A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight.[19] Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch, and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.[31]

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Hi Megan, Sorry about that – there was an issue with that section and you should now see it in the FAQ above, explaining how it’s determined. The weight loss per week will depend on how much weight you have to lose, as weight loss happens more rapidly the more overweight you are. But in general, between 0.5 and 2 pounds loss per week is reasonable.
A. When you first start a ketogenic diet, you may temporarily experience flu-like symptoms such as dizziness, brain fog, irritability, stomach trouble, insomnia, and more, as your body switches from burning glucose to burning fat. These symptoms can occur for a few days up to a few weeks and are a natural reaction that you’re encouraged to push through. You can alleviate symptoms by increasing hydration, electrolytes, and natural salt consumption. Get lots of rest and exercise gently. Lastly, consuming activated charcoal binds any toxins stored in the fat you’re shedding and can reduce nasty detox symptoms.

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Hi Michelle, You don’t necessarily have to “hit” macros to get into ketosis. Ketosis is achieved by restricting carbohydrates, that’s it. Fat is needed for satiety and protein is needed to prevent muscle loss. So make protein a goal and carbs a limit, then eat enough fat to stay satisfied and don’t go over your macros. You can get more individual help in our support group.

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The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favorably with the traditional ketogenic diet.[18]
The keto diet isn’t exactly new. It’s been used to treat epilepsy since the 1920s, and it’s had promising outcomes from treating Type 2 Diabetes. However, epilepsy and diabetes aren’t the only reason people give the ketogenic diet a try. It’s also used as a diet for weight loss. The diet banishes most carbs, including fruit, and opts-in for fatty foods like avocados, salmon, eggs, cheese, butter, oil, and the holy grail of fatty meats — bacon.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[19] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[18] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[19] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[45]

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The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]

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Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]

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Thank you, Maya! That helps a lot. I’ve had a difficult time with some tracking apps, because it goes by what others put in and finding an exact match is tough. I like your idea of just tracking for the day. I thought about getting a notebook and doing it that way. I’ll ponder that. Thank you for adding the nutritional info on each recipe. That helps so much!

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Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[19] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[31] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[18] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[51] Other formula products include KetoVolve[52] and Ketonia.[53] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[53]
But what’s lost in the many trend articles and books about “going keto” for weight loss today is that this diet is the same one the now-late Dr. Robert Atkins and other low-carb evangelists have been selling since the 1960s. (Diet peddlers have an incredible knack for rebranding old ideas over and over, and in our eternal confusion about what to eat, we keep falling for it all.)

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Since the ideal protein intake is fixed based on your lean mass and activity level and your net carbs intake is specified by you, the only macronutrient that needs adjusting is the fat intake. Your fat intake is used to adjust the calorie intake. The more fat, the more calories. Typically, you adjust fat so that you reach but not exceed your target calories.

Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.


But people who started following the keto diet noticed weight loss for a few reasons: When you eat carbs, your body retains fluid in order to store carbs for energy (you know, in case it needs it). But when you’re not having much in the carb department, you lose this water weight, says Warren. Also, it's easy to go overboard on carbohydrates—but if you're loading up on fat, it may help curb cravings since it keeps you satisfied.

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Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[56]

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First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]

For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]

DEXA scans are proven to be the most accurate measurement of body fat. They’re commonly available at gyms and some doctor offices when requested. If you don’t have access to this, you can always go the old-fashioned route and use a good quality caliper. The last resort is using a guide to visually estimate – this can sometimes be a little bit inaccurate, so try to over estimate your body fat percentage.
If you stick to g of carbs, g protein, and g fat, you will eat kcal and lose kg (lbs) in the first month. Keep in mind that your body weight can fluctuate by ±2kg (±4lbs) on any given day from water weight and what's in your stomach. Recalculate your macro ratio once a month! Changes in body composition have a large influence on the recommendations and weight loss.

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Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]

Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.

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I have been with the Keto diet for about 3 weeks. It is a learning curve. I am learning new stuff every day. Your website is the best for me. I love your recipes and free information. I feel like I need to start counting my Macros. I use your recipes but I like to change things up a bit to suit my taste, like adding more veggies, switching out the almond milk for cream. How can I get counts for the recipes when I do substitutions?

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A dirty keto diet also follows the standard keto diet but with disregard to the nutrient value or quality of the food consuming. For example, you could go to a fast food restaurant and order a bunless cheeseburger chased down with a diet soda and still be keto. This works if you’re traveling and really have no better options, but is not recommended in the long run because of a host of negative effects, such as the inflammation, cravings, increased blood pressure due to the high sodium, and bloating.

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Compared to the baseline diet, the low-carb diet did not cause subjects to experience an increase in fat loss. To be more specific, it took the full 28 days on the low-carb diet for the subjects to lose the same amount of fat as they did in the last 15 days on the baseline (higher-carb) diet that wasn’t even designed to get them to lose weight. The researchers did not find evidence of big benefits regarding energy expenditure or fat loss after switching to a low-carb diet.

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NOTICE: The information contained or presented on this website is for educational purposes only. Information on this site is NOT intended to serve as a substitute for diagnosis, treatment, or advice from a qualified, licensed medical professional. The facts presented are offered as information only - not medical advice - and in no way should anyone infer that we or anyone appearing in any content on this website are practicing medicine. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professional. Seek the advice of a medical professional for proper application of ANY material on this site to your specific situation.

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