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  • Denise Scott

Is a Keto Diet Appropriate for Children?

Last week I reviewed the paleo diet and this week the keto diet. These are somewhat similar diets, both being low carb and high fat, but there are differences that I will explore.

The ketogenic or keto diet has been around for over a century and was developed for children with hard to control seizures before anti-seizure meds were available. This very high-fat diet seems to benefit some children in this category. The keto diet is somewhat similar to the Atkins diet, which is also high fat and low carb but doesn’t restrict protein.

The word KETO spelled out with food.

The diet is very high in fat - 70-90% - and very low carb - only 20 to 50 grams daily (about 5-10%), which is extremely low. It contains moderate amounts of protein. Compared to the paleo diet, keto is higher in fat.

The premise behind this diet is to change your body from carb burning (how we usually derive energy) to fat burning, by severely restricting carbohydrates and increasing fat as the primary energy source. Burning fat puts the body in ketosis, increasing ketone bodies, which act on the brain to reduce seizures.

The keto diet is now touted for weight loss since it is “fat-burning.”

What do you eat on a keto diet?

Anything with fat! Butter, cream, oil, meat, seafood, eggs, avocado, nuts, seeds - the focus is on healthy fats, not processed food fats.

The carbohydrates in this diet come from non-starchy vegetables such as leafy greens, broccoli, asparagus, zucchini, olives, tomatoes, cucumber, celery, etc.

Unlike paleo, keto does allow dairy and soy.

Pictured are foods that are allowed on a keto diet - lots of animal fats, some vegetables, nuts, and dairy as seen here. Note that grains, legumes, and fruit are absent.

What do you avoid on a keto diet?

You avoid most carbohydrates - legumes, grains, fruit, any sugar, starchy vegetables.

What are the drawbacks of the keto diet?

The side effects of this diet, termed the “keto flu”, include headache, fatigue, nausea, and constipation caused by ketosis. Building up ketone bodies makes you feel sick and gives you smelly breath (ketone breath).

The bad breath of ketosis smells like acetone - think nail polish remover!

As with any restrictive diet, there is the risk of deficiencies. These include fiber, vitamin K, water-soluble vitamins (vitamin C, folate, and B vitamins), potassium, and linolenic acid.

There is a potential increase in cardiovascular disease (similar to the Atkins diet) due to its high fat content which includes saturated fats.

The keto diet may increase the risk of kidney stones.

This diet can adversely affect a child’s overall growth, muscle mass, and bone health.

The weight loss that occurs initially comes from water loss. The keto diet does not allow for flexibility and is difficult to maintain long-term. Once off the keto diet, weight gain usually recurs.

Once again, this diet eliminates major food groups and energy sources that children typically rely on. My alarm is that any extremely restrictive diet that eliminates whole food groups and creates nutritional deficiencies is not healthy or appropriate for children.

A comparison, as I did last week, of the macronutrients for keto, paleo, and recommended childhood nutrition is as follows:

Macronutrients - protein, fat, carbs - spelled out in wooden tiles set in a skillet.

Macronutrients - as a percent of total daily calories

Keto Paleo My Plate

Carbohydrates 5-10% 30% 45-60%

Protein 10-20% 30% 10-20%

Fats 70-80% 40% 30-40% (infants)

25-35% (4 and older)

As you can see, the keto diet is far too restrictive of carbs for children and too high in fats.

These restrictions thus limit vitamins, minerals, fiber, antioxidants, and prebiotics, all good for a growing child and the gut microbiome.

Despite what you may find online, including keto-friendly recipes for children, this diet is not healthy or safe for children. Kids require an appropriately balanced, nutrient-rich diet. The keto diet does not provide this.

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