The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]


If you’re like many resolution setters this time of year, you’ve already mapped out a route to your local gym. Maybe you’re planning to pound the treadmills or sweat it out in crowded studio classes. But if your ultimate goal is to drop extra pounds, you might want to ask how far all those miles and squats will really get you. According to a number of weight loss experts, focusing on your nutrition could give you a lot more bang for your buck. “By far, diet outweighs exercise if you want to lose weight,” says Heather Mangieri, RDN and spokesperson for the Academy of Nutrition and Dietetics. “You have to change your diet to change body composition. You can never out-exercise a bad diet.” So don’t sweat it—at least not quite so much. Here’s where to start with a weight loss resolution.

Focus on exercise: The most compelling studies favor physical activity for mental acuity, says Gary W. Small, M.D., the director of the UCLA Longevity Center and a coauthor of The Alzheimer’s Prevention Program ($14, amazon.com). A study from the Annals of Internal Medicine found that people who were fitter at midlife had a 36 percent lower risk of developing dementia later in life than did their less-fit peers. “When people exercise, the areas that control memory, thinking, and attention increase in the brain,” says Small. “Regular exercisers also have less of the abnormal protein deposits in the brain that have been linked to Alzheimer’s.” That’s not to say that diet has no impact, says Small: “It’s just that the effects of exercise are more pronounced based on the evidence we have now.” Foods rich in omega-3 fatty acids (such as fish, nuts, and flaxseed) and antioxidant-rich fruits and vegetables (like strawberries and spinach) have been shown to improve brain health, while refined sugars and processed foods can have the opposite effect.

Add spices or chilies to your food for a flavor boost that can help you feel satisfied. "Food that is loaded with flavor will stimulate your taste buds and be more satisfying, so you won’t eat as much," says American Dietetic Association spokeswoman Malena Perdomo, RD. When you need something sweet, suck on a red-hot fireball candy. It's sweet, spicy, and low in calories.
×