Back to School: Tips for Packing Keto Lunches

We are excited to welcome back Dana Haddox-Wright, keto mom and guest blogger extraordinaire! Dana lives in Connecticut with her husband and two adorable daughters. Her 6-year-old daughter has Dravet Syndrome and has been on the ketogenic diet for over two years. As you prepare for your children to head back to school, we hope you will find Dana’s tips for packing a keto lunch box useful and timely. Be sure to check out Dana’s previous blog posts: “Tips for Making the Ketogenic Diet Fun” and “Ten Things That Only Keto Parents Would Understand“. 

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Preparing food for children can be a daunting task, particularly when they are on the ketogenic diet. Kids on the diet are not always predictable. What they absolutely love one day, they may not want to touch the next. And the hours spent in the kitchen might drive any parent crazy (or to drinking, whichever comes first). The struggle is real for us. Just when we narrow down several “favorites” the kids love, we are then confronted with another challenge….SCHOOL.

Work Around School Policies

School policies on food vary by district, but most do not allow tree nut products. No macadamia nut, almond, or peanut-based foods are allowed much of the time. This significantly limits our fat options. If your child’s school cafeteria does allow nuts at designated tables, then you are ok. Other parents will need to get creative. Coconut is a useful substitute, but you may need to convince your school administrators that it is ok. When my daughter’s school told me that I would not be able to send in coconut based foods, I was confused. I contacted the keto dietician, and she told me that though coconuts grow on trees they are technically not “tree nuts,” and it is very rare for individuals with tree nut allergies to have a reaction to them. She wrote the school a letter that was shared with the school nurses, and problem solved. Once you know what you CANNOT send to school, you can experiment with alternate recipes. Try using coconut flour or flaxmeal in exchange for nut flours.

Keep It Simple

Another helpful hint is to keep things simple. You can make delicious meals that do not require a lot of components or ingredients. A few of my daughter’s favorites that are not messy or complex include the bake and freeze pizzas (using flaxmeal instead of macadamia nuts), cheesecake, hotdogs with “awesome sauce” (low sugar ketchup and mayonnaise with cut up cooked hot dog mixed in) and a side of cream (made into whipped cream). Last, but not least, a nice water bottle with a keto-safe flavoring and some liquid stevia is a great alternative to the juice boxes that kids often have.

Remember the Social Aspect 

Lunch period is time that kids socialize. Something to remember is that kids pay attention to what their peers pack in their lunches. Knowing this, I try to make my daughter’s lunches tasty and fun while meeting all the keto requirements. You may also want use the school lunch calendar as a guide. Attempt to mimic what the school cafeteria will be serving.

Listen to Your Child

Take time to listen to your children. If they say they want carrots or apple, attempt to work them into new recipes (assuming you have time in your busy schedule). In the end, it is all about making things easier while keeping our little ones safe.

Put On Your Advertising Hat

As the head keto-chef in my house, I try to prepare things that even I would want to eat. Think like an advertiser. Market to your child, and everyone wins. Find keto-friendly food coloring for cookies or cakes, or even for their water to add to visual appeal. On a diet that is so restrictive, there are ways to turn limits into opportunities.

Know That It’s All Worth It

Know that the time you spend being a keto mad scientist, is time well spent. Your kids, whether they can verbalize it or not, will appreciate your effort. They will know that you put your love for them into everything including their school meals.

-Dana

Fiber and the Ketogenic Diet for Epilepsy

By Ellen Sviland Avery, MS, RD, LD, CNSC

As many of you know, the ketogenic diet is a very high fat, moderate protein and low carbohydrate diet. Since carbohydrates are limited, this can also limit an important nutrient in the diet: fiber. In today’s KetoConnect post, registered dietitian Ellen Sviland Avery answers your questions about fiber and why it’s important for children on the ketogenic diet for epilepsy.

Why is fiber important?

Fiber is important in a healthy diet to maintain gut health.  It is recommended that children older than 2 years of age consume a minimum amount of dietary fiber equivalent to their age plus 5 grams of fiber per day. For example, a 4-year old child should consume at least 9 g of fiber per day (4+5=9). A safe range of dietary fiber intake for children is suggested to be their age plus between 5-10 grams of fiber per day. 1 Research has also shown that up to 55% of children don’t meet fiber needs with an oral diet. 2,3

How does this affect my child on the ketogenic diet?

As previously stated, fiber may be limited in the ketogenic diet. Fiber is primarily found in fruits, vegetables and grain products. Due to the low carbohydrate intake of the ketogenic diet, these foods are typically consumed in small quantities, limiting the amount of fiber consumed. Because of the lack of fiber and bulk in the diet, constipation is a common side effect. 4,5 Gastrointestinal symptoms, especially constipation, are seen in ¾ of all ketogenic diet patients.6

So how do I improve these side effects?

To help prevent or alleviate constipation with the ketogenic diet, talk to your child’s doctor or dietitian to ensure your child is receiving adequate fiber and fluid. Speak with the dietitian about foods that may be higher in fiber that will fit in your child’s ketogenic ratio. Sometimes just increasing the amount of fiber consumed by small amounts will help with constipation. If needed, the doctor or dietitian may also prescribe a fiber supplement or even a carbohydrate-free laxative. Do not give your child any laxative without first consulting with the medical team.

How can KetoCal help with fiber needs?

KetoCal 4:1 contains fiber to help meet your child’s fiber needs while on the ketogenic diet. One drink box of KetoCal 4:1 LQ contains 2.6 g fiber. The great thing about the fiber found in KetoCal is that it comes from a patented blend of six different types of fibers, rather than just one type. This helps to better resemble the blend of fiber one would get from eating a healthy diet. Talk to your dietitian to see how KetoCal fits into your child’s meal plan!

-Ellen

  1. Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics. 1995;96(5 Pt 2):985-8.
  2. Butte NF, Fox MK, Briefel RR, et al. Nutrient Intakes of US Infants, Toddlers, and Preschoolers Meet or Exceed Dietary Reference Intakes. Journal of the American Dietetic Association. 2012;110(12):S27-s37.
  3. Hampl JS, Betts NM, Benes BA. The ‘age+5’ rule: comparisons of dietary fiber intake among 4- to 10-year-old children. J Am Diet Assoc. 1998;98(12):1418-23.
  4. Dahl WJ, Niebergall EJ, Owen RJ. Implications of fiber inadequacy in the ketogenic diet: a case study. ICAN: Infant, Child, & Adolescent Nutrition. 2011;3(5):3.
  5. Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009;50(2):304-17.
  6. Bergqvist AG. Long-term monitoring of the ketogenic diet: Do’s and Don’ts. Epilepsy Res. 2012;100(3):261-6.

Ketogenic Diet Myths and Misconceptions Series: Heart Disease

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One of the most common misconceptions about the ketogenic diet for epilepsy is that it will lead to heart disease, also known as cardiovascular disease. It is true that consuming high amounts of certain types of fats (including cholesterol, saturated fats and trans fats) can lead to high levels of lipids in the blood, which may increase an individual’s risk for developing heart disease. It is also true that high lipid levels are a common side effect of the ketogenic diet. However, when the ketogenic diet is used under proper medical and nutritional supervision, lipid levels can typically be controlled.

When an individual is on a ketogenic diet for epilepsy, their health care team will regularly monitor their blood lipid levels. If high lipid levels are found, adjustments can be made to the diet in order to bring the levels down to a safe level. This is just one of the many reasons why it is so important to only do the ketogenic diet under close medical and nutritional supervision.

A 2008 study from Johns Hopkins Hospital found that about a third of children developed high lipid levels after starting the ketogenic diet[1]. Interestingly, the researchers noted that in many cases, the high lipid levels were only temporary. As the children’s bodies adjusted to the high fat diet, their blood lipid levels often normalized and returned to near pre-diet levels within 6-12 months[2].

As mentioned above, the ketogenic health care team can make certain adjustments to the diet in order to help prevent or manage high lipid levels. For one, the ketogenic dietitian can help caregivers to incorporate more healthy fats into the diet and reduce the intake of unhealthy fats. The Children’s Hospital of Philadelphia (CHOP) published a report in 2009 about six children who developed high lipid levels on the ketogenic diet[3]. The children’s caregivers were encouraged to reduce foods with high levels of saturated fat and cholesterol (such as heavy cream, butter, egg yolks, etc.) and to incorporate more healthy fats into the diet (such as vegetable oils, nuts, etc.). These simple diet adjustments led to improved lipid levels for all six of the children observed.

It’s important to note that high lipid levels may be less of a concern for children on the ketogenic diet who are tube-fed or who otherwise consume a formula-only ketogenic diet. The previously mentioned 2008 Johns Hopkins study found that children on formula-only ketogenic diet were much less likely to develop high lipid levels in comparison to children who consumed a solid food ketogenic diet. This may be because ketogenic diet formulas have relatively low levels of saturated fat (20%) in comparison to the amount of saturated fat in a typical solid-food ketogenic diet (60%).

In summary, the belief that a ketogenic diet for epilepsy will lead to heart disease is a common misconception. Although high lipid levels can increase an individual’s risk for developing heart disease, lipid levels can usually be managed with close monitoring and guidance from the ketogenic diet health care team. As always, be sure to discuss any questions or concerns with your health care provider.

 

  1. Nizamuddin, J., et al., Management and risk factors for dyslipidemia with the ketogenic diet. J Child Neurol, 2008. 23(7): p. 758-61.
  2. Kossoff, E.H., et al., Ketogenic Diets: Treatments for Epilepsies and Other Disorders. Fifth ed. 2011, New York, NY: Demos Medical Publishing.
  3. Fenton, C., C.M. Chee, and A.G.C. Bergqvist, Manipulation of Types of Fats and Cholesterol Intake Can Successfully Improve the Lipid Profile While Maintaining the Efficacy of the Ketogenic Diet. ICAN: Infant, Child, & Adolescent Nutrition, 2009. 1(6): p. 338-341.

Ketogenic Diet Infographics

Information graphics, better known as infographics, are visual representations of information. Infographics provide a quick and clear way to learn about a topic without having to read a large amount of text. They are a popular way to share information via social media.

Given the current popularity of infographics and their usefulness for sharing complex information in an easier-to-understand way, we searched the web for the best infographics about the ketogenic diet for seizures and epilepsy. Below is our list of the top five infographics that are helpful for learning about the ketogenic diet.

If you are a parent considering the ketogenic diet for your child, we hope that you find these infographics useful for learning more about how the diet works. If your child is on the ketogenic diet and you are already familiar with how it works, these may be useful for explaining the diet to friends, family, teachers, etc.

  1. Our favorite infographic about the ketogenic diet is from Lurie Children’s Hospital of Chicago. It does a great job of explaining the basics of how theketogenic diet works.

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  2. We may be biased about this infographic since it’s ours, but we think it’s useful for spreading awareness about intractable epilepsy and how theketogenic diet may help for some individuals.

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  3. This infographic from Duke Children’s Hospital provides a nice visual comparison of the percentage of fat, carbohydrate, and protein in a typical diet, classical ketogenic diet, modified Atkins diet, medium chain triglyceride (MCT) ketogenic diet, and low glycemic index treatment (LGIT).

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  4. Here is another infographic from our website, which we think is useful for explaining the difference between the classical ketogenic diet and the newer variations (modified Atkins Diet, MCT ketogenic diet, and LGIT).

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  5. Lastly, here is an infographic shared on Facebook by Gillette Children’s Hospital with holiday tips for parents of children on theketogenic diet. The winter holidays may be over, but these tips are useful for managing special occasions allyear long, such as birthday parties, Valentine’s Day, Easter, etc.
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Do you know of a helpful infographic about the ketogenic diet for epilepsy? Please share a link in the comments below!