In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
Most low-carb diet authors don't recommend bothering with it. Even many of those who think a ketogenic diet is a good thing just assume that a very-low-carbohydrate diet (under about 50 net grams of carbohydrate) is ketogenic. On the other hand, many people have found that monitoring their ketones, at least for a while, provides valuable information.
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