While ketogenic diets are currently experiencing a surge in popularity, the story of their discovery and evolution is a fascinating one. The Charlie Foundation is celebrating 100 years since the invention of ketogenic metabolic therapy.
The Origins of Ketogenic Therapy
The origin of fasting went back even further, to the writings of Hippocrates in 460BC. In the 1920s, Dr. Russel Wilder at the Mayo Clinic began using a ketogenic diet in his patients who had epilepsy based on the notion that fasting was effective in preventing seizures. Wilder and his colleagues worked on different equations for creating a diet that mimicked the effects of fasting. They tested these on people who had diabetes successfully then began testing them with adults and children who had epilepsy, also with success. Eventually, Wilder published the ratio system of the three dietary macronutrients (aka “macros”), fat, protein and carbohydrate. The ratio is simply the relationship between the grams of fat to the grams of protein plus carbohydrate. In a 4:1 ratio there are four times the amount of fat in grams as there is protein and carbohydrate. The ratio system allows for variations which range between 5:1 and 1:1, however, not all ratios are appropriate for all people.
The Tedious Math of Early Ketogenic Diets
Although I get crazy excited by math and science, the tedious math equations involved in the classic ketogenic diet aren’t fun. In my early career of working with patients on classic ketogenic diet therapy, I struggled to find the time to figure out ketogenic macros then translate that into servings of food that also had to taste good. Computer applications were just becoming available and I was at the right place at the right time.
KetoDietCalculator: A Modern Solution
I was fortunate to meet a computer developer who saw this as a doable application. After months of coding and testing, we had produced a program together that was user-friendly and created ketogenic meal plans in seconds, literally seconds! KetoDietCalculator has evolved into a multi-featured tool that has been upgraded many times over the years. This unique program can be used to create variations of the ketogenic diet including different ratios (5:1, 4:1, 3:1, 2:1, 1:1) as well as the MCT oil diet, modified Atkins, and the LGIT (all are approximately 1:1 ratios). The program may be used to design diets for any age and can be modified to the specific dietary needs of an individual. KetoDietCalculator can create meals with baby food, solid food, liquid diets (formulas), or any combination of these, and, it can be accessed on mobile devices i.e.
Instructions for calculating ketogenic recipes by hand from The Epilepsy Diet Treatment, An Introduction to the Ketogenic Diet (Freeman MD, Kelly RD LD, Freeman) 1994. This book is now in its 7th edition. In comparison, here is an example of the “calculation” of a meal and its recipe in the KetoDietCalculator (KDC). In this example, Keto Porridge is one of over 300 “Standard” meals” and snacks that users can choose from. After selecting, each meal is calculated to match the individual’s macronutrients. Macronutrients (protein, fat, carbohydrate) are highlighted in yellow at the bottom. The user can adjust the meal for to suit their preference and add to or delete items in the meal. No long hand algebra necessary!
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Advantages of an Internet-Based System
A great advantage in using an internet-based system is that food data is updates are live to all users the instant they are uploaded. Department of Agriculture’s Food Composition Database. Commercial food nutrient information is obtained directly from the manufacturer. The carbohydrate content of medications and supplements is also obtained directly from the manufacturers.
Important Considerations and Access
KetoDietCalculator is for use by people who are under the supervision of a medical team, and some features of the program are only viewable to these professionals. The program is housed on a HIPPA server with anti-virus protection and is backed up every 15 minutes. This unique tool is free to health care providers who are then able to grant access to patients or clients. A licensed nutritionist must register for the program via the site (www.KetoDietCalculator.org).
Estimating Ratios in Packaged Foods
Did you know that you can quickly estimate the ratio of a packaged food item? This is a helpful skill to have when you are shopping and reading nutrition labels. You can quickly and easily estimate the ratio of a food item, but remember, there still may be hidden carbohydrate!
The Resurgence of the Ketogenic Diet
The Ketogenic Diet was almost extinct in 1994 when a little boy named Charlie Abrahams developed difficult-to-control epilepsy. His parents learned about the diet in a medical textbook and took him to Johns Hopkins Hospital in Baltimore, Md. His seizures stopped within days of starting the diet and he remained on it for five years. He is now 21, remains seizure-free, lives on his own and attends college. The family shared their story with the media and answered thousands of letters that followed. Charlie’s father, Jim Abrahams, wrote, directed and produced First Do No Harm, a 1997 television movie starring Meryl Streep and based on a true story of another child who also became seizure-free thanks to a Ketogenic Diet.
The Ketogenic Diet as a treatment for epilepsy was discovered in 1921 by Dr. Russel Wilder, MD, of the Mayo Clinic. At about the same time, German biochemist and Nobel laureate Otto Warburg published a study showing that cancer cells, unlike normal cells, use glucose for energy.
Read also: Keto Calorie Counting: A Detailed Guide
Personal Experiences and the Power of Ketogenic Diets
In 1995 I worked with a teenager who had a large inoperable brain tumor that caused seizures. He was given just weeks to live but his tenacious mother pursued all possible treatments and was referred to me to start the Ketogenic Diet. Not only did he stop having seizures, he became more alert and active, and was able to enjoy life for another year. His neurologist determined that the diet stopped his seizures and also slowed the rapid growth of his lethal brain tumor.
In 1999 I was asked to initiate the diet in a girl who had been in intensive care for three months. She was suffering constant seizures and had been placed in a drug-induced coma several times in efforts to arrest her seizures. Within a week of providing her a ketogenic formula through a feeding tube, her seizures diminished and she was soon able to go home. This method of Ketogenic Diet delivery has since been reported effective in over 40 patients in a dozen separate medical publications.
Ketogenic Diets for Epilepsy
The diet is traditionally offered after the failure of two or more anti-seizure medications. Statistically, after a second drug has been tried, the likelihood of another one controlling seizures is less than 3 percent. Ketogenic Diets improve epilepsy in over half of those who try it. Similarly, is it possible to prevent certain types of epilepsy simply by eating differently? And if we evaluate those who become seizure-free on Ketogenic Diets, could we determine the metabolic link to their epilepsy? This “special diet” would be based on whole (unprocessed) foods including fats and would eliminate sweets and added sugars.
The Benefits of a Ketogenic Lifestyle
People are shocked when they see me pour extra virgin olive oil over my meals. Eating this way I’ve experienced many benefits including clearer thinking and a greater energy level. No longer do I have the afternoon “slump.” My complexion is clearer and the post-meal bloating I experienced before is gone. People are generally surprised to learn that I’m in my 60’s. When I’m asked about my diet, my simplest explanation is that I’m on ancestral diet with generous fat-this means mostly natural/unprocessed foods including meat, fish, poultry, seeds, nuts, vegetables, berries and fats from nuts, extra virgin olive oil and butter. I feel full for long periods, I don’t crave sweets, and typically eat only two meals a day within an 8 hour window (not advised for children). Although it can be difficult to maintain this kind of diet in our carb-loaded society, eating at home is my best option.
Considerations Before Starting a Ketogenic Diet
Think the Ketogenic Diet is right for you? Talk to your doctor before adopting a Ketogenic Diet, or connect with one of our qualified diet professionals to determine a course of action that is right for you. The below links provide access to diet professionals and hospitals with expertise in ketogenic therapies.
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Understanding Ketosis
The term ketosis refers to a byproduct of the breakdown of fat into useable energy, called ketones. This fat can be derived directly from the food we eat, known as nutritional ketosis, or from stored body fat.
The Charlie Foundation's Impact
The Charlie Foundation has been supporting training to medical professionals including over 300 Ketogenic Training Seminars in 12 countries since 2006.
Defining the Ketogenic Diet
The Ketogenic Diet, or Keto for short, is a way of eating that mimics the effects of fasting. By consuming a diet rich in quality fats, adequate in protein, and low in net carbohydrates (total carbs minus fiber), the body’s metabolism begins to utilize fat as its main source of fuel.
The Classic Ketogenic Diet and its Calculations
The classic ketogenic diet (KD) is a mathematically calculated diet with specific daily goals of fat, protein, and carbohydrate. Precise quantities of foods are then derived from these values which result in meal plans for the individual patient. The algebraic algorithm to determine a single meal requires approximately 35 calculations. This process is time consuming given that each individual requires many meals for variety and satisfaction. Computer applications can process multiple calculations in seconds. In 1997, a program was designed by this author with LifeTime Computing, a computer software company.
Zucchini Keto Recipe Example
EasyYIELD: 8 ServingsMACRONUTRIENT RATIO: 2:1CALORIES: 200KETO DIET PLANS: Classic Keto, Modified Keto, Modified Atkins, Low Glycemic Index, and MCT Oil
Zucchini is readily available, inexpensive and low-carb on it’s own, it’s perfect for incorporating into ketogenic meal plans! We made this simple side dish to accompany our Sweet Italian Sausage & Chestnut Stuffed Turkey Breast for Thanksgiving 2018. You could easily add additional ingredients such as onion, tomato, or other spiralized vegetables to this dish to add different flavors and textures. To save time, or if you do not have a spiralizer, look for pre-spiralized vegetables in the produce department. Please do not use frozen spiralized zucchini for this recipe as it has not been tested. Allow them to sit over the sink for about 2 hours, they should release a good amount of moisture. Gently dry and squeeze the excess moisture from the noodles with a paper towel.
2Pre-heat the oven to 350 degrees. Grease a 9 inch baking dish with a small amount of butter then place the zucchini noodles in the baking dish in an even layer.
3In a small sauce pan, combine the heavy cream, butter and cheese. Heat the mixture over medium heat until the butter and cheese are completely melted and the sauce is smooth. Remove from the heat and add optional seasonings.
4Pour the cream mixture over the noodles and bake for about 1 hour or until nicely browned.
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