The Indian keto diet has been designed based on the protocol of Dr. John Freeman of the John Hopkin’s Hospital. In our modified protocol for the diet we have brought about some changes which makes adaptation of the diet easier. The modifications in the diet are briefly discussed below.
We are able to eliminate the most difficult phase of the diet, i.e. fasting. Now, we put patients on a low carbohydrate diet, prior to starting the actual ketogenic diet, which helps body to utilize glucose stores and thus helps metabolism of fats rather than carbohydrates for formation of ketone bodies. Thus, now we start the ketogenic diet without fasting the child.
We also realised that many parents were apprehensive of hospital admission of 3-4 days, and so, now we have successfully started this diet treatment on an OPD basis.
Lower Keto Ratios:
In our experience, most children do not require higher ratio of fat:protein + CHO. We, start out with a ratio of 2:1 and are able to maintain stable 4+ level of ketones even with such a lower ratio, in most cases. If & when required, we do increase this ratio depending on the level of ketones in the urine. Lower keto ratios allows more variety in the diet as it allows more amount of carbohydrates and thus, diet doesn’t become monotonous or boring.
Normal Lipid Levels:
One of the major concern while giving a high fat diet is, maintaining lipid levels.We use a combination of oils & ghee ( different types of fatty acids ) to maintain lipid levels at or near normal values.
We use a combination of Groundnut oil ( MUFA ), Corn oil or Safflower oil ( PUFA) and Ghee ( Clarified butter – Saturated fat ) in equal proportion.
Successfully implemented in Adults:
The ketogenic diet has been used since several decades for the control of seizures in people with uncontrolled epilepsy. Most of these have been children, we have successfully implemented classical ketogenic diet in adults too for over 5 years.