrate  

• Recommended brand: Keto MoJo  

  • Company has excellent customer service, how-to resources, and FAQ on website.  

• Advantages:  

  • Dual glucose/ketone meters available  

  • More accurate  

  • Levels are reflected in real time  

  • Not impacted by hydration  

• Disadvantages:  

  • Potentially more expensive (cost of strips have decreased from $0.99/each to $0.80/each with the newest meter model) 

  • Lack of insurance coverage (newest meter may be eligible for FSA and HSA) 

  • Involves finger prick which can be painful and traumatic for some children  

Option 3: Breath ketones

• Measures acetone 

• Has been around for >100 years but not widely used in the epilepsy world at this time 

• Recommended brand: Keyto 

• Advantages:  

  • Non-invasive 

  • Simple  

• Disadvantages:  

  • Expensive (one-time cost versus daily strips with blood meteres)  

  • Lack of insurance coverage  

• Personally I do not have any experience using breath ketone meters in my patients, but I did find this article that was interesting and helpful.   

In my opinion, urine ketones are a good option for many of my patients who don’t need a very specific level of ketosis. For example a child that does well regardless if ketones are small or large versus a child who needs to be within a very specific ketone range of say 5-6 mmol/L depicted in blood levels.  

Patients with a consistent intake of water (g-tube fed kids for example) who get the exact same fluid and formula intake every day are also good candidates for urine ketones. In these situations, the variability of hydration isn’t a factor.    

On the other hand, patients that really need to be at a specific ketone level for seizure control may need a blood meter. Many of my GLUT 1 Deficiency Syndrome and Dravet Syndrome patients have meters for this exact reason.  

And finally, the reality is that cost can play into my decision! In most cases I’m already asking families to pay for supplements, a gram scale, specialized formula and food so if insurance will not cover a blood meter then urine ketones may be my only option.   

When I do have families measuring urine ketones in the home environment, I certainly do check their blood level in clinic every 3-6 months. From a cost perspective this does allow insurance to hopefully cover the lab draw and usually provides frequent enough information to tweak their keto plan appropriately.  

Utilizing both urine levels at home and blood levels from the lab can help you look at the big picture without unnecessarily pricking the child. Because the reality is we are already asking these children to eat a restricted diet – unique from their peers- and now we want them to prick their fingers on a regular basis?  I certainly know kiddos that wouldn’t bat an eye at pricking their finger and then I also know children that it completely traumatizes them. It’s a balance between getting the best data to guide treatment but also not causing pain or trauma if we don’t have too. Maybe that is where breath ketone meters really can play a role in the future!  

Overall, there isn’t a right or wrong – I have keto colleagues that only do blood meters while I have other keto colleagues that only do urine ketones. Beth Zupec-Kania, RDN, CD wrote a great blog titled “Checking for Ketones” a few years ago for the Charlie Foundation for Ketogenic Therapies that would be a great read to get another perspective on this topic. 

When Should You Check Ketones?  

Easy answer- however often your keto team tells you too! Seriously, they know your kiddo better than me writing this general blog on ketone levels!  

My thought process for my patients involves the following questions:  

• How old is the child?  

• How easy is it to obtain ketone levels (in other words- let’s not traumatize the small humans)?  

• How much variability is in the diet? 

• What form of ketone monitoring (blood vs urine) are we using?  

Generally, if I have a patient starting the diet I will ask for daily ketone levels so I can evaluate the transition into ketosis. On the other hand, for those kiddos who are stable and have minimal variety in their diet (for example kids on g-tube feeds), then weekly levels are adequate.  

Checking ketones during times of increased seizure activity may also be helpful. Scenario – A child who is normally in large ketones with good seizure control randomly has a dramatic increase in seizures. Parents check a ketone level and find the level is abnormally small. We can then go back and brainstorm any changes over the past few days to identify what potentially decreased the ketone levels and prevent in the future. We can also adjust the diet to get the ketones boosted quickly back to the large range.    

So at your next keto appointment when your RD and MD ask you – what have your ketone levels been……? Now you know that this is a loaded question and not as black and white as we would hope! If your team is asking you to check your ketone levels X times a week or month – please do so. The ketone level can provide good clinical insight and guide changes to the diet to better help your child’s seizure control.  

Disclaimers:  

Insurance coverage of ketone monitoring supplies will vary largely from state-to-state and insurance companies.  

We are not affiliated with nor did we receive any funding from ketone monitoring companies for this blog.   

This blog is not intended to be medical advice. This is strictly one ketogenic dietitians’ opinion. Please always follow your ketogenic diet teams instructions for all aspects of your ketogenic diet including ketone monitoring.  

Growing Pains

By Jessica Lee

We started our ketogenic journey when our daughter was an infant and while it felt strange to travel with extra cans of keto formula or bring a scale to a restaurant, having a very young child with a disability can sometimes be a little easier because sympathy is more readily expressed by strangers. Once your child starts growing up, new environments mean new challenges. While our daughter is no longer on the diet, we do keep a tight rein on her nutrition in general and even that can sometimes feel like a struggle as she sees other kids at school and their versions of lunches and snacks. 

In talking to another mom of a keto kid, she brought up the issue of bullying and social isolation when kids get older, specifically in middle and high school. Such a delicate time period for our children’s development and critical to their self-esteem, yet there aren’t many resources out there to support kids on medical diets.  Add to what we remember as kids the new area of cyberbullying and one can easily feel helpless.  

The CDC defines bullying as “any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated. Bullying may inflict harm or distress on the targeted youth including physical, psychological, social or education harm.” 

 Estimated rates of bullying are anywhere from 7-31%. 

 Victims of bullying are at increased risk for depression, anxiety, relationship problems, poor health, poor academic performance, and suicidal ideation/attempts.  

Boys, minorities including LGBTQ youth, overweight, youth with ADHD/autism/learning disabilities, youth with epilepsy and food allergies are more likely to experience bullying.  

While we all hope we have instilled confidence in our kids that will carry them through tough times, here are some tools to help in those hard moments.  

Protective factors include parent connectedness and positive parenting as well as empowering children with skills to handle bullying.  Here are some steps to empower your keto kid! 

1. Ensure safety-talk with your child about the situation to determine if there is any physical harm or concern for suicidal ideation (and contact authorities when appropriate)

2. Build skills 

   a. Role playing-children can learn how to respond to a bully  Ex) Look directly at the bully, speak in a firm loud voice “You don’t scare me”, “Be cool and stop this”, or “Why are you talking to me?” 

   b. Walk away with your head held high and tell a teacher or parent 

   c. Consider bringing a keto snack to have your child share with the rest of the class (something yummy!) 

   d. Cyberbullies-Don’t respond, keep evidence, block the bully, talk to a trusted adult and report it to school 

3. Empower adults and kids to step in 

   a. When bystanders intervene, 57% of episodes cease within 10sec 

   b. Increase awareness by promoting empathy toward victims 

   c. Condemn the behavior, not the bully 

   d. Have a talk with your child’s teacher to learn what they are seeing at school and work together 

If you feel your child is being bullied and needs further attention, consider talking to a local counselor or therapist about helping.  

Remember you are not alone! We have families ready to help with our Keto Friends network. While we are often matching parents, we have older kids and young adults who would be happy to talk to an older child who is struggling.  Our keto community is strong and growing! 

Sources include CDC, American Academy of Pediatrics, Contemporary Pediatrics