How to begin a Ketogenic Diet

TO support THE TREATMENT OF CANCER

Partner with a Ketogenic Diet Specialist

If you haven’t already, sign up to become a member of MaxLove Project. For qualified childhood cancer patients we fully fund initial consultations with ketogenic dietitians who work long-distance. You should also check to see if your child’s hospital has a ketogenic clinic in its neurology department. The diet is widely used to treat patients with epilepsy. While the KD doesn’t have to be a difficult diet to follow and maintain for most kids and adults once they are in ketosis, challenges can emerge. A consultation with an experienced dietitian will help your child safely get into ketosis and maintain maximum health while on the diet. 

Tell your oncologist that you intend to put your child on a ketogenic diet

Expect your doctors to be highly skeptical of the ketogenic diet. But they also need to know that you are choosing to use this potentially powerful therapy. To assuage your doctor’s fears you can tell him/her that Children’s Hospital of Orange County has passed a protocol to use the KD as an adjunctive cancer treatment and is presently treating several pediatric glioma patients with the KD. You can tell them that the University of Iowa is currently conducting human trials with the KD as a treatment for several different types of cancer. Mice studies have been and are being conducted at Boston College, Duke University, Yale University, and Barrow Neurological Institute in Phoenix. Share with them our review summary of the latest research on the KD and cancer. It can be found in the resource section at www.maxloveproject.org. Finally, if they remain skeptical or even disapproving, then remember that you are in charge and they are only advisors. Many parents have seen their doctors follow only after they start the diet. Once they see the child healthy and happy and in full ketosis, much of their fear subsides. And remember: the KD has been used for 90 years with epileptic children. It has been shown to be perfectly safe. 

If it seems overwhelming then start slow

Although your dietitian may want to start quickly with a fast, you may choose to start slow. Keep in mind that most dietitians will have experience only with epilepsy. In these cases the goal is to stop seizures as quickly as possible, and so the KD is initiated as quickly as possible. You and your child might be happier if you phase in the diet over the course of a couple weeks by first cutting out all sugar (this means honey, syrup, cane juice and fruit juices). After a few days of no sugar, cut out all refined carbohydrates (all pasta, white rice, chips, crackers and bread) and high-glycemic fruit (all fruit except for berries). After a few days of no sugar, refined carbohydrates, or high-glycemic fruit, cut out all grains (no rice, wheat, oats, quinoa, millet, etc.) and all dairy except for butter, heavy cream, full fat sour cream, and a limited amount of fatty cheeses. By day 15 you are pretty much on the ketogenic diet. You might be wondering what you’re going to eat now that you’ve taken all this stuff out of your child’s diet. We’ll provide a quick list and a bunch of resources below.

Talk with your dietitian about supplementation

Important supplements on the ketogenic diet include probiotics, sodium (salt), magnesium, potassium, calcium, and vitamin D. Potential supplements include omega-3 fatty acids (fish oil) and curcumin (turmeric). 

Follow your child and get on a low-carbohydrate, high-fat diet with them.

Many of the most popular diets today (Paleo, South Beach, Wheat Belly, Atkins) are low-carb, high-fat. Why? Because it is a very healthy diet and a very delicious one as well. It has been shown to be an effective treatment for obesity, metabolic syndrome, and diabetes. Emerging research is showing that it might also be effective for brain health, mood and anxiety regulation, and building physical endurance. It will make it much easier on your child if he/she sees you eating exactly as he/she does.

Don’t be discouraged by the KD’s dietary limitations

It can be a wonderful and delicious way to eat! It’s not a joke: you can really eat eggs, bacon, butter, and heavy cream while on the diet and be extremely healthy! Saturated fat is not a killer, it is your friend.

Start testing glucose and ketone bodies (beta-hydroxybutyrate)

The most accurate way to test both is with the Precision Xtra Blood Glucose and Ketone Monitoring System by Abbott Diabetes Care. You will need to use their small lancet to get a quick poke of blood, squeeze the blood into a small disposable strip that you insert into the monitor, and then wait a couple seconds for a reading to appear. You will measure both glucose and ketones. The ketone strips particularly are expensive but you may be able to get a prescription through your oncology team which would support the cost. The data of blood sugar and ketone number is essential to feel most empowered on the diet. This is how you can really see the effects of meals, physical activity and even stress. You will know more about how to tweak, adding fat and sometimes even adding more carbs to make the diet as effective and powerful as possible. 

The small poke is not fun for kids at first but it really is small and usually disappears within a minute. Many parents offer a treat like a sugar-free candy after every poke. Some children start to ask for a poke in order to get the candy! Some families make it into a competition with a number of participants testing blood to see who "wins" in their numbers. It can be made into a fun game.  

We cannot offer medical advice here so be sure to ask your keto coach about your target numbers for blood sugar and ketones.