The ketogenic, or "keto," diet is a high-fat, very-low-carbohydrate eating plan that has received considerable attention as a potential weight-loss strategy. While it has been used for centuries to treat specific medical conditions, such as epilepsy in children, its application for weight loss in teenagers requires careful consideration. This article explores the ketogenic diet, its potential benefits and risks for teenagers, and provides guidance on making informed decisions.
Understanding the Ketogenic Diet
The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose-the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods-an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day-less than the amount found in a medium plain bagel-and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein.
When very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. When ketone bodies accumulate in the blood, this is called ketosis.
Historical and Current Uses of the Keto Diet
In the 19th century, the ketogenic diet was commonly used to help control diabetes. In 1920 it was introduced as an effective treatment for epilepsy in children in whom medication was ineffective. However, this diet is gaining considerable attention as a potential weight-loss strategy due to the low-carb diet craze, which started in the 1970s with the Atkins diet (a very low-carbohydrate, high-protein diet, which was a commercial success and popularized low-carb diets to a new level). Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat.
Foods to Eat and Avoid on a Keto Diet
Many versions of ketogenic diets exist, but all ban carb-rich foods. Some of these foods may be obvious: starches from both refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some that may not be so obvious are beans, legumes, and most fruits. Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Strong emphasis on fats at each meal and snack to meet the high-fat requirement. Some dairy foods may be allowed. Although dairy can be a significant source of fat, some are high in natural lactose sugar such as cream, ice cream, and full-fat milk so they are restricted. Protein stays moderate. Certain fruits in small portions like berries. Fruits other than from the allowed list, unless factored into designated carbohydrate restriction.
Read also: Easy Low-Carb Cheese Crackers
Potential Benefits of the Keto Diet
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes.
A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.
A study of 89 obese adults who were placed on a two-phase diet regimen (6 months of a very-low-carbohydrate ketogenic diet and 6 months of a reintroduction phase on a normal calorie Mediterranean diet) showed a significant mean 10% weight loss with no weight regain at one year. The ketogenic diet provided about 980 calories with 12% carbohydrate, 36% protein, and 52% fat, while the Mediterranean diet provided about 1800 calories with 58% carbohydrate, 15% protein, and 27% fat. Eighty-eight percent of the participants were compliant with the entire regimen.
Potential Risks and Side Effects of the Keto Diet for Teenagers
Following a very high-fat diet may be challenging to maintain. Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included.
The main potential side effects associated with the keto diet in children are dehydration, electrolyte imbalance, digestive issues, such as nausea, vomiting, diarrhea, and constipation, elevated blood cholesterol levels, low blood sugar, impaired growth, vitamin and mineral deficiencies.
Read also: Keto Calorie Counting: A Detailed Guide
It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)-nutrients typically found in foods like whole grains that are restricted from the diet.
Ketoacidosis: A Serious Concern
Excessive ketone bodies can produce a dangerously toxic level of acid in the blood, called ketoacidosis. During ketoacidosis, the kidneys begin to excrete ketone bodies along with body water in the urine, causing some fluid-related weight loss. Ketoacidosis most often occurs in individuals with type 1 diabetes because they do not produce insulin, a hormone that prevents the overproduction of ketones. However in a few rare cases, ketoacidosis has been reported to occur in nondiabetic individuals following a prolonged very low carbohydrate diet.
The Keto Diet and Epilepsy in Children
The ketogenic diet may be a treatment option for kids with epilepsy who are not successfully treated with medication or are not candidates for surgery. The Dietary Treatment Program in Children's Hospital of Philadelphia's Neuroscience Center takes a team approach to establishing a child's ketogenic diet plan, with expert input from neurologists, dietitians, skilled nursing staff and social workers.
When the ketogenic diet is started, your child will be admitted to the hospital to make sure they tolerate the food and safely convert into ketosis. The ketogenic diet for epilepsy is initiated gradually over the course of four to five days as an inpatient, without the need for fasting. During this time, families learn all the details about diet management. Parents and caregivers can take cooking classes in our Keto Kitchen, where our experts can teach you how to make a high-fat meal delicious. Your child’s nurse may also teach you how to check your child's urine and blood for ketones and glucose. The dietitian will determine how much fat, protein, and carbohydrates your child is allowed, and how the diet will be eaten during the course of the day. All food that your child will consume will be weighed on a gram food scale to the tenth (0.1) of a gram. Vitamin and mineral supplements are required to keep your child healthy while on the diet. Medications and other products like toothpaste and mouthwash contain varying amounts of carbohydrates. It is important to choose products containing the lowest amounts of carbohydrates when your child is on the ketogenic diet. Hidden carbohydrates in these products can interfere with the positive results of the diet. Children usually stay on the diet for about two years. They are then slowly weaned off of the diet and changed back to a regular diet.
Keto Diet for Epilepsy Management
When implementing the keto diet to help manage epilepsy in children, a specific regimen is followed to ensure consistent results. The diet is typically administered under the supervision of a physician, registered nurse, and registered dietitian.
Read also: Magnesium Supplements for Keto
Before starting the diet, a registered dietitian is consulted to determine the child’s nutritional needs and establish a meal plan. Traditionally, the diet comprises 90% fat, 6-8% protein, and 2-4% carbs (11).
The program often begins in a hospital or intensive outpatient setting for the first 1-2 weeks. On day one, one-third of the total calorie goal is achieved, followed by two-thirds on the second day, and 100% on the third day (11).
In a clinical setting, all-in-one formulas containing the necessary nutrients may be used to initiate the keto diet for the first week, after which whole foods are gradually reintroduced (11).
The child and parents are thoroughly educated on the diet, and the necessary resources are provided before they return home.
The diet is usually followed for about two years, at which point it’s either discontinued or transitioned to a modified Atkins diet to allow for more flexibility (1).
Studies have also found that the keto diet can be safe and effective for infants and toddlers with refractory epilepsy (12, 13, 14).
Still, as these populations are extremely vulnerable, the decision to use this diet must be made on an individual basis by a physician.
Considerations for Teenagers
Adolescents are at a time in their lives in which body image may become increasingly important to them. Adhering to an overly restrictive diet can lead to unhealthy behaviors and significantly affect their relationship with food. These unhealthy behaviors could lead to eating disorders, which are prevalent in the adolescent population (18, 19).
Given the restrictive nature of the keto diet, as well as its potential effects on growth and food culture, it’s not recommended for healthy children.
The Role of Carbohydrates in a Teenager's Diet
Loaves of bread, grains and cereals are carbohydrates that provide energy for your brain and muscles. They're also an excellent source of fibre and B vitamins. Without enough carbohydrates, you may feel tired and run down. Fruit and vegetables have lots of vitamins and minerals which help boost your immune system and keep you from getting sick. They're also essential for healthy skin and eyes.
Alternatives to the Keto Diet for Weight Management in Teenagers
Though one study suggests that the keto diet may be effective for weight loss in teens, many other eating patterns are less restrictive and easier to follow in the long term, such as whole-foods-based diets (20, 21, 22). The same idea applies to children. While the keto diet can aid weight loss, other eating patterns require less restriction and don’t carry the risks associated with the keto diet (20).
Unless a keto diet is recommended and guided by a physician for medical purposes, it’s inappropriate for most children and teens.
Instead of dieting, try these tips:
Check that “occasional” treats are not “regular” treats. Fast food and dining out contribute added fat, calories and sugar to a child’s diet. “I have parents tell me that Monday and Wednesday were hectic, so they hit the drive-thru. Friday was dad’s birthday, so they went to the steakhouse and had cake,” Nowacki explains. “Parents should step back and make sure that what they think is an occasional indulgence isn’t something they are doing regularly.”
Step it up. “Inactivity creates a perfect storm because if a child is inactive and mindlessly indulging in snacks that aren’t nutrient dense, like chips, they can end up with a massive calorie imbalance,” Nowacki says. “Over a year, that imbalance could mean excessive weight gain in an already overweight child.” Parents should encourage kids to step away from their screens and start moving. Whether it’s an organized sport or jumping on the trampoline, movement matters.
Ask your child: Can you choose better? Help your child understand that food is fuel, and some foods provide better get-up-and-go. When they choose food, teach them to ask themselves if it’s good for their body. “A teen might tell me they had a salami sandwich, a fruit cup, soda and broccoli with cheese for lunch,” says Nowacki. “I encourage them to look at their food differently and ask what they might do to make the meal healthier.”
She suggests some simple switches:
- Choose lower-fat deli meat like chicken.
- Pick whole wheat bread rather than white bread.
- Grab fresh fruit instead of the fruit cup.
- Skimp on the cheese sauce or skip it altogether.
- Choose water rather than soda.
The Importance of a Balanced Diet for Teenagers
Eating healthy food is essential at any age, but it's especially important for teenagers. As your body is still growing, you must eat enough good quality food and the right kinds to meet your energy and nutrition needs. Being a teenager can be fun, but it can also be problematic as your body shape changes. These physical changes can be hard to deal with if they aren't what you are expecting.
Meat, chicken, fish, eggs, nuts and legumes (e.g. beans and lentils) are good sources of iron and protein. Dairy foods like milk, cheese and yoghurt help to build bones and teeth and keep your heart, muscles and nerves working properly. Overeating fat and oil can result in you putting on weight. Try to use oils in small amounts for cooking or salad dressings. Fluids are also an essential part of your diet. Drink water along with electrolytes to keep hydrated so that you won’t feel so tired or thirsty.
tags: #keto #diet #for #teenagers #information