Ketosis for Children

Dr. Anthony Gustin is a board-certified sports chiropractor, functional medicine practitioner, entrepreneur, podcast host, and founder of Perfect Keto.

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Living the ketogenic life is a great health decision, but those with kids might wonder about ketosis for children. How might the keto lifestyle benefit our offspring, too? This article explores ketogenic foods for both medical reasons as well as the pros and cons involved for health promotion in children.

Uses of the Ketogenic Diet for Kids

The ketogenic diet was actually initially developed for children. It was, and still is, used in hospitals as an effective alternative therapy for reducing seizures in kids with epilepsy.

Besides epilepsy, though, ketosis has been used as treatment for children with other conditions where the body isn’t able to use glucose efficiently, including:

  • Lennox Gastaut syndrome
  • Glucose transporter type-1 deficiency
  • Dravet syndrome
  • Pyruvate dehydrogenase deficiency

Hospital treatment to induce ketosis in children works a little differently than just eating keto at home. Below is an overview of how it typically works.

Ketosis Treatment Process for Children

Hospital treatment with the keto diet for children with epilepsy might start with a medically-monitored fast for one or two days. Fasting helps speed up the creation of ketones. Other programs might avoid fasting, and instead, gradually increase fat intake over a few days. Medical staff will monitor closely during this time to ensure there are no adverse changes.

After this phase, the child may first be given keto shakes to drink before moving to solid food. A medical team that includes a registered dietitian, the physician, and a registered nurse are typically involved [1] to make the child is avoiding any nutritional deficiencies and not having any adverse side effects.

The team will also educate parents on how to incorporate the diet into the child’s daily life and how to check urine for ketones, as well as how to check for other products in the home that might contain carbohydrates, such as mouthwash, toothpaste, and medications. These small things matter when following a ketogenic diet for medical reasons. This process can take around 1-2 weeks [1].

If the diet is successful and the child’s parents are able to fully monitor and help them follow the diet well enough at home, the kids may be able to take less medication for their condition. Regular follow ups are done to monitor metabolism and seizure control.

Ketogenic Macronutrients for Children

The nutrient ratio for the ketogenic diet in children is typically 4:1 for fat to protein and carbs combined. Additionally, foods might be weighed per gram on a scale. Protein might be changed depending on the current weight of the child. See this link from Children’s Hospital for how a sample menu might look.

The ketogenic diet used by medical hospital teams might be higher in unhealthy fats (just look at the state of regular hospital food these days). Many hospitals will have their own formulas for keto foods, such as a blend of oils, shakes, or other pre-made foods with butter, heavy cream, and vegetable oils that are easier for kids. Parents might want to closely monitor the quality of ketogenic foods being used.

As far as whole food sources for fat and protein, those would be similar to the standard ketogenic diet food list. Since carbohydrates are basically non-existent on keto for kids, any carb-rich foods like breads, rice, other grains, or sugars are eliminated.

Ketogenic Diet for Children at Home

Besides keto being used for medical reasons in children, parents following the ketogenic diet wonder how they can get their kids on board with the food (and also help them learn to grow up making healthy choices) at home.

A good place to start is with finding certain keto-friendly recipes they might like. Here are some ideas for kids and adults alike:

Breakfast: keto pancakes or waffles, smoothies, eggs and bacon, breakfast tacos

Lunch or Dinner: sandwiches with low-carb bread, meatballs, keto pizza, chili, buffalo bites, keto enchiladas

Desserts or Snacks: fat bombs, nuts or seeds/nut butters, jerky, or keto cookies (see more keto snacks here)

Ketovangelist also has a great post on transitioning children to more ketogenic diet foods and Healthful Pursuit has a list of fun, creative keto recipes that the kids might enjoy!

Keto Nutrition for Kids

As far as nutrition on the ketogenic diet, there are some specific ways ketogenic foods are beneficial for kids:

Infants, toddlers, and growing children need a good amount of iron [2] and fat [3] in their diet for proper growth. Healthy ketogenic foods provide plenty of both. These are important for brain development and growth as well as absorbing and using fat soluble vitamins and building nerve tissue [4].

With refined, high-carbohydrate foods widely available and affordable, it’s unfortunately no surprise that one in six U.S. kids and teens are obese and type 2 diabetes is now seen so commonly in children. The connection between the intake of these foods and high blood glucose and insulin resistance is reason enough for parents to show concern about the high-carb foods their children are consuming.

If you look at these foods’ labels, you’ll see they’re fortified with vitamin and minerals for this exact reason—on their own, they’re very nutritionally poor.

So, let’s look at the pros of keto for kids:

Healthy Ketogenic Foods

Remember:

Nutrient needs for children are higher than adults.

Children are pickier and it might be more of a struggle to get them to eat the right foods for a ketogenic diet.

There’s a fine line between making healthy choices for your kids and being so restrictive that a healthy relationship to food develops later in life. We recommend educating kids on how foods affect us and empowering them to make health-promoting choices they’ll feel good about.

Take Away Message

At the end of the day, it’s important for healthy kids to receive great nutrition daily from high quality protein and fat sources. Compared to many of the “kid friendly” foods out there high in refined carbs and sugars, this is a big win for keto. Our kids deserve the best we can give them and that includes optimal nutrition.

Sources:

[1] Lee, Eunjoo, Hoon-Chul Kang, and Heung Dong Kim. “Ketogenic Diet for Children with Epilepsy: A Practical Meal Plan in a Hospital.” Clinical Nutrition Research 5.1 (2016): 60–63. PMC. Web. 20 July 2017.

[2] Saloojee, H., and J. M. Pettifor. “Iron Deficiency and Impaired Child Development.” Bmj323.7326 (2001): 1377-378. Web.

[3] Milner, John A., and Richard G. Allison. “The Role of Dietary Fat in Child Nutrition and Development: Summary of an ASNS Workshop.” J. Nutr. 129.11 (1999): 2094-105. Web.

[4] Purdue University. “Infants, Toddlers Should Not Restrict Fat Intake, Experts Say.” ScienceDaily. ScienceDaily, 4 February 1998. <www.sciencedaily.com/releases/1998/02/980204072045.htm>.

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Responses (6)

  1. My 9 year old daughter has recently decided (on her own!) that she wants to join mom and dad in the keto lifestyle. She is doing so well, even when no one is watching. We (my husband and I) take potassium and magnesium supplements daily, mostly to ward off muscle aches and cramps, but she can’t swallow pills and I’m not sure how much of each a child needs. I want to make sure she is getting everything she needs to be successful. Any suggestions?

  2. Hi there can you please help me someone i know has a child with Polyarteritis nodosa. I think a medical ketogenic diet would help out greatly. Could you give me any information on if this could help her child so i can forward it to her. Thank you

  3. I have a 9 year old son who is very overweight. He is now doing keto. I just wonder if his carb intake should be under 20

  4. Hi Mary, the macros for keto diet in children is typically 80% fat and 20% protein and carbs combined.

  5. @Bekah

    The easiest way to ensure kids get the adequate electrolytes is from sea salt/Himalayan salt added to foods that require salt …. and hemp seeds. Hulled hemp seeds are high in fat moderate protein and low carb. They also have a high mineral content. 3tbsp of hemp seed is enough mag, cal, zinc, etc for an adult.

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