Re: new diet questions-Pam

[Guest guest]

Hi Pam,

Yes, 1800 cals does sound q high, the 'book' range for his age/weight would be

1265-1380 cals per day, lower end for less active, higher end for more active

with quicker metabolisms.

But - he may well be one that does actually need more than this, and

therefore, as has already mentioned, he sounds like a candidate for a

calorimetry (also known as a ree dx) test, which will more accurately determine

what his individual resting expenditure (metabolic) rate is. The dietician will

then add on percentages for activity level, growth etc and give you a ballpark

figure to aim for calorie wise. Not 100% exact, but a heap more accurate than

the table cal/kg values usually used.

Not many keto centres use this test as a diet finetuning tool, but we found it

invaluable with our son , at one point it showed a deficit (unknown to us

for months) of approx 300 calories - which had been causing all sorts of

problems nutritionally and seizure control wise.

The other thing to consider is what 'ideal' weight your team is aiming for, as

they may be setting calories per kg of ideal weight instead, to aim for more

growth due to his 5% percentiles, and giving more calories accordingly. If this

is what they are doing though, it pays to start at existing weight if using

book/table values, and them slowly inch up cal wise depending on weight/height

changes, level of ketosis, and seizure control.

The keto diet is supposed to metabolically mimic starvation, and although

there is an outside chance that those cals might be okay for him, it would be

unusual to maintain good ketosis and seizure control when they are that much in

excess of the 'standard' used. 55 gms of carb per day is a LOT, goodness, my

nearly 8 yr old son would not know himself on that level! He is a lot heavier

than (27 ish kgs) and is on 1550 cals per day, (57 cals pr kg - average

activity level) 3.5:1 ratio, with protein set at 1 g per kg of weight.

Looks to me like 's ketone instability and increased seizures is already

telling you that he is on too many cals, his glucose levels are probably too

high for him to be maintaining good ketones, and although it is very important

not to undernourish keto kiddies, excess cals will not usually work seizure

control wise.

I also do not know of that many kiddies who can start and then remain on a

2.5:1 ratio, (we wish...) but perhaps the fact that his body is used to being in

ketosis might help there (they maintain ketosis easier after being in it for

while).

I think it is prob more a calore issue at this point, but you may find you

have to do both - lower cals and increase ratio depending on how he responds to

any changes. Try and do one change at a time if possible, keeping a close eye on

weight and obviously ketone levels, bearing in mind that weight gain from excess

cals might not show on the scales for 2 weeks - a month.

----- Original Message -----

From: capnmacncrew@...

Hi all

We started on the keto diet a week ago. We had been doing heavy fat Atkins

( 10 carbs /day and unlimited fatty meats) for 6 months with much success. We

wantd to change to keto to help get rid of those last pesky szs. Since Atkins

is not meaured it is hard to figure out daily changes to see what does and

doesn't work. was in heavy ketosis most of the time with occasional dips

to medium ketones when he had too much lean protein.

Well, last week we were started on the keto with a 2:1 ratio. I was

concerned since it upped 's carbs to 55 gms/day instead of the 10 he was

used to. Lo and behold, he is out of ketosis and having many seizures per hour.

At least that shows the ketosis helps to control szs! Yesterday I called the

doc and she upped his ratio to 2:5. She told me she has never had to go higher

than 2:5 and has had great success with sz controlat that ratio with many

children. I was and still am skeptical.

My question is 2-fold. First, obviously I am wondering about the ratio. He

started on 2:1 last evening and is goes between no ketones and trace amounts of

ketones right now. Tomorrow I call the doc again. Should I insist on a higher

ratio? or see below?

The second question has to do with calories. is 8yo, weighs 23km, is

very slight for his age (he is at the 5th% in height and weight). He is

extremely athletic and has always eaten much more food than anyone I know, even

my teenage sons who also are very athletic and active. is well known for

the huge amounts of food he normally eats so he might need more calories than

the average boy his age. The doc put him on 1800 calories/day which surprised

me. Does this seem correct to you? My own personal calculations seemed to be

closer to 1300/day, but I am very new to this and don't know the ropes. I'm

frustrated that after 6 months of ketosis we are out of it now and after all

that hard work.

I am wondering if we should lower the ratio or calories first? Any opinions

from experienced moms and dads?

thanks much

Pam, mom to age 8 and 10 others