Chances are, you've heard some buzz about the ketogenic diet. The popular diet is grabbing headlines and celebrity endorsements, and with all the attention, a younger crowd might consider trying the keto diet for weight loss, too.
But is the keto diet safe for teens? And is it a solution for parents who are trying to help overweight children lose pounds and get healthy?
Many doctors and dietitians believe more studies are needed to determine whether the keto diet is a safe weight-loss method over a long period of time. Melissa Fossier, a registered dietitian at Children's Health℠, does NOT recommend the keto diet for children and teens – unless it's used only for specific medical reasons. Learn why.
What is the keto diet?
The ketogenic diet was initially created around 1920 as a treatment for epilepsy under medical supervision. More recently, keto has become a popular diet for weight loss. It is a high-fat, very low-carb diet, which also includes moderate amounts of protein.
People following this fad diet typically eat foods higher in fat and do not restrict protein foods. Examples of common keto foods include butter, oil, avocado, heavy whipping cream, high-fat cheese, bacon, sausage and fatty fish, such as salmon. Nuts, eggs, leafy greens and other colorful vegetables are also a part of a keto diet.
The keto diet includes none or reduced amounts of grains, bread, rice and pasta, fruits, sweets or juice.
This high-fat, low-carb diet aims to put the body into a state of ketosis. Normally, the carbohydrates you eat break down into a sugar called glucose – which your body uses as energy. But when you restrict carbohydrates, the body doesn't produce as much glucose. When this happens, the body turns to fat as an energy source and produces a substance called ketone bodies. When there are high amounts of ketone bodies in the blood, the body is in ketosis.
"The body basically thinks it's in starvation mode, so it switches to fat as a back-up energy source, and that's part of the reason there is weight loss," explains Fossier.
Why the keto diet is not recommended for children and teens
The keto diet is not recommended for weight loss in children because it seriously limits carbohydrates, and children need carbs to be mentally and physically active. Children on a healthy, well-balanced diet should typically eat about 130 grams of carbohydrates a day (approximately 45-65% of their calories), whereas the keto diet limits carbohydrates to approximately 20-30 grams a day.
Foods high in a carbohydrate called fiber help promote feeling full and aid in weight control or weight loss. Fiber found in vegetables, fruits and whole grains helps maintain steady blood sugars and prevent constipation as well.
"Carbohydrates provide us with energy and important nutrients," explains Fossier. "Children need carbohydrates for growth and development, to do homework, to read books and to go outside and play."
Side effects of keto diet for children
When the body goes through ketosis, children (and adults) might feel some initial side effects, including:
- Constipation
- Diarrhea
- Fatigue
- Irritability
- Nausea
- Vomiting
"The side effects happen because the body literally thinks it's starving," explains Fossier.
Additionally, the keto diet may affect focus and concentration, cause nutritional deficiencies, and can lead to high levels of cholesterol and triglycerides, weak bones and kidney stones.
Keto diet and epilepsy
The keto diet was first developed in the 1920s as a treatment for epilepsy. Today, in certain cases, doctors might recommend the ketogenic diet to help control seizures in children with epilepsy, spasms and other types of disorders. There is ongoing research on the diet's impact on other diseases, most often in adults, such as ALS, Alzheimer's and Parkinson's disease, cancer and type 2 diabetes.
Before starting the diet, the doctor looks at the patient's blood work and considers other factors.
The types and amounts of foods are carefully chosen and monitored. Patients work closely with a dietitian. Not all patients with seizure disorders are good candidates for the ketogenic diet. Always check with your doctor first.
Healthy weight loss options instead of keto for kids
For children and teens who need to achieve a healthy weight, dietitians with Children's Health recommend establishing healthy habits over specific fad diets. Fossier recommends seven tips:
1. Eat a healthy, well-balanced diet
To provide children with a wide variety of nutritious foods, refer to MyPlate guidelines. "If you make a plate like that at every meal, you're doing a great job," says Fossier. "Whether a child's weight is high or low, at least you know you're providing all the nutrients your child needs to grow and thrive."
2. Limit processed foods and foods with added sugar
These foods include soda, sweetened drinks, cookies, candy, chips, desserts and baked goods
3. Choose nutritious snacks
Make sure kids are snacking only when truly hungry, and choose healthy options. Encourage small portions that incorporate one or two food groups. For example, try half a peanut butter sandwich on whole grain bread, sliced veggies with hummus or bean dip, or unsweetened yogurt with fruit.
4. Stay positive and give your child the facts
Explain to your child that it's most important to eat the right foods to support healthy growth and maintain energy throughout the day. For example, tell them, "You want to eat fruits and vegetables because they help you concentrate at school, give you energy to play and make you feel better overall."
5. Don't focus on the number on the scale
"Children come in all shapes and sizes. What's important is how our body functions, how we feel and how healthy a child is," says Fossier.
6. Offer new foods repeatedly
Even if a child didn't like certain nutritious foods a year ago, offer them again. Children's tastes change as they grow.
7. Encourage children and teens to pick an activity they love
Walk, run, ride a bike. If your child likes video games, download a game that requires them to be active. Find a favorite sport. Turn on music and dance. If they enjoy the movement, go for it.
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