Spooky Fun Without the Sugar: Surviving Halloween on Keto

By: Maggie May (Parent Superstar) 

Holidays—especially Halloween—can be particularly challenging for children on a strict ketogenic diet for epilepsy. Celebrations at school, with friends, and with family are often centered around food, and pumpkin spice and candy seem to be everywhere this time of year. For keto kiddos, this can bring mixed emotions as they’re surrounded by so many things they cannot have.

Fortunately, there are ways to make the season feel more inclusive. Many store-bought keto-friendly treats are available. Retailers like Target and Walmart also offer a growing selection of non-food Halloween goodies—such as slap bracelets, fun erasers, and bubbles—which can sell out quickly as the holiday approaches, so it’s wise to stock up early. And if you’d like to bring some festive fun into your kitchen, be sure to check out this blog for a collection of delicious Halloween recipes designed with keto families in mind.

School Celebrations

If your child has a party at school, be sure to let the teacher know in advance how you’d like to handle any treats that are passed out in school.  Fortunately, it seems like schools are more allergy aware than they once were.  My daughter’s school encourages non-food treats for parties and requires 1-week notice to bring in food items, but inevitably things slip through the cracks.  My daughter’s preference is to be included anyway (knowing full well she can’t have the treats) and is happy to bring any candy home to her brother.  If that isn’t your child’s preference, you can let the teacher know you’d like them to pull out any candy before your child gets it. 

Trick or Treating

 For trick-or-treating on Halloween, there are several different ways parents have handled it over the years.  Be no matter which path you take, be sure to let your kids know there is a “no eating while trick-or-treating” rule.

Teal Pumpkin Project

Dealing with an allergy or strict metabolic diet is difficult, but the Teal Pumpkin Project is helping.  Houses that have a teal pumpkin by the door are letting trick-or-treaters know in advance that they have non-edible treats.  You can buy a teal pumpkin bucket (often available at places like Target and Walmart) to let people know your child has a food allergy and would prefer a non-edible treat, if they have one available. 

Check out the Food Allery Research & Education website for more information or to add your house to the map or find houses nearby that have non-edible options – new for 2025!

 Hand Out Treats to Neighbors in Advance

Another idea to get through the sugar-laden festivities is to go to neighbors in advance and deliver little toys or keto-friendly treats to give your child when you get to their house for trick-or-treating.

The Switch Witch

And one last idea that has worked well for us (including my non-keto kid) is our beloved Switch Witch. Each year leading up to Halloween, we read about the Switch Witch (see poem below) to be reminded of how it works.  We trick-or-treat as usual and then after trick-or-treating, we come inside and the kids dump their haul into a bag and during the night, the Switch Witch trades it for acceptable treats or maybe even a toy.  Even my non-keto kid has been happy to trade his candy.  And keto kids or not, what parent doesn’t love less candy around the house?!  Everybody wins!

A few of our favorite candies to put in food packs (all in moderation and run by your dietitian first, of course):

• Lily’s chocolate bars and peanut butter cups

• Quest peanut butter cups

• Shameless Snacks (peach and watermelon gummies, available at Target)

• Russel Stover Fruit Chews (Starbursts)

• Zollipops 

 No matter which way you decide to celebrate Halloween, when it’s all said and done, I’m always reminded about how adaptable kids are.  We surely don’t give them enough credit.

Click here for a downloadable PDF of The Switch Witch poem. 

Disclaimer:
The products listed are examples that may fit a ketogenic diet. Nutrient content varies by brand, so read labels carefully and choose the lowest-carb option. Some may need added fat to meet ketogenic ratios, and many contain sweeteners or sugar alcohols that aren’t suitable for everyone. Always consult your healthcare team before adding new products to your diet.

Weaning Off the Ketogenic Diet: A Guide for Parents and Caregivers

By: Laura Dority, MS, RD, LD

Edited by: Amy Merwarth, RD, LD 

Weaning off the ketogenic diet (KD) is a highly individualized process. While this guide provides general suggestions, every patient’s journey will be unique. Always consult your ketogenic diet team to create a personalized plan that fits your needs.

The ketogenic diet significantly alters metabolism, so a gradual transition is usually recommended. A slow, structured approach can help minimize side effects and ensure a smooth shift back to a balanced diet.

General Guidelines for Weaning

1. Take It Slow

The longer someone has followed the ketogenic diet, the more gradual the transition should be.

• Short-term use (3–4 months): Can often be discontinued within 1–2 weeks.

• Long-term use (1+ years): May require 3–6 months or longer for a safe transition.

Some families may prefer an even slower approach, which can be accommodated based on tolerance and medical guidance.

2. Adjust the Ketogenic Ratio Gradually

For those on a classic or modified ketogenic diet, which are prescribed as a ratio of fats to proteins and net carbohydrates (e.g., 4:1, 3:1, 2:1), weaning typically involves lowering this ratio step by step over time.

• Reduce the ratio by 0.25 to 0.5 steps every 2–4 weeks.

• Monitor for any symptoms and slow the process if needed.

A gradual reduction helps prevent electrolyte imbalances and ensure a smoother transition out of ketosis.

3. Reintroduce Carbohydrates Wisely

For individuals following a Modified Atkins Diet (MAD) or Low Glycemic Index Treatment (LGIT), reintroducing carbohydrates should be done carefully. Increasing daily carbohydrate intake by 5–10 grams per day, focusing on complex carbohydrates like whole grains, legumes, fruits, and starchy vegetables, supports a smooth transition out of ketosis. Avoid adding excessive sugars or processed foods too quickly.

4. Liberalize Food Choices

As you transition off KD, begin incorporating a wider variety of foods:

• Swap heavy cream for whole milk.

• Increase lean proteins (chicken, fish, tofu, eggs).

• Introduce more vegetables and fiber-rich foods.

A gradual shift prevents digestive discomfort and helps maintain balanced nutrition.

Monitoring During Weaning

Even after reducing ketosis, it’s important to monitor for side effects like fatigue, digestive discomfort, and seizure activity. If concerns arise, consult your medical team promptly.

After Weaning: What to Expect

• Seizure Monitoring: If seizures return, discuss treatment options with your provider.

• Balanced Nutrition: Continue focusing on whole, unprocessed foods.

• Medication Adjustments: If the ketogenic diet led to reduced use of seizure medications, adjustments to medication dosages may be needed during weaning.

Final Thoughts

Every patient’s weaning process is different; therefore, working closely with your ketogenic team is key. Open communication, patience, and careful monitoring will help ensure a safe and successful transition. If you have any concerns, don’t hesitate to reach out to your medical provider—you are not

alone in this journey!

Once Upon a Time: A Story About Bones, Brains, and Supplements

By: Rebecca Legi, MS, RD, CSP

Once upon a time, there lived a clever, curious girl named Laura. She loved climbing trees and playing tag with her siblings. Sweet Laura had the kind of personality that could light up a room. But Laura also had epilepsy — seizures came like sudden storms, leaving her tired and scared.

Doctors tried many medicines, but none worked well. Some made her sleepy; others made her cranky. One day, her neurologist suggested something different: the ketogenic diet. Laura and her family were not particularly enthusiastic about this idea — the diet is strict and difficult to maintain — but with the help of their keto dietitian, they decided to give it a chance.

After just a few weeks, Laura’s seizures nearly stopped. She felt clearer, steadier, and much happier. Everyone was thrilled with the effect of the diet. After some time, they even began considering weaning her off some of her medications, relying more on the diet for seizure control.

At a follow-up appointment with their dietitian, Laura’s parents mentioned that Laura hadn’t been taking her prescribed vitamin and mineral supplements.

"There are so many of them, and she doesn’t like how they taste," they said. "She makes such a fuss about taking them that we finally gave up. We figured she’s doing so well it wouldn’t hurt."

Would it?
Not right away, no.

Nutritional deficiencies are quiet little goblins that sneak in through the cracks when no one is looking. They don’t make a fuss at first — they nibble at your strength, drain your bones, and swipe tiny bits of focus and calm from your brain each day. You don’t notice they’ve been there until, one day, something feels... off.

While the ketogenic diet is an effective therapy for epilepsy, it is nutritionally incomplete without supplementation. A 2008 study assessing micronutrient adequacy across ketogenic diet ratios (4:1 to 1:1) found that at the strictest ratio (4:1), the diet met recommended daily intakes for only 3 out of 28 essential vitamins and minerals. Even at the lowest ratio (1:1), adequacy improved but remained insufficient, covering just 11 of 28 nutrients.¹ Another study confirmed these results, adding that these deficiencies increase with age.²

What’s more, emerging research suggests that the ketogenic diet may interfere with the absorption of certain vitamins and minerals — even when intake is adequate. This means that simply meeting the numbers on paper might not guarantee the body is actually getting everything it needs. That’s why it’s extra important to be vigilant about taking your supplements.

That might have convinced some of you to take your multivitamin, but you might still wonder:

"What about extra supplements on top of the multivitamin? We can skip that if needed, right?"

Well, a few micronutrients stand out as needing extra attention because even a multivitamin can't fully meet the recommended amounts. These nutrients are calcium, phosphorus,² ³ and magnesium.²

These three nutrients — along with vitamin D — play a big role in supporting healthy growth and strong bones. When we don’t get enough of them, it can lead to problems like soft or brittle bones (osteomalacia or rickets), a higher risk of fractures, and even decreased growth.⁴

But that's not all.

Low calcium levels can also affect the brain. In children with epilepsy, insufficient calcium may increase brain excitability, which can contribute to seizures.⁵ To complicate things further, many children with epilepsy are taking anti-seizure medications like carbamazepine, which increases the activity of cells that break down bone. Combined with low intake, it sets the stage for weakened bones and a high risk of fractures.⁶

Sounds familiar?
Yes — those are two out of the three long-term side effects of the ketogenic diet your keto team warned you about.⁷

And then there’s the third: kidney stones.

This is where I also try to convince you to take your baking soda mix, sodium bicarbonate, or Effer-K regularly at the prescribed amount and time. You've heard the story of how ketones make your blood acidic, creating the perfect environment for your kidneys to form stones. The baking soda counteracts this acidity — but did you know this acidity can also contribute to poor bone health?

Without baking soda to help the kidneys offset blood acidity, the body diverts vitamin D into forms that manage acidity instead of using it for bone building.⁸

So, what’s the takeaway?

The ketogenic diet can be life-changing for managing epilepsy, but it comes with hidden risks if we’re not careful. Supplements are not just an extra chore — they are essential partners in your journey. They protect your bones, support your brain, and safeguard your overall health for the long haul.

Without the right nutrients, small cracks can form silently over time, affecting growth, focus, energy, and resilience. Staying committed to the prescribed supplements — including multivitamins, minerals like calcium, phosphorus, magnesium, and supportive therapies like baking soda — isn’t just about following the rules.

It’s about giving your body the full support it needs to thrive on the ketogenic journey.

Love your bones. Protect your brain. Support your whole self. Take your supplements — every single day!

With love and bone-saving wisdom,
Your ketogenic dietitian

Follow Rebecca on Instagram @Rebeccalegi & LinkedIn.

References:

1.      Zupec‐Kania, Beth, and Mary L. Zupanc. “Long‐term management of the ketogenic diet: Seizure Monitoring, nutrition, and supplementation.” Epilepsia, vol. 49, no. s8, 4 Nov. 2008, pp. 23–26.

2.      Prudencio, Mariana Baldini, et al. “Micronutrient supplementation needs more attention in patients with refractory epilepsy under ketogenic diet treatment.” Nutrition, vol. 86, 1 June 2021, p. 111158.

3.      Liu, Yeou-Mei Christiana et al. “A prospective study: growth and nutritional status of children treated with the ketogenic diet.” Journal of the American Dietetic Association vol. 103,6 (2003): 707-12.

4.      Cosenza, Linda et al. “Calcium and vitamin D intakes in children: a randomized controlled trial.” BMC pediatrics vol. 13 86. 23 May 2013.

5.      Fraser, Lisa-Ann et al. “Enzyme-inducing antiepileptic drugs and fractures in people with epilepsy: A systematic review.” Epilepsy research vol. 116 (2015): 59-66.

6.      Shiek Ahmad, Baemisla et al. “Bone Mineral Changes in Epilepsy Patients During Initial Years of Antiepileptic Drug Therapy.” Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry vol. 19,4 (2016): 450-456.

7.      Groesbeck, Darcy K et al. “Long-term use of the ketogenic diet in the treatment of epilepsy.” Developmental medicine and child neurology vol. 48,12 (2006): 978-81.

8.      Sampath, Amitha et al. “Kidney stones and the ketogenic diet: risk factors and prevention.” Journal of child neurology vol. 22,4 (2007): 375-8.

Weaning the Ketogenic Diet: A Guide for Patients and Caregivers

By: Laura Dority, MS, RD, LD

Edited by: Amy Merwarth, RD, LD 

Weaning off the ketogenic diet (KD) is a highly individualized process. While this guide provides general suggestions, every patient’s journey will be unique. Always consult your ketogenic diet team to create a personalized plan that fits your needs.

The ketogenic diet significantly alters metabolism, so a gradual transition is usually recommended. A slow, structured approach can help minimize side effects and ensure a smooth shift back to a balanced diet.

General Guidelines for Weaning

1. Take It Slow

The longer someone has followed the ketogenic diet, the more gradual the transition should be.

• Short-term use (3–4 months): Can often be discontinued within 1–2 weeks.

• Long-term use (1+ years): May require 3–6 months or longer for a safe transition.

Some families may prefer an even slower approach, which can be accommodated based on tolerance and medical guidance.

2. Adjust the Ketogenic Ratio Gradually

For those on a classic or modified ketogenic diet, which are prescribed as a ratio of fats to proteins and net carbohydrates (e.g., 4:1, 3:1, 2:1), weaning typically involves lowering this ratio step by step over time.

• Reduce the ratio by 0.25 to 0.5 steps every 2–4 weeks.

• Monitor for any symptoms and slow the process if needed.

A gradual reduction helps prevent electrolyte imbalances and ensure a smoother transition out of ketosis.

3. Reintroduce Carbohydrates Wisely

For individuals following a Modified Atkins Diet (MAD) or Low Glycemic Index Treatment (LGIT), reintroducing carbohydrates should be done carefully. Increasing daily carbohydrate intake by 5–10 grams per day, focusing on complex carbohydrates like whole grains, legumes, fruits, and starchy vegetables, supports a smooth transition out of ketosis. Avoid adding excessive sugars or processed foods too quickly.

4. Liberalize Food Choices

As you transition off KD, begin incorporating a wider variety of foods:

• Swap heavy cream for whole milk.

• Increase lean proteins (chicken, fish, tofu, eggs).

• Introduce more vegetables and fiber-rich foods.

A gradual shift prevents digestive discomfort and helps maintain balanced nutrition.

Monitoring During Weaning

Even after reducing ketosis, it’s important to monitor for side effects like fatigue, digestive discomfort, and seizure activity. If concerns arise, consult your medical team promptly.

After Weaning: What to Expect

• Seizure Monitoring: If seizures return, discuss treatment options with your provider.

• Balanced Nutrition: Continue focusing on whole, unprocessed foods.

• Medication Adjustments: If the ketogenic diet led to reduced use of seizure medications, adjustments to medication dosages may be needed during weaning.

Final Thoughts

Every patient’s weaning process is different; therefore, working closely with your ketogenic team is key. Open communication, patience, and careful monitoring will help ensure a safe and successful transition. If you have any concerns, don’t hesitate to reach out to your medical provider—you are not alone in this journey!

Keto Hope Blog: Keto Super Stars: Meet Eleanor

Author: Hilary Bassett

How the Ketogenic Diet Transformed My Daughter’s Life: A Journey with Ring 14 Syndrome

When I first learned about the ketogenic diet, I had no idea how profoundly it would change my daughter Elee's life. Elee has been on the keto diet for over 2 years now, since she was 11 months old, and it has been nothing short of life-changing. But our journey didn’t start with a simple decision to try a new diet; it began with a heartbreaking and terrifying health crisis.

A Challenging Beginning: Elee’s Diagnosis and Struggles with Seizures

Elee was diagnosed with Ring 14 Syndrome, a rare genetic disorder that causes a wide range of developmental and physical challenges, including severe seizures. Her first seizure occurred at 9 months old in October 2022. We went to the hospital by ambulance for treatment. Unfortunately, her seizures didn’t respond to rescue medications and she was hospitalized for more than a month, not leaving until December 2022. Despite all medical efforts, we couldn’t seem to gain control over the frequency or severity of her seizures.

For a child as young as Elee, watching them go through such a traumatic experience was heart-wrenching. Before her seizures began, Elee had been a happy, healthy baby who loved exploring new foods. She had been exclusively breastfed and began baby-led weaning at 6 months. Her love for food knew no bounds, from pizza and chicken to broccoli and steak. But as the seizures took over, she lost her appetite, and her eating habits regressed drastically.

The Turning Point: Introducing the Ketogenic Diet

The turning point came right before Thanksgiving in November 2022, when we made the decision to start Elee on the ketogenic diet. Through the lens of social media, we had already seen how some children with epilepsy experienced remarkable improvements in seizure control through this high-fat, low-carbohydrate approach. I was intrigued by the idea of using food as a form of “pharmacology,” especially since traditional medications hadn’t worked for her.

At the time, Elee had gone as long as 72 hours without a seizure, but that was her longest streak. When we began the keto diet, something miraculous happened. Elee went a record 52 days without a seizure! She was still on several anti-epileptic medications, but the combination of the ketogenic diet and her meds seemed to work synergistically, giving her the control we had longed for. Even though she still occasionally experiences seizures, they are now limited to once a month, a far cry from the constant struggle we faced before. She is currently experiencing her longest seizure free streak and is at 84 days today!

Rebuilding Her Strength and Love for Food

When we started the keto diet, Elee had regressed to only taking breast milk in bottles. To help her regain her strength and confidence in eating, I introduced her to a medical ketogenic formula mixed with breast milk. Slowly but surely, she regained the energy to start eating real food again. For her first birthday, I made her a homemade 4:1 keto cake, which she absolutely adored. Little by little, Elee started eating whole foods again, and today at 3 years old, she’s thriving on a 2.5:1 ratio.

I’m constantly in awe of how she’s able to enjoy a wide variety of delicious keto foods, from her favorite chopped veggie sub salad with oil and mayo, homemade cheesy goldfish snacks, and spinach bites, to salmon and steak. I use ingredients like cream cheese, butter, olive oil, avocado oil, heavy whipping cream, and MCT oil to keep the fat content high, ensuring she stays within her keto ratio.

The Reality of Managing the Keto Diet for a Toddler

As much as the ketogenic diet has been a miracle for Elee, managing it is no small feat. I’m a huge advocate for the diet, and I’m passionate about sharing her journey on her Instagram page, @pawsforelee. I make all her food from scratch, with the occasional exception of a hot dog (which she loves paired with pimento cheese). To make her meals more exciting, I use dozens of silicone molds to create themed snacks for each week’s learning focus in preschool. I also use these molds for birthday parties and other social events, ensuring Elee has something she can eat while other kids are enjoying their treats.

However, despite the success we’ve had with the keto diet, there are many challenges. The process of calculating her meals and ensuring her fat-to-protein-to-carbohydrate ratio is precise is still a significant hurdle. I use an app for meal planning, but its ingredient database is limited, and I often find myself doing manual calculations to ensure everything is accurate. Many parents I’ve spoken to have given up on the keto diet for their children due to these difficulties, and I understand why. The burden of calculating ratios and creating balanced meals by hand can be overwhelming.

What I’ve Learned and My Hopes for the Future

Looking back, I’m incredibly grateful for the keto diet and how it has helped Elee, but I know there’s room for improvement. I’ve learned that making my own recipes is not only doable but also becomes easier with time. It’s a labor of love, and while it takes effort, I know it’s making a world of difference in Elee’s health. My hope for the future is that as she grows older, the keto diet will become her primary form of seizure control, with fewer medications required.

In an ideal world, there would be better tools for parents managing the keto diet for children. I’m in conversations with a keto app developer to add ratios to their program, which would make the process significantly easier. If we could have unlimited access to a comprehensive ingredient database, meal calculations could be automated, and more parents may find success with the ketogenic diet.

Final Thoughts

Elee’s journey has been nothing short of miraculous, and while there are still challenges to overcome, the ketogenic diet has given us hope and a sense of control we didn’t have before. If you’re considering the ketogenic diet for your child, my advice is simple: it gets easier with time, and creating your own recipes is entirely doable. The results are worth the effort!

Elee’s story is one of perseverance, love, and the transformative power of food. While the ketogenic diet is not a one-size-fits-all solution, it has certainly been life-changing for our family. And for that, I’m forever grateful.

A Year in Review: Celebrating Milestones at Keto Hope Foundation

As 2024 comes to a close, we at the Keto Hope Foundation are reflecting on a year filled with meaningful accomplishments and inspiring connections. It’s been a journey of growth, learning, and impactful moments that strengthen our commitment to supporting families managing epilepsy through ketogenic therapies. Let’s take a look back at some of this year’s highlights.

Published Research: Advocating for Caregivers and Families

This year marked a significant milestone with the publication of two research articles close to our hearts.

In June 2024, we shared our heartfelt voices in Pediatric Research with our article, “Family reflections: A candid view from caretakers of patients with pediatric epilepsy”. This piece offers an intimate glimpse into the triumphs and trials of caregivers, highlighting their resilience and need for understanding from the broader healthcare system.

Then in July 2024, our literature review, “Support for caregivers of children on the ketogenic diet for epilepsy and other neurologic disorders”, was published in Epilepsy Behavior. This work sheds light on the challenges caregivers face, emphasizing the importance of providing accessible resources and emotional support. We hope it serves as a foundation for future discussions and solutions within the medical community.

Both publications are milestones in advancing the conversation around caregiver and family support—a topic central to our mission.

Keto Talk Podcast: Sharing Our Story

We had the privilege of being interviewed on the Keto Talk podcast. This platform allowed us to connect with a wider audience, sharing insights into ketogenic therapies and our dedication to empowering families. The experience was a reminder of the importance of advocacy and education in transforming perceptions about medical ketogenic diets. Listen to the podcast here. 

GLUT1 Deficiency Summit: Building Community

In June, our team attended the GLUT1 Deficiency Summit in Dallas, Texas. This incredible event brought together families, healthcare professionals, and researchers united by a shared goal: advancing the understanding and management of GLUT1 Deficiency.

The opportunity to meet so many amazing individuals—families courageously navigating rare conditions and clinicians pushing the boundaries of care—was profoundly inspiring. The Summit reminded us of the power of collaboration and the strength that comes from community.

Looking Ahead: Exciting Developments

While reflecting on the past, we’re equally excited about the future. On March 8th, we’ll host a special fundraiser in Charleston, South Carolina. While we can’t reveal all the details just yet, we promise an event that will celebrate our mission and community while raising critical funds to support families. Stay tuned for updates—this is one event you won’t want to miss!

Thank You for Supporting Us

None of this would have been possible without the unwavering support of our community. To the families, caregivers, healthcare providers, and supporters who walk this journey with us: thank you. Your dedication fuels our efforts and inspires us to keep striving for better resources, stronger connections, and a brighter future.

As we close the chapter on 2024, we look forward to continuing this work together. Here’s to making 2025 just as impactful!

Image: Jessica Lee & Laura Dority (Keto Hope Foundation Co-Founders) 

Image: Daisy Argudin (Keto Hope Foundation Program & Social Media Manager) 

—
Stay connected by subscribing to our newsletter and following us on social media (Instagram & Facebook) for updates on upcoming events and initiatives.

Low-Carb Loaves: Our Review of Keto-Friendly Bread You Can Buy or Bake

Recipe & Content Contributor: Taylor Parrish, RDN, LD

For anyone following a ketogenic diet, giving up bread can feel like one of the biggest sacrifices. Whether for sandwiches, toast, or a snack, bread is a staple many of us miss when transitioning to a low-carb, high-fat diet. Luckily, keto-friendly bread options are out there to help fill the gap. We’ve taste-tested both store-bought and homemade versions to bring you a comparison of the best keto breads on the market.

When it comes to finding a bread alternative, consider the following: 

1. Texture: Many kids like the softness of wheat-based bread. Traditional breads use yeast, which gives them volume and texture. Yeast is typically not used in keto breads. Additionally, some keto breads can get chewy when toasted. It may take some trial and error to find the right one.

2. Fiber: Keto breads often use fiber to achieve "0 g net carbs," but some kids may be sensitive to it. Monitoring blood ketones after introducing high-fiber products can help assess tolerance.

3. Ingredients: Some keto breads contain GMOs and additives for emulsification and preservatives for longer shelf life. While not always ideal, these ingredients offer convenience. Freezing bread can extend shelf life, but it may affect texture after thawing.

4. Homemade vs. Store-Bought: Baking at home can be nostalgic, but homemade keto bread may not match the texture or taste of store-bought options. We found that Scotty's Keto Homemade Bread Mix was the closest homemade alternative.

5. Freezing Tips: Slice bread into individual servings, place parchment paper between slices, and freeze. Toasting frozen bread helps improve texture after thawing.

6. Fat Absorption: When choosing a keto bread, consider how it absorbs fat, especially if the bread contains protein, carbs, and minimal fat. Toasting it in butter on a skillet can help determine absorbency. Softer breads generally absorb fat better.

1. Adding flavored fats like nut butters as a topping can enhance both flavor and fat content.

2. Homemade breads made with coconut flour and xanthan gum absorb fat better than those made with almond flour, which is grainier and contains less fat.

7. Flavor: Homemade keto breads often taste "eggy." Adding a sweetener like Stevia can help balance this without making the bread too sweet. You can also top the bread with low-carb jelly alternatives, chia jams, or Dillman Farm Organic No Sugar Added Apple Butter. 

8. Egg Whites in Keto Breads: Egg whites add volume when whipped to stiff peaks, making them a key ingredient in keto breads. However, mixing them with other ingredients can reduce their volume. They also brown faster than wheat flour, so lower cooking temperatures or covering with foil during baking are often needed to prevent over-browning. 

Let’s move on to the fun stuff… store-bought bread highlights & tasting feedback!

#1: Aunt Millie’s Live Carb Smart White Bread

• Soft and most absorbent

• Tastes like regular bread

• Easy to find in stores

• Contains inulin (may cause GI upset) & resistant starches

• Allergens: Soy, wheat, sesame 

• Nutrition per slice (28g): 30 kcals, 0.5 g fat, 3 g protein, 11 g total carbohydrate, 9 g fiber (2 g net carbs) 

• More information

#2: Lewis Healthy Life Hawaiian Keto Bread 

• Third most absorbent but not as soft

• Sweeter than normal bread 

• Easy to find in the store

• Contains resistant starches and chicory root fiber (a fiber but also used for sweetness) 

• Allergens: Wheat 

• Yellow in color (has added turmeric)

• Contains 1 g allulose*

• Nutrition per slice (28 g) = 35 kcals, 1 g fat, 5 g protein, 9 g total carbohydrate, 8 g fiber (1 g net carbs*) 

• More information

*Check with your keto team if you should subtract allulose as part of your net carb calculation. 

#3: Aldi L’Oven Fresh Keto Friendly White Bread

• Second most absorbent

• Tastes like normal bread

• Only found at Aldi’s 

• Contains inulin (can cause GI upset) & resistant starches

• Allergens: Soy, wheat, sesame 

• Nutrition per slice (28 g) = 35 kcals, 1 g fat, 4 g protein, 10 g total carbohydrates, 10 g fiber (0 g net carbs)

• More information 

#4: Base Culture Original Keto Bread

• Least absorbent but with 7 grams of fat per slice, you may not need to add as much extra fat 

• Doesn’t taste like normal bread and very grainy 

• All whole food ingredients

• Allergens: Eggs, tree nuts

• Only found at Whole Foods in the frozen section & expensive

• Nutrition per slice (30 g) – 100 kcals, 7 g fat, 3 g protein, 8 g total carbohydrates, 4 g fiber (4 g net carbs)

• More information

Don’t love any of these store-bought options? That’s okay, let’s look at some homemade bread recipes.

#5: “The Best Keto Bread Recipe”

Recipe Credit: Keto Connect 

• Not absorbent 

• Eggy texture and taste

• Yellow in color 

• All whole food ingredients (optional Stevia, but didn’t help with egg taste) 

• Allergens: Tree nuts, eggs, dairy

• Volume depends on stiff egg whites 

Nutrition information for entire recipe**: 1846 kcals, 164 g fat, 74 g protein, 18 g net carbohydrates, 12 g fiber (1.8:1 keto ratio)

Full recipe information here.

#6: Wholesome Yum Keto Bread

Recipe Credit: Wholesome Yum 

• Somewhat absorbent 

• Coconut flavor with good texture 

• All whole food ingredients

• Allergens: Tree nuts, eggs

• Best to bake on a baking sheet and then cut in half once cooled

• Volume depends on stiff egg whites 

Nutrition information for ½ recipe**: 1167 calories, 109 g fat, 37 g protein, 11 g net carbohydrates, 9 g fiber (2.3:1 keto ratio) 

Full recipe information here.

#7: Scotty’s Keto Bread Mix 

You can bake a great homemade bread mix as a quick mix without yeast (no rise time needed) or add yeast for a more traditional way of making bread. 

• Most absorbent of all homemade bread options 

• Mild flavor with an airy and soft texture (similar to angel food cake) 

• Allergens: Egg 

• Doubled in size when baked (removed from oven early due to large volume increase) 

• Expensive 

Nutrition information as a quick mix (1 bread mix package + 2 Tbsp olive oil)**: 564 kcals, 36 g fat, 36 g protein, 24 g net carbohydrates, 168 g fiber (0.6:1 keto ratio)  

Full product information here.

Image note: Image reflects a product that was not fully cooked due to large volume increase. The volume will increase the longer the cook time. 

#8: Microwave Bread Recipe

Dry Bread Mix Recipe (makes 10 servings): 

• 30 g baking powder

• 2 g xanthan gum 

• 2 g nutritional yeast

• 50 g dried egg white 

• 116 g almond flour 

Nutrition information for dry ingredient mix (entire batch)**: 905 kcals, 62 g fat, 66 g protein, 20 g net carbohydrates, 10 g fiber (0.7:1 keto ratio) 

Directions: Mix all ingredients together. Combine 20 grams of mix with 2 Tbsp water and 10-20 grams of fat (depending on ratio) in a microwave-safe dish. Microwave for 1 minute and 40 seconds. Let cool and then slice down center. 

Image shows bread as part of a grilled cheese sandwich. 

Note: I used an air fryer at 350°F for 9 minutes in a container since I don’t have a microwave.

• Buttery flavor with a grainy & oily texture that is not soft

• Allergens: Egg, tree nuts 

• You can vary the amount of fat added – we tried 10 g and 20 g but found 20 g was too much

• Easy to make a batch recipe to have a dry bread mix on hand then just add water and butter when needed. 

• A quick option since you can make it in a microwave.

And the Winner Is……?

This photo showcases breads #1-7 from left to right (#8 not pictured). The top row features the "raw" breads (not toasted and without added fat), the middle row displays the toasted bread, and the bottom row highlights the bread toasted slowly on a skillet with 15 grams of butter.

Most of my crew liked Aunt Millie’s Live Carb Smart White Bread, which was the softest option and absorbed fat the best—making it our overall winner! Most of the store-bought options we tried were well received, except for Base Culture Original Keto Bread, which no one liked. The Aldi L’Oven Fresh Keto Friendly White Bread came in second for both softness and fat absorption, making it an excellent and easily accessible choice if you have an Aldi nearby.

Among the homemade options, the Wholesome Yum bread was the overall favorite, though it had a distinct coconut flavor that might not appeal to everyone. Scotty’s Keto Bread Mix was also popular for its flavor, softness, and absorbency. In general, the homemade bread options did not absorb fat as well as the store-bought, which is important if you're following a high-keto diet that requires a lot of added fats.

My family had a great time experimenting with these bread options and we certainly met our fiber goals in the process. Please share your favorite keto-friendly bread recipe or product, and let us know what food adventure you'd like us to explore next!

**KetoDietCalculator was used to calculate nutrition information for homemade bread recipes. Exact nutrition information will vary based on specific ingredient brands used. 

Disclaimer: This blog post is not sponsored and the opinions reflected in this article are our own. Availability of products at retailers is subject to change.

Organizing Medical Records: A Vital Piece of Caregiver Support

Author: Jessica Lee

One crucial aspect of caregiver well-being is the importance of feeling organized and in control with the ability to easily and quickly access pertinent information about our loved ones. Since electronic medical records often do not “talk” to each other, managing medical documentation ensures continuity of care and empowers families with information that can significantly impact their loved one’s health.

Traditional Methods: Paper vs. Binders

If you are like me, you have relied on traditional methods like storing medical records on paper and organizing them in binders. This method offers a tangible, accessible format that is easy to annotate and personalize. However, it comes with its challenges. Paper records can quickly become cumbersome, filling multiple binders over time. They are also prone to wear and tear and organizing them in a meaningful way can be labor-intensive. Not to mention the lengthy post-visit process of obtaining radiology or surgical reports from the hospital. 

Embracing Digital Solutions

In recent years, the invention of digital solutions has transformed how families manage medical records. Online platforms and applications provide a streamlined approach to record-keeping. One such innovative tool that I came across is mejo® (available at mymejo.com), founded by a dad whose son has a rare genetic disorder. I decided to take a look for myself…

Benefits of mejo®

mejo® offers several advantages over traditional methods:

• Centralized Storage: All medical records can be stored digitally in one place, eliminating the need for multiple binders and reducing clutter.

• Accessibility: Information is available at your fingertips, anytime and anywhere with an internet connection, making it easier to share with healthcare providers, babysitters, or teachers.

• Customization: Families can personalize their records, make notes, adding important details, and organize information in a way that suits their unique needs.

• Sharing Capabilities: One of the standout features of mejo® is its ability to share selected information with caregivers, ensuring everyone involved in the care process is informed and updated.

Challenges and Considerations

While digital solutions like mejo® offer significant benefits, they do require upfront effort to input all information accurately. Families may need to spend time initially to ensure all medical history, treatment plans, and dietary records are uploaded correctly. However, the time saved in accessing and sharing information later can outweigh this initial investment.

I would love to see a tracking feature, especially for the epilepsy community. A section dedicated to seizure types, symptoms, frequency, and timing would be helpful. I would also like a section where pictures could be uploaded. This could be PDFs that include information on seizure emergency protocols or images from an MRI or a wound.

Making the Choice

When deciding between traditional methods and digital solutions, families need to consider their specific needs and preferences. Some may find comfort in the tangible nature of paper records despite their limitations, while others may appreciate the convenience and accessibility offered by digital platforms like mejo®.

Organizing medical records is a fundamental step for a caregiver. Whether choosing traditional paper methods or embracing digital solutions, the goal remains the same: to empower families with the tools they need to manage their loved one’s health effectively and efficiently. 

For more information on how we support families, please visit us at www.ketohope.org.

I receive no payment or other compensation for reviews of products or services.  All opinions stated are my own. 

Weathering the Storm: Ensuring Your Child's Ketogenic Diet During Inclement Weather

Author: Laura Dority, MS, RD, LD 

Editor: Amy Merwarth, RD, LD 

As caregivers of children on a medical ketogenic diet for epilepsy, preparation is essential, especially when faced with the unpredictability of inclement weather. Power outages, hurricanes, and other natural disasters can pose significant challenges, but with careful planning, you can ensure your child's dietary needs are met without interruption.

1. Stock Up on Non-Perishable Keto-Friendly Foods

Having a supply of non-perishable, keto-friendly foods is crucial. These foods do not require refrigeration and can be lifesavers during extended power outages. Review your child’s ketogenic meal options and make a list of non-perishable items that your child will eat. Then get with your ketogenic dietitian to compile a handful of meal options using these non-perishable options. 

Here are some examples of non-perishable food options that can work in a ketogenic diet: 

• Nuts and Seeds: Almonds, walnuts, macadamia nuts, chia seeds, and flaxseeds are excellent sources of fats and can be easily stored.

• Nut Butters: Almond butter, peanut butter, and other nut butters (without added sugar) are convenient, nutrient-dense, and shelf-stable.

• Canned Meats and Fish: Canned salmon, sardines, tuna, and chicken provide protein and healthy fats.

• Olives: These can be included as high-fat snacks that require no refrigeration.

• Coconut Milk and Cream: Full-fat coconut milk or cream can be used in place of dairy and provides a good source of fat.

• Shelf-Stable Cheeses: Hard cheeses like Parmesan can last longer without refrigeration. Consider cheese crisps or shelf-stable cheese snacks as well.

• Oils (olive, avocado, coconut): Great options to get the necessary extra fat needed to stay in ketosis and can be used in place of butter in most meals. 

• Dehydrated or Freeze-Dried Vegetables: These can be rehydrated and used in meals.

• Pork Rinds & Low-Carb Jerky: These are excellent snacks that can fit perfectly into a keto diet. Aim for products with no added sugars and preservatives.

• Medical Ketogenic Formula: Even if your child does not rely on ketogenic medical formula on a regular basis, consider having a small supply on hand for inclement weather situations. These medical formulas can provide your child with all of their nutrition needs in a shelf-stable product. 

2. Maintain an Adequate Supply of Medical Formula

For many children on the ketogenic diet, medical formulas are a vital part of their nutrition. Ensure you have a sufficient supply to last through potential disruptions by regularly checking your inventory and reordering before you run low, especially during seasons of inclement weather. Talk to your supplier about the process for emergency ordering due to weather and delivery timelines. Store the formula properly by keeping it in a cool, dry place, and check expiration dates regularly.

3. Plan for Power Outages

Power outages can jeopardize refrigerated and frozen keto foods. Here’s how to stay prepared if you have some warning of an impending storm (such as a hurricane):

• Coolers and Ice Packs: Have coolers and ice packs ready to keep perishables cold if the power goes out. Try and have several meals weighed and ready-to-go if you know your area might be impacted by a storm. 

• Dry Ice: Consider purchasing dry ice, which can keep items frozen for a longer period.

• Non-Electric Kitchen Tools: A manual can opener and battery-operated or hand-crank blender can be useful for preparing meals without power. A portable gas stove or grill can be used to cook or reheat foods when there’s no electricity.

4. Emergency Meal Planning

With the help of your ketogenic dietitian, develop a list of simple, keto-friendly meals that can be prepared with minimal ingredients and no cooking. Here are a few ideas:

• Tuna Salad: Mix canned tuna with mayonnaise and serve with olives.

• Nut Butter with Dark Chocolate: Spread nut butter on a piece of dark chocolate for a quick snack.

• Avocado & Salt: Slice an avocado and sprinkle with salt for a nutritious and easy option.

• Salmon & Avocado: Canned salmon mixed with avocado (shelf-stable if uncut) and a handful of nuts.

• Sardines & Olives: Sardines with olives, drizzled with olive oil, and a side of pickles.

5. Medication & Supply Management

Ensure all medications are filled and up-to-date. In an emergency, access to pharmacies may be limited, so having a sufficient supply is critical. For those kiddos on g-tubes and fed through a pump, consider having gravity bags and/or 60 cc syringes so that you can still provide formula without the necessary power a pump requires. Also, be sure to have an adequate supply of glucose or ketone monitoring devices and supplies if these are a part of your ketogenic monitoring plan. 

6. Hydration & Electrolytes

Maintaining proper hydration and electrolyte balance is crucial, especially during stressful situations. Stock up on:

• Water: Be sure to have an ample supply of bottled water for hydration and medication administration. 

• Electrolyte Supplements: Powdered or tablet forms are convenient and can help you stay hydrated. Check with your ketogenic diet team on best electrolyte supplements for your unique needs. 

• Broth or Bouillon Cubes: These are great for maintaining sodium levels and can be made into a quick drink.

7. Create a Disaster Kit

Assemble a disaster kit that includes:

• First Aid Supplies: Basic first aid materials and any specific items related to your child's condition.

• Flashlights and Batteries: To navigate in the dark and prepare meals using your gram scale. 

• Contact Information: Keep a list of essential contacts, including your healthcare provider and dietitian.

By preparing thoroughly, you can help ensure your child's ketogenic diet remains uninterrupted during inclement weather, reducing the risk of seizures and maintaining their health. Stay safe and proactive, and always reach out to your healthcare team with any concerns or questions.

Remember, preparation is key to navigating any storm successfully. Stay safe and take care!

Low-Carb French Fry Favorites: Satisfy Your Cravings on Keto

Author: Taylor Parrish, RDN, LD
Editor: Laura Dority, MS, RD, LD

Craving the crunch and flavor of classic French fries while sticking to your keto lifestyle? Look no further! In this blog, we share 5 keto-friendly French fry recipes that have been taste-tested and approved, ensuring you can enjoy your favorite snack without compromising your low-carb goals.

Let’s get started with jicama, turnips, and celeriac root! The goal was to add enough oil to get to around a 1:1 ketogenic ratio. The celeriac root has the most carbs and least amount of fiber so more oil was needed to achieve this goal. If you need a ketogenic ratio higher than a ~1:1, pair the fries with a high fat condiment, dip, or drizzle with oil after cooking. Adding more oil to the recipe doesn’t always work because the vegetables can only absorb so much oil during the cooking process. Any high cooking temperature oil will work in these recipes such as refined avocado or olive oil. 

Jicama Fries

Recipe Credit: Victoria’s Keto Kitchen

Start by cutting your jicama into fry-like sticks and then boil the cut jicama in water for 30 minutes until soft. Some of the sticks may turn darker brown during boiling but it’s important to boil until soft before “frying” or the middle will still be crunchy after cooking. After boiling, weigh out 141 grams jicama, 8 grams oil, and salt to taste. Then cook them at 400 F° in the air fryer for 16-19 minutes (flipping halfway). Be sure to watch closely the last few minutes so they don’t burn. For a salt and vinegar taste, add vinegar to the water when you are boiling the jicama.

Nutritional Information (full recipe):

125 calories, 8 grams fat, 12.5 grams carbohydrate, 7 grams fiber, and 1 gram of protein for a ~1.3:1 ketogenic ratio

Review:

The jicama fries had a very satisfying crunchy texture and a sweeter flavor which is characteristic of jicama…almost like a tropical potato. The vinegar was a nice change in flavor so be sure to try that option.

Turnip Fries

Recipe Credit: Dr. Axe

Turnips are a great fry option because they look, feel, and cook just like potatoes yet have significantly less carbohydrates/starch. For this recipe, start by peeling the turnips and then cut into sticks. Boiling the sticks for about 5 minutes until soft is helpful. Combine 158 grams (2 small turnips), 10 grams oil, garlic powder, and salt in a bowl and toss to coat. For this experiment, I baked half of the mixture in the oven and air-fried the other half. From the original recipe, I lowered the temperature to 400 F° to prevent the fries from browning too quickly and baked for 20 minutes, flipped, and then baked for another 15-20 minutes.

Nutritional Information (full recipe):

133 calories, 10 grams fat, 10 grams carbohydrate, 3 grams fiber, 1.5 grams protein for a for a ~1.2:1 ketogenic ratio

Review: The turnip fries tasted most like a French fry but had a “chemical” aka turnip flavor aftertaste. By boiling the turnips, the aftertaste can be reduced. While these tasted most like a French fry, they were not very crunchy and had a soggier texture. Due to the taste, turnips likely make for a great mashed potato alternative versus a fry.

Celeriac (Celery) Root Fry

Recipe Credit: Taylor Parrish

First, peel the celeriac root and use a mandolin slicer (if available) to create sticks. Then measure out 221 grams of celeriac root, 25 grams of oil, and salt to taste. If baking in the oven, bake at 425 F° for 15 minutes flipping halfway through the cooking time. For the air fryer, cook at 420 F° for 10 minutes, flip, and cook for another 6 minutes or so. The air fryer created a crunchier product compared to the oven.

Nutritional Information (full recipe):

314 calories, 26 grams fat, 20 grams carbohydrate, 4 grams fiber, and 3 grams of protein for a 1:1 ketogenic ratio

Review: The celeriac root fry had a subtle celery taste but ultimately tasted most like a French fry with a great natural flavor that didn’t require a lot of seasoning. Unfortunately, it was not crunchy and didn’t “look” like a fry. 

Now let’s move on to almond and coconut flour options! For these, during the cooking process I did spray the fries with olive oil but I didn’t calculate any of the oil into the nutritional information. These will not absorb oil well during the cooking process. You will need to pair these with a high fat dip, condiment, or additional oil after cooking to boost the ratio.

Almond Flour Fry

Recipe Credit: Ketofocus

For this recipe, I halved the original recipe so I started with 50 grams of blanched almond flour, 6 grams of xanthan gum, and 3 Tbsp of water. Combine these ingredients and knead together. Place the mixture between two pieces of parchment paper and roll out until about 1/8” thick and then put in the freezer for 30-45 minutes until firm. If you skip this step, the dough will be sticky. Using a pizza cutter, cut the dough into sticks. I used the air fryer for cooking but the original recipe also has instructions for frying and baking. For the air fryer, lay the sticks flat on the cooking sheet, spray with oil, sprinkle with salt (to taste), and bake at 400 F° for 6 minutes.  

Nutritional Information (full recipe):

288 calories, 18 grams fat, 21 grams carbohydrate, 10 grams fiber, and 13 grams of protein for a 0.75:1 ketogenic ratio

Review: These were not as flavorful as the other options but were easy to add onion or garlic powder and rely on sauce for flavor. Ultimately, these had a look and mouthfeel closest to a French fry but mimicked a breadstick in texture.

Coconut Flour Fry

Recipe Credit: Low Carb Love

For the coconut flour option, I used the same recipe and technique as the almond flour recipe but with more xanthan gum and water because coconut flour absorbs water more than almond flour (50 grams coconut flour, 12 grams xanthan gum, and ½ cup water). After combining all ingredients, cook in the air fryer at 400 F° for 5 minutes. These did result in more browning than the almond flour, so less cooking time was needed.

Nutritional Information (full recipe):

255 calories, 5 grams fat, 41 grams carbohydrate, 27 grams fiber, and 11.5 grams of protein for a 0.2:1 ketogenic ratio

Review: The coconut flour is prominent and the mouthfeel is like a crispy breadstick.

Don’t Forget Your Condiments

As important as the fries, be sure to pair your fries with keto-friendly condiments. Here are a few suggestions to help guide you:

Keto Friendly Chick-Fil-A “ish” Sauce

Alfredo Sauce

Homemade Mayo

Sugar-Free Ketchup Mixed with Mayo

Sir Kensington’s Truffle Garlic Aoili (1 gram net carbs per Tbsp) 

Primal Kitchen Dipping Sauce: Special Sauce (1 gram net carbs per Tbsp) 

Charlie Foundation Condiment Recipes

Special Sauce (Makes ~13 Tbsp)

½ cup avocado oil mayo

1 tsp no sugar added dill pickle juice

2 T sugar-free ketchup

2 T chopped-up dill pickle (no sugar added)

2 tsp Dijon mustard (emulsifier)

1 ½ tsp coconut aminos

½ tsp onion powder

½ tsp garlic powder

½ tsp paprika

Mix all of these together and store in fridge up to two weeks.

Nutrition Information (per Tbsp): 67 calories, 7 grams fat, 1 gram carbohydrate, 0 grams fiber, 0 grams protein for a 7:1 ketogenic diet ratio

General Tips To Elevate Your Keto Fries

• If possible, cut all the fries the same size and thickness. This will prevent having some crispy overdone “fries.”

• If you like fries, invest in a mandolin slicer.  This will make the process easier by creating uniform sizes.

• Watch the fries closely towards the end of cooking time. They can burn quickly.

• Let the fries rest for a few minutes before eating – this will help with the crunch factor.

• Be sure to salt before baking but to prevent burning, add remaining seasonings after baking.

Overall, both the almond and coconut flour options look most like fries but had a breadstick mouthfeel which could pair great with a high fat dip! The vegetable-based fries tasted most like a fry. I would make celeriac root fries and jicama fries again and keep turnips as an alternative for mashed potatoes. None of the fries absorb a lot of fat during the cooking process so don’t rely on oil added during the cooking process to meet fat goals. Be sure to utilize keto friendly condiments, dips, or added fat after cooking to boost the ketogenic ratio and get in adequate fat for your keto plan!  

Disclaimer: Cooking times and nutritional information will vary based on ovens/air fryers and specific brands of ingredients chosen in these recipes.