Back to School on the Ketogenic Diet: Blog Roundup

back to school busWe don’t have to tell you that managing your child’s ketogenic diet can be tricky. As the kids head back to school, you may find that it gets a little more complicated. We’ve compiled a list of blog posts to help support you. From tips for informing the school about the diet to ideas for packing a keto-friendly lunchbox, we hope that this blog collection will help make your keto kid’s transition back to school as smooth as possible.

 

 

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

Tips for Managing Non-Neuro Doctor’s Appointments on the Ketogenic Diet

We are so pleased to share a special guest blog post today by Robyn Blackford, RDN, LDN, who is a ketogenic dietitian at the Ann & Robert H. Lurie Children’s Hospital of Chicago. She is also a Keto Ambassador Robyn often receives questions from her patients’ parents about how to educate non-neuro medical professionals about the requirements of their child’s ketogenic diet. She compiled a list of her tips to share with all of you. Thank you so much for sharing your insights and knowledge with us, Robyn!

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If your child is on dietary management for intractable epilepsy you will soon find that you are the expert. It is safe to assume that most people are unfamiliar with the ketogenic diet. Sadly, this would also include many healthcare professionals. It is true that more and more people are hearing about the diet and understanding it’s general rules, but oftentimes I hear from families that they are the ones that are teaching other healthcare teams (besides their neurologist) the intricate details of the diet.

Have you gone to your local pediatrician, dentist, or maybe even another healthcare team within the same hospital that manages your child’s diet just to find out that nobody else knows what to do in regards to the diet? Even the simplest illness such as a cold becomes a huge undertaking by the pediatrician. What used to be a simple dentist visit now takes much more planning than it did before the diet. Here are a few things to consider when your child has an appointment with another health professional outside of the neurologist’s office.

Share info ahead of time. Leading up to the planned admission date for your child’s ketogenic diet initiation, you can prepare your other doctors for this major change in your child’s life. Share diet information that you receive from your neurologist and dietitian with your pediatrician and any other doctors or medical teams that they see. The authors of Keto Cookbook offer a sample letter that your neurologist can use as a template. Also, have the doctor’s office add “dextrose” as an allergy in your child’s electronic chart. This will help to flag medications that are prescribed to your child if it is in liquid form and not allowed on the ketogenic diet. Doctors’ offices usually review allergies with you at the beginning of every visit. This is a good time to reiterate that you child is following a special diet.

Your child doesn’t have to try new foods. When you’re using the ketogenic diet for management of epilepsy, you get a free pass to use the same meals and snacks over and over again. Reminding the pediatrician and therapists of these things will help them to remember the specifics of the diet. They are used to encouraging their patients to try new foods, so give them a little leeway if you have to repeat yourself to them.

Keep repeating yourself. I’m sorry that you’ll have to do this, but it’s true. People, even professionals looking at your child’s medical chart, have a short memory and may forget about the special conditions and extreme restrictiveness of the diet. People may not “get it” or take the restrictions seriously. You’re repetitiveness can only be helpful to avoid errors.

Provide exact names or samples of products. If your keto kid needs a specific toothpaste at the dentist office or an exact consistency of liquids with the speech therapist, then help them out by offering a sample of the product your child needs or a list of acceptable options for use in that office. The more you “spoon feed” that professional information about what your child needs, the more likely you will have a successful visit that encourages compliance on the diet. It makes for a more pleasant experience in that office and you can focus on why you are there instead of focusing on the diet for so long.

Be gentle and kind. You’ve heard the old adage: You can catch more bees with honey than you can with vinegar. Repeating yourself, correcting people and shielding your children from unwanted foods is exhausting. I understand. But, I also know that health professionals (who love taking care of your child!) will appreciate you and listen better when you handle them with the same kid-gloves as your keto kid. Showing appreciation to your health professionals will go a long way. They might just remember the diet guidelines easier when mutual respect is shared.

Send them to the websites. There are many great resources for parents and professionals for the ketogenic diet. Instead of spinning your wheels and trying to explain the diet (again and again), simply send them to these websites. Here are a few that I like and trust:

In addition to the neurology team, keto kids may be cared for by pediatricians, emergency room professionals, dentists, community hospitals, surgeons, gastroenterologists, nurses, therapists and the list goes on. We hope this blog post has helped you to help your other medical teams take the best care of your child while on the ketogenic diet.

Again, as a keto parent, you really are the expert! Do you have any experiences or advice to share with others?  Please share in the comments below.

-Robyn

Happy Registered Dietitian Nutritionist Day!

Did you know that today is Registered Dietitian Nutritionist Day? Each year on the second Wednesday of March, the Academy of Nutrition and Dietetics honors the many contributions of Registered Dietitian Nutritionists (RDNs).  The expertise and dedication of RDNs has a great impact on the health and well-being of their patients and community. If you have a child on the ketogenic diet, you know just how important and valuable it is to have a knowledgeable and committed RDN. If you are grateful for your ketogenic dietitian (a RDN with special training and expertise in implementing the ketogenic diet), today is the perfect day to let them know!

We’d like to give a special recognition to the many dedicated ketogenic dietitians out there, especially our five awesome Keto Ambassadors. Your contributions make a difference in the lives of your patients and the entire ketogenic diet community! Read more about our Keto Ambassadors here: http://www.myketocal.com/ambassador.aspx.

Check out this YouTube video to learn more about the many ways that RDNs make a difference.

KetoCal Supports Rare Disease Day 2015!

KetoCal is a medical food used by individuals with intractable epilepsy who are on a ketogenic diet. Within the category of intractable epilepsy, there are many different seizure disorders, many of which are rare diseases. KetoCal is also used by individuals with rare metabolic disorders that are managed with a ketogenic diet, including GLUT1 Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency (PDHD). Many individuals in our KetoCal community are living with rare disease, so we wanted to take this opportunity to show our support for Rare Disease Day 2015rdd-logo

Below is a list of just some of the rare diseases within the ketogenic diet community. Please note that this list contains only the rare diseases that we are aware of from talking with caregivers and healthcare providers of individuals living with these diseases; If we are missing one that is important to you, please let us know. If you get a chance, please take a moment to click on the links to learn more about these rare conditions.

Rare Disease Day 2015 is on February 28th. To learn more about Rare Disease Day, and how to get involved, visit http://www.rarediseaseday.org/.

Rare Disease: Numbers: Learn more:
GLUT1 Deficiency Syndrome About 500 cases have been diagnosed worldwide http://www.g1dfoundation.org/
Pyruvate Dehydrogenase Deficiency (PDHD) Several hundred cases reported https://www.rarediseases.org/rare-disease-information/rare-diseases/byID/413/viewFullReport
Myoclonic-Astatic Epilepsy (Doose Syndrome) Estimated 1 in 10,000 http://doosesyndrome.org/
Tuberous Sclerosis Complex Estimated 1 in 10,000 http://www.tsalliance.org/pages.aspx?content=2
Rett Syndrome Estimated 1 in 10,000 females (very rare in males) https://www.rettsyndrome.org
Severe Myoclonic Epilepsy of Infancy (Dravet Syndrome) Estimated 1 in 30,000 http://www.dravetfoundation.org/
Infantile Spasms (West Syndrome) Estimated 2-3.5 in 10,000 http://www.infantilespasmsinfo.org/index.php
Lennox-Gaustaut Syndrome Estimated  1 in 50,000-100,000 http://www.lgsfoundation.org/
Angelman Syndrome Estimated 1 in 15,000 http://www.angelman.org/
Landau Kleffner Syndrome Unknown http://www.epilepsy.com/learn/types-epilepsy-syndromes/landau-kleffner-syndrome
Alternating Hemiplegia of Childhood Estimated 1 in 1,000,000 http://ahckids.org/ or http://cureahc.org/

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.

Tips and Recipes for Making Valentine’s Day Fun for Your Keto Kid

valentinesdayLike most holidays and special occasions, Valentine’s Day can be tricky when you have a child on the ketogenic diet for epilepsy. Most valentine celebrations involve candy and other sweets not allowed on the ketogenic diet, which can make it stressful for parents trying to ensure that their child does not consume any non-allowed foods.  Parents may also find it challenging to make the day fun despite the dietary restrictions. Fortunately, little things go a long way when it comes to making special occasions fun for kids. For today’s KetoConnect Blog Post, we have some tips and ideas for small ways to make Valentine’s Day fun and special for your keto kid.

Add a Festive Touch!

You can make any meal more festive with a cute Valentine’s Day-themed straw, cup, plate, etc.

Decorate Your KetoCal!

Replace your child’s regular KetoCal with pink, strawberry-flavored KetoCal. Simply add a sugar-free, carb-free strawberry flavoring, such as DaVinci Gourmet’s strawberry syrup, to the KetoCal LQ Vanilla. Add your festive straw and voila!–You have a Valentine’s treat!

Another idea is to actually decorate the KetoCal LQ drink box. We found some cute ideas on Pinterest, such as these. You can find more ideas on our “Valentine’s Day on the Ketogenic Diet board on Pinterest! (Please note- these ideas use juice boxes, so you would just use your KetoCal LQ boxes instead).

Make Everything Heart-Shaped!

Another easy way to make Valentine’s Day special is to make your child’s favorite foods in the shape of a heart. Below are a few ideas:

  • Make your KetoCal pancakes into hearts by pouring the batter into a cookie cutter on the pan.
  • Make a heart-shaped KetoCal pizza by spreading the pizza dough into the shape of a heart before topping and cooking (you could do this by hand or using a larger-sized cookie cutter–just place the cookie cutter on the parchment paper and spread the dough inside of it to shape the pizza).
  • Make heart-shaped muffins or cupcakes using heart-shaped silicone baking cups, such as these.

Embrace Pink!

Celebrate Valentine’s Day by making recipes that are naturally festive by color! Here are some recipe ideas that are pink and perfect for Valentine’s Day.

Rasstrawberry_smoothiepberry or Strawberry Smoothie:

Our KetoCal Raspberry or Strawberry Smoothie recipes are naturally pink in color and perfect for Valentine’s Day. Optional–Top with whipped heavy cream sweetened with carb-free sweetener and serve with a festive straw!

KetoCal Cherry Float:

Add scoops of KetoCal Vanilla Ice Cream to any sugar-free, carb-free cherry-flavored soda, such as Zevia® Black Cherry or Professor Fizz (please note, these sodas are not carb-free but the carb comes from erythritol, which some dietitians do not count towards total carbohydrate– check with your dietitian first). Usually, the carb-free cherry soda is red in color but if the brand you use is not, you could add a small amount of red food coloring. Optional- top with whipped heavy cream sweetened with carb-free sweetener and serve with a festive straw!

Strawberry Panna Cotta:panna-cotta

Panna Cotta is a creamy Italian dessert. Our KetoCal Strawberry Panna Cotta recipe is tasty and perfectly-colored for a Valentine’s Day treat!

Make Awesome Non-Food Valentines!

Many valentines involve candy, but there are many other options for non-food valentine treats which are just as much fun for kids. We found some awesome ideas for non-candy valentines on Pinterest. You can check them out on our “Valentine’s Day on the Ketogenic Diet” Pinterest board. If your child’s school is having a Valentine’s Day celebration, send along some non-food valentine treats for your child and the rest of the children to enjoy. If you are friends with other parents of children in the class, you could share some non-food Valentine ideas with them as well. There are likely other children in the class with food restrictions, such as those with food allergies, and many parents try to minimize their children’s sugar intake, so you might find that other parents embrace the awesome non-food valentine idea too!

-Mallory