The simplest keto meals

Posted on December 15, 2013 by Ted Brekken

Ted here. This post is about the very simplest keto meals. Especially from the perspective of the secondary cook.

Christy is a food wizard. She gets food. She can create new things from basic components. She can produce batches of treats for Nora that we can use over the week. That is not an area of significant competence for me, but I can certainly make simple keto meals for Nora. So what do we do when energy and time are low, more complex treats are not available, and Nora needs to eat? Here is our most basic template for an easy lunch (or dinner).

Base:
Start with a base of avocado. Avocados are stellar. They are at about a 3.5:1 ratio on their own, plus they are fibrous. They can be simply diced, or spread as butter. We’ll generally start with 20 to 30 grams of avocado for a meal. Macadamia nuts (see more on them below) can also serve the role of a meal base. Both avocados and macadamia nuts work well to start the meal calculation because they are both high ratio, and give you a solid start on all four of the major constraints: carbs, protein, fat, and fiber.

Carbs:
The major sweet parts of the lunch come from apple, red pepper, carrots or berries (e.g., blueberries, strawberries, and raspberries). Peppers and raspberries get priority because of their high fiber and low carb content (relatively). Apples, blueberries, strawberries, and carrots pack much more of a carb punch, so those are added if the other major constraints are met and there is still a bit of carb to give. Generally there will be 5 to 30 grams of total fruit, depending on the mix.

Protein:
Cheddar cheese is the primary protein base. Nora likes it, it is easy to cut and weigh, and it has a good amount of fat too. It is versatile too in that it can be served sliced, cubed, shredded, melted, or melted and reformed. Something like 10 grams to 20 grams is typical. Sliced turkey and ham are also popular. Ham is nice because it has some fat. Sometimes we’ll put cream cheese and butter on the sliced meat and roll it up to get more fat in there.

Fat:
Cream is our primary fat, either mixed with water and a few drops of vanilla flavoring to make “milk,” or steamed in our espresso machine with a pinch of cocoa powder. The amount of cream will be between 10 and 40 grams, depending on what else is in the meal. We’ll might also look for opportunities to put butter on or in things. The other two big fat delivery mechanisms are macadamia nuts and kalamata olives. Those are especially nice if I want to avoid liquids (i.e., cream) in the meal, for example, with a packed lunch. Macadamia nuts do have some carbs, so it will use up some of that allotment, but their high fat and high fiber content provide a significant tradeoff for that. Kalamata olives are one of very few foods that have both fat and carbs, but no protein, so they make a natural keto complement to meat and cheddar. However, they have no fiber.

Fiber:
The fourth constraint. Generally I check for fiber when I am satisfied with the amount of carbs and the ratio of the meal. If the fiber content is too low — we shoot for about 11 grams of fiber for Nora over the day — then I’ll circle back and see if I can trade something out for more raspberries, macadamia nuts, or Flackers. Flaxmeal is another option, and can be mixed in with any butter in the meal.

Variety:
Lastly, we’ll check to see if there is a reasonable variety of textures and tastes. Meaning, is there something creamy and something crunchy? Is there something sweet and something salty?

A typical, very simple lunch:
8 g apple
15 g avocado
15 g cheddar cheese
8 g Flacker with 8 g butter
15 g macadamia nuts
13 g cream with water and vanilla flavoring to make “milk”
—————————
3.52:1 ratio
2.5 g carbs
6.9 g protein
33.1 g fat
4.4 g fiber
336 calories

At the bare minimum, if I have avocado, cheddar cheese, raspberries, and cream, I can cobble together the most basic tasty meal that satisfies all the constraints. Add some sliced meat, other berries, apples, peppers, carrots, cream cheese, macadamia nuts, kalamata olives, and Flackers, and we can switch things up enough to keep the simple meals interesting from day to day.

Keto clinic checkup and diet changes

Posted on December 13, 2013 by Christy Anderson Brekken

On Monday we made our way to Portland for another keto clinic check up with Dr. Wray. Nora continues to thrive. She is in her 20th month of seizure freedom! Her growth rate is right on track even after 2 years of diet therapy, 60th percentile for height and 75th for weight (I think she’s ready for a growth spurt). Dr. Wray reviewed her history and genetic testing and feels that there is no reason to keep her on a carb-restricted diet in the long term. Very good news.

Her labs were all fine. For those of you keeping score at home, her cholesterol panel was good at 188, triglycerides at 54, LDL (bad) minimally elevated at 135 and HDL (good) normal to good at 42. Her blood bicarb level was at 21, which is normally low but not too low.

We still can’t get Cytra-K in crystal form as before, so we will continue with baking soda (6 g dissolved in water given over the course of the day). She has avoided stomach upset after we learned to give small amounts of baking soda solution between meals. It seems to be a problem on an empty or full stomach. We have the option of using Cytra K oral solution (great cherry flavor!), but the stats I got from the dietician suggest that it has 3 g of carbs in her daily dose. We don’t think that’s a good trade off, when she could be getting 3 g of carbs through fruits and veggies. We will stick to the baking soda for as long as Nora tolerates it.

The biggest news is that we are going to adjust her diet to prepare for weaning her in April after her 2 years seizure-free. For the last 6 months she has been getting about 11 g carbs, 25-26 g protein and about 130 g of fat per day, which is 1300-1350 calories at a 3.5:1 ratio (fat to carb+protein).

That’s a small amount of carbs even by keto diet standards for this number of calories. When we increased her calories last time, the dietician suggested going up to about 16-17 g carbs, which felt like a big jump from 10 g of carbs, so we only increased it to 11 g at that time. Now we are going to keep the calories and ratio the same, but bring her carbs up to 16-17 g per day. That gives us a new daily target of 16-17 g carb, 20-21g protein, 128-133 g fat.

We will increase it by a gram every few days, so that she is up to 16 or 17 by the holiday break. Today she is up to 13 and is fine so far! When we told her that we were going to let her have more fruits and veggies she was so excited! It’s tiny baby steps to coming off the diet, but slow changes give us peace of mind. Slow but significant for Nora. Although she won’t do it all at once, going from 11 g to 16 g of carbs will feel pretty good!

I often get the question about “what does 1 g of carbs look like?” Of course, it depends on the food. It’s hard for me to answer on the fly because now I think in grams, not number of blueberries or baby carrots. Today I calculated one gram of carb for several of Nora’s regular foods. Some of them have significant fat and protein as well (so they are bigger servings), for those I listed their ratio too:

1 g of carbs in:
8 g blueberry
17 g macadamia nuts (5.43:1 ratio)
8 g apple
14 g carrot
11 g almonds (1.63:1 ratio)
46 g avocado (3.62:1 ratio)
15 g kalamata olives (4.5:1 ratio)
16 g strawberry (not pictured)
18 g raspberry (not pictured)

With 5 extra grams of carbs per day, Nora can have about 6 more baby carrots per day, or 40-50 small blueberries! That’s a lot!

Dr. Wray continues to be delighted by Nora, and to delight us. Anders joined us for the appointment because of a no-school snow day. Dr. Wray made a note of Anders presence in his follow-up report we received in the mail, and that is name is “pronounced with a soft A, which is the Norwegian articulation of his name.” See doc, we read these things with care. Anders thanks you.

Bringing Keto to Kindergarten, Part 3

Posted on December 5, 2013 by Christy Anderson Brekken

It’s almost half way through the school year!

When things are going along fine but you know there are potential problems lurking, it’s hard to feel really at ease. You can’t really know that things will be fine until something goes wrong and you see how everyone handles it. We had our first real keto-problem at school yesterday. It was handled perfectly. We have a new kind of peace of mind about Nora at school.

We have been sending her “milk” in a small mason jar with a drink/pour lid. I’ve always been afraid that it will pop open and spill all over the lunch box, losing all of that necessary fat to make up her ratio. It didn’t spill yesterday–the jar broke! Nora opened her lunch box to cream and broken glass. Yikes.

The school called me, but I was teaching and my phone was off. They called Ted next, who was much more clever than I would have been. When I heard their message I was ready to jump on my bike and get new cream over there. Luckily I called the school back first and found out that it was taken care of.

When Ted got the call, he asked if they had any butter at the school. They did not (really? not part of a healthy school lunch, I guess). The secretary suggested that they have olive oil in the teacher’s break room, so Ted calculated that 2 teaspoons of olive oil would do the trick. Nora wasn’t happy about it, but she took it and no one had to leave work.

On a related note, we still have not made a formal 504 plan with the school. The nurse has not contacted me about it again, and in the rush of daily life I have not pushed it. It is comforting to know that her teacher (who was part of the chain of command) and the school staff were aware of her needs and worked with us to find a solution.

Nora also had her routine blood draw yesterday for Monday’s keto clinic appointment with Dr. Wray. Ted took her in when the lab opened at 7:30, so she was a little late to school. When she came into her classroom some of her friends came over to give her hugs and brought her to the rug where they were singing and dancing their morning songs. Ted left with a warm and happy feeling about Nora’s school. That’s another wonderful kind of peace of mind.

Many thanks and muchas gracias to the wonderful people of Garfield school who take care of Nora every day!

Odds, Ends, and Giving Thanks

Posted on November 26, 2013 by Christy Anderson Brekken

Just a quick update with a few keto notes that have been on my mind. Nora is 19 months + 2 days seizure free, getting over a nasty cold/flu and looking forward to Thanksgiving break from school.

Still no Cytra-K and Nora’s keto clinic appointment for last Friday had to be rescheduled because her doctor had a family emergency. We wish him the best and are looking forward to getting a new appointment.

Thanks to Ted’s creative parenting and Nora’s 5-year-old maturity, taking baking soda as a Cytra-K substitute is going smoothly. Ted mixes up 1 tsp of baking soda in about 1/2 cup of water. We give her up to an ounce with every meal and snack. On school days she has one at breakfast, then one with afternoon snack, dinner and anything left at bedtime. No more pukies for awhile, so it must be doing the trick and spreading it out over the day seems to help ease any tummy upset.

To convince her to take it, Ted played Mojo Jojo for several days, telling her that if she takes her baking soda she will have super powers like the PowerPuff Girls to defeat him, but if she doesn’t take it then he can take over the world (he was very convincing!) She gulped it down and attacked!

This morning as we were trying to get to school on time, she said “but I haven’t taken my baking soda yet!” and sipped it down all by herself. Although it will never be a yummy treat, it’s also not torture anymore. What a relief.

I also wanted to share some keto updates and success from other families. I cry when I read their history and their bumps in the road because I know what it is like, but I’m also so hopeful and proud to see them overcome. Good attitudes and stories are contagious. Even though I may never meet most of these families in person, I hope they know that we are out here pulling for them, and I know that they (and our readers) are pulling for us too. We are always stronger together.

One of the first keto families that we connected with online is nearly weaned off the diet, after 5 long years of struggling with Doose syndrome and fighting for seizure control. I don’t have a blog post with the news, but I’m so thankful to keep up with Fawn on Facebook to get the news as it happens. Jade is out of ketosis! We are celebrating with you!
Amazing KetoCook mom Dawn posted an update at long last. I had the honor of meeting Dawn at the Charlie Foundation conference over a year ago. She has done so much for keto parents everywhere, but her most important accomplishment is seeing beautiful Charlotte through Dravet syndrome every day and continuing to do everything possible to head off a seizure. We have learned so much from you and we are cheering you on always. Your family is an ongoing inspiration.
And ketokid Autumn from Fort Wayne is in the news for 18 months of seizure freedom!

We have the deepest gratitude for the support we have received from everyone in our lives, near and far. Here’s to a restful and filling Thanksgiving holiday with our closest ones happy and healthy.

No Cytra-K?!?

Posted on November 10, 2013 by Christy Anderson Brekken

Last week was time to order another box of Cytra-K (for background, see The Blood Acid Chronicles). But the manufacturer is out! Our pharmacy called all 14 other pharmacies in town, and there was none to be found.

The back-up plan is to give Nora 1/2 tsp of baking soda twice per day. But Nora absolutely hates it. We dissolve it in a little bit of water, but we have to fight to get her to take it. Ted has discovered that Arm & Hammer tastes better than the kind sold in bulk at our co-op, but it is little comfort to Nora.

I put a tiny bit in her hot chocolate without telling her to see if she could taste it. It’s like the princess and the pea.

Nora’s doctor has a fax on his desk that he will find first-thing Monday morning asking for a substitute. Any suggestions for other substitutes for preventing blood acidosis?

Buttered up

Posted on October 2, 2013 by Christy Anderson Brekken

Word on the keto-street is that Organic Valley Heavy Whipping Cream is the only brand that consistently has no carbs. Their process is good enough to take only the fat and leave all of the lactose behind. And it’s organic–even better.

But we have a problem. We’ve notice that the Organic Valley cream we get from our local co-op is often very clumpy, while the Organic Valley cream that we get from another grocery store is consistently smoother.

So what’s going on in that clumpy container? In “On Food and Cooking: The Science and Lore of the Kitchen,” Harold McGee says it simply: “you agitate a container of cream until the fat globules are damaged and their fat leaks out and comes together into masses large enough to gather.” I suspect that the creamery trucks need better shocks to avoid all of that agitation.

The clumps that we find are baby butter. We try to stir them back into the cream, but we are really just breaking them up for a more even distribution. When we heat cream with clumps, they turn into yellow pools of butter. When Ted found a very clumpy carton this weekend, his idea was to put it in the microwave to heat, then it would re-distribute itself better. After heating and stirring, he put it in the fridge. When it came out of the fridge, there was a butter disk on top! (It was half-eaten by the time I took a picture. No, I didn’t eat it.)

Now, that’s cool, right? But we have a problem. We just extracted fat from the cream. We could do a rigorous weighing and calculation to determine how much fat was removed from the container to calculate and use the “thin” cream for Nora. But instead we bought a new carton and I will drink the thin cream in my coffee this week. Everybody wins.

Lesson: Buy smooth cream if possible. If your cream is clumpy, don’t heat it. Redistribute the clumps as well as you can for reliable fat measurement.

Bringing keto to kindergarten, part 2

Posted on September 20, 2013 by Christy Anderson Brekken

Me: “Mmmm, Nora. These pumpkin bars are so good. You are the luckiest keto-kid on the block.”
Nora: “No, I’m the only keto-kid on the block.”

And that pretty much sums up the social issue with starting school. Nora has been so amazingly compliant about her diet that the last 20 months has been relatively easy emotionally. Also, she has been home with her beloved Laura while I’m at work, socializing mostly with other families that we know and who know Nora. And if someone offers her food, our assertive little Nora clearly states: “no thanks, I can’t, I’m on the ketogenic diet for epilepsy.” I have heard it with my own ears. But I was also there to step in if Nora did not assert herself. When she is at school, she is on her own.

Starting kindergarten means that everything is new. All new people and kids who eat together 3 times per day. Nora is in school from 8:15 to 2:40, where they eat breakfast, snack and lunch together. Of course, Nora’s teacher and school staff are informed about her diet (I will address that in part 3), so it is not up to a 5 year old to explain it to the adults.

But she is her own advocate with her peers and she is well aware that she is the only keto-kid on the block. Other kids have other food issues to navigate, such as nut, dairy and gluten allergies. Plenty of other kids bring their own lunches and a few opt-out of breakfast. But after just the first day she was aware that *everyone* was drinking milk with their breakfasts and lunches and she wanted milk too.

I was trying to avoid liquids in her school meals, which are only asking to be spilled. But when she really wanted to have “milk,” I felt like it was more important to honor her wishes than avoid the risk of spilling. We’ve been giving her “keto milk” made with cream (an amount needed to achieve the ratio in the meal), diluted with water and with a drop of vanilla or other flavoring (she also likes banana). Our standard packing method is an 8-oz mason jar, the kind you use for canning jam. This summer I punched a hole in the top of a lid to fit in a straw. To make it spill-proof in a lunch bag, you just add a second solid lid under the screw cap, then to serve remove the second lid and insert a straw.

The straw is great for avoiding big spills while drinking, but I think that the changing of the lids is a bit much for a 5 year old who has 25 minutes to eat while surrounded by other kids. After the first day of school I tested her on unscrewing the lid to drink directly from the jar like a cup, which worked fine for the few days that we tried it.

I also started searching for small travel-and-kid-friendly cups that we could send to school. We came up with these reCAP mason jar lids and have used them successfully for the last week. They are plastic and have a rubber gasket to create a good seal. Nora can pop open the pouring lid herself. I am still nervous that the pour top will not stay closed in a lunchbox, but so far, so good. I check and double check it before I send her off.

I also brought in 6 of her Mexican Chocolate Protein Cupcakes with frosting and put them in the school freezer, so that she has a snack on hand if the class has a special treat. The question will be whether everyone remembers that she has a treat in the freezer. But if I tell Nora about it, she will be sure to inform everyone. Next I have to figure out how I will be informed that she had the extra snack at school. I suspect that I will hear it from Nora first, and they are at-ratio so if I don’t hear about it the ratio is fine, she just gets lots of extra calories that day.

She has been to school for 8 days now, and every day she comes back with empty food containers and no stories of spilling. It all seems to be working so far from her end. I feel pretty confident that Nora will tell me her wishes so that her lunches are appealing and easy to eat with her class, because the top priority is to keep her happy and independently choosing to stay on the diet.

The only mishap so far was one day when the whole class did not get morning snack because their schedule was rushed. When I picked her up the teacher reported that she had an emotional day, then when we got home I discovered that she had not touched her morning snack. She was adamant that no one ate snack, so the next day I told her teacher that if they don’t eat snack she needs to get that food at lunch time. Her calories are apportioned over the day, and missing some will make a girl cranky. It’s in everyone’s best interest to feed Nora.

Bringing keto to kindergarten, part 1

Posted on September 11, 2013 by Christy Anderson Brekken

Nora started school this week! Our school district does a “gentle start” for kindergarten. We met with her teacher for a half-hour last week, when we got to talk to her directly about the diet and Nora’s needs. Then Nora went on Monday for a full day with half of the kids in her class. Today she is there for the first full day with the whole class and it’s the regular schedule from here on out.

We are happy that Nora is in a school for full-day kindergarten, which goes from 8:15 to 2:40. The kids eat 3 times in that span–breakfast, snack and lunch. Three times the meal packing every day. But we are so excited that it is a Spanish-immersion school, where she will be learning exclusively in Spanish every-other day or every-other week (depending on how the teacher decides it works best for this group). She is in a classroom with one bilingual teacher rather than switching teachers weekly. Nora loves language and has been trying to speak Spanish for a few years, with a convincing accent. I can now leave it to the teacher to give her real vocabulary.

Because there is so much involved with sending Nora to school and the story will be unfolding for the rest of the week and next, I am going to write several blog posts about different aspects of bringing keto to kindergarten.

For now, the only sure thing is our parental perspective. Every parent feels anxiety and excitement at sending their child off on the first day of school. My feelings tend to run toward pride and joy that they are growing up and entering their own worlds. Nora makes that feeling easy because she is eager to join in, with only a trace of shyness or anxiety at the new situation. I don’t have to leave her crying; she leads me right to her classroom and gets herself settled in. I feel fortunate for that.

But she has lived a sheltered keto-life. She was enrolled in preschool when her epilepsy was at its worst in 2011. We took her out of school and hired a nanny, our beloved Laura, to care for her at home when I was at work. Laura has been with her ever since. She has had a dedicated adult with her to open containers and scrape out dishes for all of this time. Now taking her to school means that she doesn’t have that kind of one-on-one supervision, which raises anxiety about whether she will eat all of her meals as prepared for her, while resisting any temptation to share food from other kids.

We are also retelling Nora’s story over and over again–to the school nurse, to the teacher, to other parents that we are meeting or don’t know well. I brought in the newspaper article about her 1-year seizure free anniversary because it’s an easy to read explanation and lends it legitimacy. And every time I say that she is doing so great now, we are feeling confident that she will continue to stay seizure free, I want to knock on wood or throw salt over my shoulder. Those feelings of anxiety are lessening as time goes on, but they are still there. Bringing her Diastat prescription to the office just in case she has a prolonged seizure is a prudent and necessary step, but brings up frightful images of seizures at school that I don’t want to see in my mind. For all of the hope of the last 20 months, there is still the fear of a relapse. Somehow we have to continue to hope for the best and prepare for the worst, which is front and center during this transition.

To cope with that anxiety, I have looked for strategies to make her meals as simple as possible and ease any social issues that she will feel. Even though the adults are supposed to watch out for her (more on that in another post), I would rather avoid the risks by making everything as independent for her as possible. Then she can also avoid a little of the stigma that may come from being “different” (more on that later too). Other kids will bring their own lunches too, so if Nora can sit down, open her own meal and eat it all herself, all the better.

I baked a lot over the last weekend to store up some easy high-ratio finger foods rather than relying on liquids like cream or oil to achieve her 3.5:1 ratio. We are trying not to include too many foods that require eating with a spoon so that there is not much left behind in the dishes. We are also trying to avoid anything that can spill easily, which would most likely be cream and critical to keeping her ratio where it should be (more on that later too).

All of this comes at a time of transition for everyone on our family. Anders is also back at school. Both kids are playing soccer this season, Ted and I both work at OSU and are preparing to teach again this fall. I was off all summer, so I was preparing Nora’s meals as we ate rather than preparing and packing the night before in a lunchbox. New routines means that everyone is a little off-kilter as we get busier, and everything is a little more rushed and a little more difficult.

Did you ever have one of THOSE keto-baking nights? I had one last night. Sometimes it is harder than usual. I was trying to make Nora’s pumpkin bars (which, if I have not raved about them yet, are at http://ketocook.com/2012/10/03/pumpkin-cheesecake-bars/). They have been a staple in the breakfast rotation for the last year and are so good. I always start measuring with eggs because I try to hit some multiple of the recipe based on getting the eggs to come out even. I hate storing and wasting eggs.

By my version of the recipe (altered a bit to get 3.5:1 for Nora), I cracked 3 eggs and came out pretty even at making 18 bars. That was a fairly reasonable number; next I went to the computer to calculate how much of the rest of the ingredients to add. Then I went to add the macadamia nuts. I keep some ground in the fridge for easy cooking, but of course I was almost out. Got out the food processor to grind more. Done with that. Measured a few more things…now my small jar of coconut oil was almost empty. Got out the 5-gallon jar to refill the small one. Always a messy job. Poured a glass of wine (I already did the math, so it was good timing). Finished measuring everything out and put it in the mixer. Went to help Nora out of the tub…came back 10 minutes later with the mixer still on–excellent, the bars will be well mixed. Measured them into individual silicone baking cups, so many that I had to bake them in shifts…then there is clean up. But for a night of baking, we have plenty of breakfasts ready to serve. Beats the morning rush.

Today and tonight we were strategizing about lunch packing, getting ready for tomorrow. It must be fall, for the evenings in front of the gram scale are here.

Feeding our kids, ourselves

Posted on August 27, 2013 by Christy Anderson Brekken

One of the most common questions that we hear from people who learn about Nora’s diet, or who have known that we have been doing this for 20 months, is this: Do you eat like Nora too? How has your diet changed?

Simple beautiful keto meal. In the cup is a little poached egg (one of the first from our own chickens!) swimming in heavy cream. Nora also had fish oil and her cytra jello on the side.

This simple answer is this: Yes, we eat like Nora because we eat the same foods. Cheese, avocado, nuts, red pepper, berries, meats, eggs, cream, butter. But we don’t measure our food or eat in the same proportions as Nora does. We can have a fresh and simple family meal from mostly the same foods, but Nora has less fruit and a side of heavy cream. I’ve included several keto meals from this summer that were so pretty I took a picture.

I’ve noticed that as we have been so intensely focused on feeding Nora for her health, we have migrated to healthier eating patterns ourselves. Most people recoil at the fat-laden ketogenic diet and have an automatic association that fat is unhealthy. But there is more to the ketogenic diet than adding fat, and fat is not inherently unhealthy. It is an essential macronutrient that we all need. Our bodies’ interaction with food is much more complicated than fat = bad or carbs = bad…or any other such simplistic notion.

Lovely keto meal at the coast: 1/2 hard boiled egg (white only), baby shrimp in the egg, cucumber, pepper, kalamata olives and bleu cheese dip (recipe to follow).

I was deeply impressed by the latest pamphlet released by the Charlie Foundation called “Does what I eat affect my epilepsy?” about how diet affects epilepsy even for people not on the ketogenic diet. I was struck by their simple 2-step prescription:

1. Eliminate simple sugars
2. Eat a natural, whole foods diet

These two simple rules are good for every body, not just for controlling seizures. This is what the ketogenic diet has shown us, almost by trial and error. It is impossible to eat simple sugars on the diet. There aren’t enough carbs to give. And that’s been one major shift in our diet too. We rarely eat sweets or sweet drinks. I rarely eat bread anymore.

But it’s not about deprivation. It’s about shifting to step 2, natural whole foods. Now we eat a ton of fruit. It’s a good thing that Anders was already our little fruit bat, with a personal record of eating 7 apples in a day! He loves sweets, but does not expect them daily. A special dessert will be cobbler made with berries, no added sugar, and an oatmal-flax-butter topping with a touch of brown sugar. Of course, Nora has her own separate serving to her specs.

Improvised zucchini torta. I had the same meal! Pan-fried zucchini, cut up leftover pork chop, cheddar, avocado, red pepper, iced tea and cream.

When I started learning the carb content of various foods and giving Nora the best bang for her 10 to 11 carbs per day, I focused on how to load her up on berries and red peppers rather than wasting carbs on empty foods. Sure, she gets 3 or 4 grams of 85% dark chocolate in several of her snack recipes, but I consider those carbs well-spent on pure pleasure, not an empty food. This is not a deprivation diet. And squares of that chocolate bar are my go-to snack when I want something sweet. One or two squares is enough when it is high-quality. For me it’s not about no carb or low carb, but lower carb.

Now get ready, here comes the self-help-infomercial part. I have been reluctant to write this because I don’t want to sound all “rah rah! here’s the secret! you can too!” But it’s the truth, so here it is: In these last 20 months, I have lost 15+ pounds, and so has Ted. We never had a weight loss goal, but found it as a surprising natural consequence of shifting our diets subtly toward Nora’s. We exercise the same, eat the same number of calories (we aren’t counting, but don’t feel hungry), we just eat slightly differently. I put heavy cream in my coffee in the morning because it’s available, and I finally stopped putting in a teaspoon of sugar. It’s been a slow change all around. And I think that’s partially why people ask. They notice that we have slimmed down, we have energy, we feel young and healthy, my last lab work is great despite a family history of heart disease, high cholesterol, high blood pressure and diabetes.

Now that I’ve transitioned to eating this way, I notice the difference when I stray. If I’m at a party and I have a piece of cake, I feel cruddy for several hours. I had a donut at the farmers’ market one day and just wanted to sleep all afternoon. Beer makes me feel bloated and crappy, so I’m sticking to wine and cocktails (that’s right). It takes time to put together those associations and you can only really feel them once you have been away from simple sugars for awhile.

I have to consciously remind myself that I will feel like crap if I eat some cake and it’s not worth it. If Nora is with me it is easy to say “no” to sweets for myself because it is not fair to eat them in front of her and I want to be a good model for her. If she is not with me, it is much harder and I’m learning to just take a few bites or make another choice. But Nora doesn’t get “just a bite.” She has been and must continue to be the strong one. I am teaching her, and she is teaching me.

I met many amazing parents when I was at the Charlie Foundation conference a year ago. We were all wading through the same problems of managing our child’s epilepsy using diet, which is wonderful because it works but introduces so many social and behavioral issues as well. And it is so much daily work for the parents. While at the conference I heard tired parents talking about how they make a meal for their kid, then eat a bowl of cereal or a TV dinner to feed themselves. That made me so sad. They were sad for themselves; they felt deprived.

Parents, it is just as important to feed yourselves healthfully as it is for your kids. You can persevere through this if you keep yourself healthy and strong, and good food is as important to your health as your child’s. Even your kid on the ketogenic diet. And even if your kid is not on the ketogenic diet. Parenting is hard work. You are equally important. When you weigh out a meal, you can make yourself a plate of the same foods, just hold the heavy cream and give yourself an extra serving of veggies and a few crackers or a tortilla. You deserve it. No one should be deprived of good food, least of all such dedicated parents. And it’s really as easy as those 2 simple steps. Start slow but be consistent. Most of all, be kind to yourself.

Don’t call me cupcake…

Posted on April 12, 2013 by Christy Anderson Brekken

and don’t feed me cupcakes…unless they are keto-cupcakes! Just to make the point, Nora is holding one of her 4:1 cupcakes in the photo!

We ordered these great keto t-shirts through http://www.ketogoods.com/SHOP.html. Proceeds from each order go to The John M. Freeman Pediatric Epilepsy Center at John Hopkins Hospital to support research and efforts for the ketogenic diet.

They came with 5 stickers with the same message: “Please don’t call me cupcake and DO NOT feed me cupcakes. I’m on a special diet for epilepsy.” The stickers will be great to put on Nora’s lunch boxes, just as an extra reminder to everyone.

Nora got another purple shirt (more her size) that says “Hey, I’m on a magic diet for epilepsy so please do NOT feed me.” I like that one, but Nora preferred the cupcake one, of course.

My t-shirt says: “Someone I love is on the ketogenic diet for epilepsy.” Because it’s true.

Oregon Keto Kids

Ketogenic Diet for Epilepsy

Category Archives: Tips and Tricks