Re: HELP NOW calculating calories/ratio etc

[Guest guest]

Bill, , Cammie

Thank you all so much for your help. I've got to dig out the old meals

plans and the Freeman diet book b/c I had put them away. Well, I called his

dietician in Chicago and she was willing to help me with calculations. He was

on

2:1 when we went off so we're going to go to that and move up if we need to.

was never able to handle the high ratios and his ketones are

large (160) on the sticks right now on the Atkins. Interestingly, his

dietician told me that several children that our previous neuro had taken off

keto

and on to Atkins ran into constipation like we have and then came the seizures.

Its such a nasty thing that constipation.

We are going to try to wing it until we get back into the dietician here but

its a mess. Long story but I'm so frustrated that it makes me want to go

become a dietician here in this large city that should have more qualified

help.

The dietician in Chicago told me today to call her with any questions and

was eager to help so I feel good about that. Plus I have all of you experts

here. Please keep your fingers crossed for us that this goes smoothly and

that he transitions well. I'm going to put things together tonight and then

send out our supplements etc to see what you all think.

THanks So much

This list has been so great for so many years for us. Hard to believe 5

years ago we started on this list and here we are starting keto again and for

the

3rd time, right at Thanksgiving.

[Guest guest]

Dear

Turn to page 128 of THE KETOGENIC DIET - A TREATMENT FOR EPILEPSY book (by

Freeman) and begin there. It tells you how to figure it all.

Also, double check with what you were doing last time. Do you still have your

menus, journal, etc? He may have grown since then, so they will need adjusting,

but there should be a good comparison.

Hope this helps.... a good night's homework. :-) .

lloydandleslie@... wrote:

I am in need of help NOW. I am so frustrated b/c my son was on the keto

diet for 2 years and then went to the Atkins diet and now we are trying to go

back to keto becuase he needs it so bad. Well, we changed Drs in this process

b/c our neuro was 4 hours away and would not accept insurance and we can't

afford to pay out of pocket anymore. Our neuro here wants him to go back on

keto b/c it really is his only option that works for him. The drugs make him

crazy and cog decline so severe. His seizures are daily and they are

increasing.

We can't get in with the dietician here and I know how to do the diet. We

went to Hopkins for the first time and I did my own meals for the last 18 mos

on the diet. However, I did not calculate calories and protein our dietician

with our doc in Chicago did that.

Can any one help?

is 47 pounds 45 inches tall

He is 7 (in 3 weeks).

I need the diet rx (calories, protein, fat etc) to plug in my meal planner.

Thanks so much. If anyone knows the formula, would you pass it on.

THanks

[Guest guest]

,

Chapter 8 in Dr. Freeman's book has the formulas used at Hopkins to

calculate protein and calorie allotments. For both of these, you

need to consider 's individual situation. I don't have a

boy's growth chart, but just looking at the girl's it seems he is on

the low end of both height and weight. Is he very active or not so

much so?

On p. 122 of the book, it lists the average protein requirement for 7-

10 y/o to be 1.0g/kg. That would be 21.4 g/day of protein. If it

were me, I might roll up to at least 22, maybe a tad higher if he's

active or if you want to try for a bit more growth. was 7 when

she started the diet, 97% for height, about 80% for weight which gave

a BMI of 50%. Dietician gave her 1.1g/kg of protein which turned out

to be 30g. We increased this after a short time and she was doing

well because she regained her activity level.

On p. 131, calorie levels are set at 55-60 cal/kg for 7-10 y/o.

Assuming average everything, would be between 1175-1282

calories. Again, you might need/want to adjust this for his specific

situation.

Have you been using the Stanford planner? If so, you know that you

can plug in the protein value, calories, ratio, and number of meals

per day, and it will calculate fat and carb for you. If you are

using a different planner that doesn't do this, I will do it for you

if you let me know what values you want to choose for those 4

values. The book also tells you how to calculate fat and carb

values, but the planner is easier and quicker.

I hope that you will be able to get some help from a dietician. I

think a good dietician's expertise and input is invaluable. I can't

imagine doing this alone because of all the fine points to be

considered. I'm sure Hopkins ordered laboratory tests that were

specific to keto kids as well a routine labs to keep track of his

progress. I wonder if you called them if they would give you some

help by phone, given that is a former patient, until you

can get established elsewhere. I'm sorry your insurance won't pay

Hopkins any more... that has to be hard for you. You've been to one

of the best and now the insurance co. decides that you can't go back--

bah!.

Hope this helps. If you need something else, post back... especially

if you do want me to run numbers through my planner.

Cammie

> I am in need of help NOW. I am so frustrated b/c my son was on

the keto

> diet for 2 years and then went to the Atkins diet and now we are

trying to go

> back to keto becuase he needs it so bad. Well, we changed Drs in

this process

> b/c our neuro was 4 hours away and would not accept insurance and

we can't

> afford to pay out of pocket anymore. Our neuro here wants him to

go back on

> keto b/c it really is his only option that works for him. The

drugs make him

> crazy and cog decline so severe. His seizures are daily and they

are

> increasing.

>

> We can't get in with the dietician here and I know how to do the

diet. We

> went to Hopkins for the first time and I did my own meals for the

last 18 mos

> on the diet. However, I did not calculate calories and protein

our dietician

> with our doc in Chicago did that.

>

> Can any one help?

>

> is 47 pounds 45 inches tall

> He is 7 (in 3 weeks).

>

> I need the diet rx (calories, protein, fat etc) to plug in my meal

planner.

>

> Thanks so much. If anyone knows the formula, would you pass it on.

>

> THanks

>

>

>

>

[Guest guest]

According to Dr. Freeman's book on the diet(you have a copy, right?),

calculations are in chapter 8, page 119.

For a 7 year old at 47 pounds(21.4 kg), use 60 cal/kg. That gives 1284

calories per day. If your son is very active and needs to gain weight

you might have to go higher in calories. If he is very inactive, you

might have to go lower in calories. There is a wide variation. My

daughter is about the same weight and gets 830 calories per day. She is

an adult so not growing and uses a wheelchair so not at all active.

Any medications can also affect the calories as some affect appetite

and/or metabolism.

Make sure you weigh very carefully every week at the same

time of day before a meal to see how the weight is going. Probably, if

you don't see a weight loss, you will fine tune by dropping calories.

Fluid intake would be about 1200 cc per day.

Do you use 3 meals and 2 snacks a day? Do you calculate that with your

meal planner?

For protein, use 1.1 gm/kg of body weight. That gives 1.1 x 21.4 = 23.5

gm of protein per day.

If your son is average weight/height use 4:1 ratio. If he is

overweight(weight vs. height), use 3:1. If he is overweight, you would

also be using lower calories. If we assume average weight/height, use

4:1, then the energy unit is 40 calories. And at 1284 calories, that

becomes 1284/40 = 32.1 units per day. Fat is 4x32.1= 128.4 gm/day.

Protein plus carbohydrate is 32.1 gm/day. Protein is 23.5 gm/day.

Carbohydrate is 32.1-23.5 = 8.6 gm/day.

You remember that the diet is very lacking in vitamins and minerals. You

need to provide very good supplements.

Be sure to check for too high ketones when starting the diet as the 4:1

ratio is high. Computer meal planners tend to give a higher effect to

the ratio as compared to the old substitution methods.

Bill

lloydandleslie@... wrote:

> I am in need of help NOW. I am so frustrated b/c my son was on the keto

> diet for 2 years and then went to the Atkins diet and now we are trying to go

> back to keto becuase he needs it so bad. Well, we changed Drs in this

process

> b/c our neuro was 4 hours away and would not accept insurance and we can't

> afford to pay out of pocket anymore. Our neuro here wants him to go back on

> keto b/c it really is his only option that works for him. The drugs make him

> crazy and cog decline so severe. His seizures are daily and they are

> increasing.

>

> We can't get in with the dietician here and I know how to do the diet. We

> went to Hopkins for the first time and I did my own meals for the last 18 mos

> on the diet. However, I did not calculate calories and protein our dietician

> with our doc in Chicago did that.

>

> Can any one help?

>

> is 47 pounds 45 inches tall

> He is 7 (in 3 weeks).

>

> I need the diet rx (calories, protein, fat etc) to plug in my meal planner.

>

> Thanks so much. If anyone knows the formula, would you pass it on.

>

> THanks

>

>

>

>

[Guest guest]

If you go with 3 meals and 2 snacks(a snack being 1/2 a meal), then you

get 16.1 gm of fat, 2.9 gm of protein, and 1.1 gm of carb per snack. And

32.1 gm of fat, 5.9 gm of protein, and 2.2 gm of carbohydrate per meal.

Bill Barber wrote:

> According to Dr. Freeman's book on the diet(you have a copy, right?),

> calculations are in chapter 8, page 119.

>

> For a 7 year old at 47 pounds(21.4 kg), use 60 cal/kg. That gives 1284

> calories per day. If your son is very active and needs to gain weight

> you might have to go higher in calories. If he is very inactive, you

> might have to go lower in calories. There is a wide variation. My

> daughter is about the same weight and gets 830 calories per day. She is

> an adult so not growing and uses a wheelchair so not at all active.

>

> Any medications can also affect the calories as some affect appetite

> and/or metabolism.

>

> Make sure you weigh very carefully every week at the same

> time of day before a meal to see how the weight is going. Probably, if

> you don't see a weight loss, you will fine tune by dropping calories.

>

> Fluid intake would be about 1200 cc per day.

>

> Do you use 3 meals and 2 snacks a day? Do you calculate that with your

> meal planner?

>

> For protein, use 1.1 gm/kg of body weight. That gives 1.1 x 21.4 = 23.5

> gm of protein per day.

>

> If your son is average weight/height use 4:1 ratio. If he is

> overweight(weight vs. height), use 3:1. If he is overweight, you would

> also be using lower calories. If we assume average weight/height, use

> 4:1, then the energy unit is 40 calories. And at 1284 calories, that

> becomes 1284/40 = 32.1 units per day. Fat is 4x32.1= 128.4 gm/day.

> Protein plus carbohydrate is 32.1 gm/day. Protein is 23.5 gm/day.

> Carbohydrate is 32.1-23.5 = 8.6 gm/day.

>

> You remember that the diet is very lacking in vitamins and minerals. You

> need to provide very good supplements.

>

> Be sure to check for too high ketones when starting the diet as the 4:1

> ratio is high. Computer meal planners tend to give a higher effect to

> the ratio as compared to the old substitution methods.

>

> Bill

[Guest guest]

Going from Keto diet to Atkins is a big mistake. There is no advantage

and it is much less healthy. It is much better to wean off keto as per

Dr. Freeman's book. Although I would go slower and less abruptly than is

in the book. The risk of seizures re-occurring is also much higher on

Atkins.

Bill

lloydandleslie@... wrote:

> Bill, , Cammie

>

> Thank you all so much for your help. I've got to dig out the old meals

> plans and the Freeman diet book b/c I had put them away. Well, I called his

> dietician in Chicago and she was willing to help me with calculations. He

was on

> 2:1 when we went off so we're going to go to that and move up if we need to.

> was never able to handle the high ratios and his ketones are

> large (160) on the sticks right now on the Atkins. Interestingly, his

> dietician told me that several children that our previous neuro had taken off

keto

> and on to Atkins ran into constipation like we have and then came the

seizures.

> Its such a nasty thing that constipation.

>

> We are going to try to wing it until we get back into the dietician here but

> its a mess. Long story but I'm so frustrated that it makes me want to go

> become a dietician here in this large city that should have more qualified

help.

> The dietician in Chicago told me today to call her with any questions and

> was eager to help so I feel good about that. Plus I have all of you experts

> here. Please keep your fingers crossed for us that this goes smoothly and

> that he transitions well. I'm going to put things together tonight and then

> send out our supplements etc to see what you all think.

>

> THanks So much

> This list has been so great for so many years for us. Hard to believe 5

> years ago we started on this list and here we are starting keto again and for

the

> 3rd time, right at Thanksgiving.

>

>

>

>

>