What Do Keto Kids Eat?

Ketogenic Foods by Ratio.

The classic ketogenic diet of a 3:1 ratio means that for every 3 grams of fat you eat, you can eat 1 gram of carbohydrate plus protein. So 3:1 means that for every 4g you eat, 3g of that are fat and the remaining 1g is carbs + protein. That works out to eating  over 75% fat. Wow, that is a lot of fat … and math! So where does all that fat come from? What do keto kids actually eat? Sticks of butter, slices of bacon, glasses of heavy cream? Well, yes and no.

There are three main types of fats in foods: saturated fat, monounsaturated fat and polyunsaturated fat. Eating foods that are high in these fats (yes, even saturated fat) is the goal of the ketogenic diet. Eating enough fat in the right combination (or ratios) with carbohydrates and proteins, is how you get into ketosis. Eating low-carb foods is equally key, and sometimes one can get fixated on the question “how many grams of carbs are allowed for this meal???” But simply eating low carbohydrate foods is not enough to get into ketosis. This is why parents of keto kids need to be very specific about the foods their kids eat, and precise about calculating the macro nutrients.

Your kid’s doctor and dietician will decide what ratio is best to begin with, but keep in mind that it is not set in stone, and can change up or down over time. The ratio is influenced by a variety of things like: how severe your kids’ case is, how old your kid is, what your insurance will cover, and whether your family will be able to adapt to the strict ratios and labor-intensive work of measuring each meal on a gram scale. Or, if this will be too demanding and imposing on you and your kid. 

As an alternative to the classic ketogenic diet the less restrictive MAD (Modified Atkins Diet) approach (a 1:1 ratio) can work sometimes equally as well — plus you can then more easily make meals for the entire family. Most older kids do MAD, it is easier to follow, allows more protein, requires no calorie restrictions and one can go out to eat more easily on it. 

Most parents tweak and fine-tune the diet over time and adjust ratios depending on their kid’s control of symptoms and tolerance to fat. Once your kid starts the diet and gets into ketosis you will have an idea of how well they will do — and how much fat they will need to eat in order to maintain ketosis and produce good ketones. Personally, we had trouble understanding why Drake had to start at the strict 3:1 ratio and not at the lower 1:1 ratio since his symptoms were mild — but now we realize that so much depends on how well Drake does in ketosis, what level of ketosis works best for him, and if having overly high ketones would have been a problem. Trickily, every kid has a different metabolism, and that metabolism can change with both time and diet.

Seeking out healthy high fat foods for your keto kid is the key to success — along with finding foods your kid actually enjoys eating! For Drake that is nuts! I joke that 50% of Drake’s fat comes from nuts; though unfortunately his favorite nuts are peanuts (high in protein) and cashews (high in carbs). If only he loved macadamia or brazil nuts (a good source of selenium) my life would be easier. So when planning your meals, remember that nuts have carbohydrates and protein in them too, and if you eat too much protein, it can turn into glucose and then interfere with ketosis. Nuts are also high in omega 3 and omega 6 fatty acids along with other nutrients. Nut flours are a great way to make baked ketogenic snacks and desserts. Also go for nut butters that are natural and unsweetened. 

Nuts from Highest FAT to Lowest FAT by RATIO:

Macadamia nuts
(6 : 1)
Pecans
(5.4 : 1)
Brazil Nuts
(3.6 : 1)
Pine Nuts
(3 : 1)
Macadamia nut butter
(3 : 1)
Walnuts
(2.9 : 1)
Hazelnut flour
(2.8 : 1)
Hazelnuts
(2.7 : 1)

Almonds
(2 : 1)

Almond Butter
(2 : 1)

Almond Flour
(1.6 : 1)
Peanuts
(1.3 : 1)
Peanut Butter
(1.2 : 1)
Cashews
(1  : 1 )


Seeds from Highest to Lowest FAT by RATIO:

Flaxseed
(2.1 : 1)
Sesame Seeds
(1.7 : 1)
Sunflower Seeds
(1.5 : 1)
Pumpkin Seeds
(1.4 : 1)
Chia Seeds
(1.3 : 1)
Hemp Seeds
(1.2 : 1)
Sunflower Seed Butter
(0.9 : 1)

The SUPERSTARS of FAT by RATIO:

Avocados and Coconuts

Avocados
(4.1 : 1)
Coconut Oil
(100% fat!)
Coconut Manna
(4.5 : 1)

Coconut Shredded
(4.5 : 1)

Coconut Meat
(3.5 : 1)

Coconut Flour
(.4 : 1)
Coconut Milk
(2.8 : 1)


High FAT Dairy Products by RATIO:

Full fat dairy products are a great source of fat with only 0g to 1g of carbs! Many keto kids rely heavily (no pun intended) on heavy cream for its concentrated fat content and 0g carb count. Always have heavy cream in your fridge! I like, Organic Valley, Horizon, or Trader Joe’s heavy cream brands best. Also remember that cheeses have a sneaky bit of protein in them too.

Heavy Cream
(8.8 : 1)*
Butter, European
(203.3 : 1)*
Butter
(89.1 : 1)*
Ghee*
(100% fat!)
Mayonnaise
(47 : 1)*
Sour Cream
(4 : 1)*

Cream Cheese
(3.3 : 1)*

Mozzarella Cheese
(.9 : 1)*
Parmesan Cheese
(0.7 : 1)*
Cheddar Cheese
(1.2 : 1)*

* Keep in mind that FAT content will vary by brand.

High FAT Protein by RATIO:


For every article out there touting how amazing bacon tastes, you will see another pointing out how bad bacon is for you— because of the saturated fat, sodium, and nitrate content. But on the ketogenic diet, bacon is king! It has way more fat than chicken or turkey, and is at about a 1.5 ratio on it’s own. So don’t fear the bacon, and even do as Homer Simpson says and “butter your bacon!” Not kidding! Pork based meats are the highest in fat. Don’t forget that you should seek out cuts of meat with extra fat on them like sausage and hamburger. Look for non-lean options or check with your butcher.

High to Moderate Fat:

Bacon
(1.5 : 1)*
Sausage
(1.1 : 1)*
Pepperoni
(1.9 : 1)*
Hot Dogs
(1.1 : 1)*
Pork tenderloin
(0.2 : 1)
Ground Beef 85% lean
(0.8 : 1)
Chicken Breast
(0.1 : 1)
Turkey Breast / or Deli Sliced
(0.1 : 1)*

* FAT content will vary by brand.

Eggs, Eggs, Eggs!


Always have eggs on hand! Eggs are among the healthiest and most nutritious foods on the planet, especially with the new findings about saturated fat. And for keto, the less egg white, the better.

Eggs, mixed
(0.7 : 1)
Egg Yolk
(1.4 : 1)
Egg White
(92% protein)


All plain meat and fish are low in carbohydrates, usually less than 1g of carbs. When going out to eat, avoid any meat or fish with coatings of breading or sugary glaze or sauces on them. Just remember to keep count of the protein from meats and add fats until the ratios match your goals.

 

High FAT Fish By RATIO:


Fatty fish such as salmon, tuna, trout or sardines are full of omega-3 fatty acids and protein that is not high in saturated fats. If your keto kid doesn’t like the taste of fish, white fish such as Halibut, Mahi Mahi or Sea Bass have a mild non-fishy flavor. Add butter and/or a dip of non-carb dressing or mayo to enhance fat ratios.

High to Moderate Fat:

Salmon
(0.7 : 1)
Sardines
(0.5 : 1)
Mussels
(0.1 : 1)
Oysters
(0.4 : 1)
Tuna
(0.3 : 1)*
Trout
(0.3 : 1)
Sea Bass
(0.2 : 1)
Crabmeat
(0.2 : 1)
Tilapia
(0.1 : 1)
Halibut
(0.1 : 1)
Clams
(0.1 : 1)
Mahi Mahi
(0 : 1)

Cooking or Baking with High FAT Oil:


Cook or bake with high fat oils — you will get a lot of bang for your buck! MCT oils are a special case to learn more about before use, but it can be quite helpful.

High Fat Oils:

Macadamia Nut Oil
(100% fat)
Coconut Oil
(100% fat)
Avocado Oil
(100% fat)
Olive Oil
(100% fat)
MCT Oil
(100% fat)
Walnut Oil
(100% fat)
Canola Oil
(100% fat)

Other Sources of FAT by RATIO:

Full-Fat Salad Dressing
(9.5 : 1)*
Green Olives
(9.8 : 1)
Kalamata Olives
(2.9 : 1)
Black Olives
(2.7 : 1)
Dill Pickle
(0.2 : 1)
Lily’s Dark Chocolate
(2.7 : 1)
Baker’s Chocolate
(1.9 : 1)
Hershey’s Cocoa, Unsweetened
(0.2 : 1)

* Keep in mind that FAT content will vary by brand.

Fruits from Lowest to Highest Carbs:


Except for avocados and coconuts (are they a fruit, vegetable or nut? I don’t know) all fruits and vegetables are considered a source of carbohydrate to varying degrees. Berries are generally lower in sugar than other fruits and are also the highest in antioxidants and other nutrients. Lemons and limes are also in the lower carbohydrate category. One snack we do is whipped heavy cream with a bit of Truvia and berries.

Lowest Level of Carbs:

Raspberries
(0.1 : 1)
Strawberries
(0.05 : 1)
Blackberries
(0.04 : 1)
Blueberries
(0.03 : 1)
Lemons
(0.04 : 1)
Limes
(0.04 : 1)
Cranberries
(0.02 : 1)

Moderate Level of Carbs:

Watermelon Honeydew melon Cantaloupe
Peach’s Apricot Plums
Cherries Apples Pears
Oranges Kiwi Grapefruit
Nectarines Grapes

High Level of Carbs (avoid):

Pineapple Pears Bananas
Pomegranates Mangos Prunes

Avoid dried fruit and fruit juice altogether!

Vegetables from Lowest to Highest Carbs:

Eating vegetables every day is encouraged on the ketogenic diet and a great source of fiber! But some vegetables are high in sugar and don’t cut it nutritionally, such as starchy potatoes and corn; so they should be avoided. Focus on above-ground leafy greens — fresh, frozen or in a can is fine. The calculations change whether the vegetable is cooked or raw; I suppose since the cooked vegetable will weigh differently, but the nutritional values stay the same. Also low carbohydrate vegetables are a great vehicle for high-fat butter or dressing. The first time we ate steamed broccoli with tons of European butter and salt we couldn’t believe how good it tasted. Low carb, yum!

Low to Moderate Level Carbs:

Broccoli Celery Carrots Cauliflower
Zucchini Red, Green or Yellow Pepper Kale Cabbage
Green Beans Asparagus Cucumber Tomatos
Lettuce Spinach Brussel Sprouts Mushrooms
Artichokes Pumpkin Spaghetti Squash Peas

High Level of Carbs:

Potatoes Sweet potatoes Beets
Squash Corn  **

** however, air-popped popcorn with lots of butter and salt will work.

The fun comes in when you can combine all these high-fat foods into a delicious meal for your keto kid. The trick is finding the time to do all this cooking and baking!  This diet is definitely a labor of love — “emphasis on labor”! I spend most days: meal-planning, grocery shopping, cooking, cooking, cooking, cleaning up and then cleaning up again. Plus researching and writing about the ketogenic diet. With all the ongoing and new keto research, I find new stuff every day to help make eating keto easier and tastier. This is my kids medicine after all!

Author: Debra Lane

Debra & Ken Lane maintain this blog to chronicle their son's journey of living with the rare neurometabolic disorder, Glucose Transporter Type 1 Deficiency Syndrome (Glut1 DS for short). And hope to raise awareness and understanding of the non-epileptic form of Glut1 DS. Drake’s Glut1 journey started at the age of 3 with episodes of Ataxia and Dyskinesia. Now at the age of 8 he is 2 years symptom-free — thanks to the right diagnosis and the ketogenic diet.

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