Whoa em gee, you don’t know how badly I needed this particular recipe at this particular point. Worn down by Christmassiness, I’d been eating my parents’ Cinnamon Life cereal for the last couple days which, for various reasons, is a terrible idea for me. AND I HAVE THE INGREDIENTS FOR YOUR CEREAL. It’s a boxing day miracle, for real. Thank you for what you do.
I made this bread several times now using ground flaxseed in place of the psyllium powder and it came out perfect every time. I decided to try it as a sweet bread and added 1/2 cup raisins, 1 Tbsp. cinnamon, 1/4 cup erythritol and 2 Tbsp. Splenda. After it was done I iced it with 1/2 cup powdered sugar mixed with enough milk (about 1 Tbsp. to keep it thick but a little runny. Now I have a healthy, delicious, loaf of cinnamon raisin bread. Thanks for the great recipe!
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]
I literally need a vegan keto cereal in my LIFE. I know this recipe is NOT vegan, but I would love to try making this with flaxseed meal instead of the egg white! Anyways, I most certainly ADORE cereal and can easily eat it by the handful. Granola is even MORE dangerous because the serving sizes are smaller and the flavor and crunch factor are just addictive!
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
Supplements: MCT oil and fish oil, ensuring they are USDA-organic, hexane-free, and non-GMO. One important thing to note: MCT oil delivers beta-hydroxybutyric acid (BHB), which is the most important ketone body, and its benefits can be gained without fasting or even carbohydrate restriction. While the full benefits of a ketogenic diet will only be realized if you adhere to the diet in its entirety, incorporating MCT oil into your current diet and supplementation is a good way to benefit from ketone bodies on a smaller scale.

Made in mini muffin pans, will have to oil them better next time so they come out easier. Taste great, although sadly more like a muffin than donut (the shape doesn’t help, lol). I may try to thicken it up to deep fry next time. Was out of cinnamon so I used pumpkin spice. Not so strict on low-carb and wanted the kiddos to like them, so offered cinnamon/sugar, powdered sugar, and toasted coconut for coating. I recommend the coconut! Browned in a dry skillet makes it nice and crunchy… just how to make it stick was the only drawback.


AMAZING! I just made this bread and I can’t believe how perfect it is! My fiance and I are doing low carb. Not quite keto but trying to stay close to that range of carb intake! Honestly I’ve just been saying I’m avoiding bread, potatoes, and pasta. Either way this bread rocks. The only substitutions I made to the recipe was plain seltzer water in place of the still water. Wanted to give the dough some extra lift. I also put some pumpkin and sunflower seeds on top to increase the heartiness. This bread came out rocking our socks off. Can’t wait to make some grilled cheese Sammie’s with it!
I have been on the Atkins diet for the past month and a half (with great results!) But, I am not too crazy about the taste of the Atkins low carb baking mix. I decided to give this one a try, and I am so glad I did! I have read thru some of the other reviews, and for the most part, it was given high marks. I'd like to add to that five star rating by saying how much easier it is to use. No clumping, no harsh after taste, and I love the whole grain flavor! The pancakes are awesome, and its good to be able to have them again! You feel satisfied on a very small amount of anything made with this product, and remain comfortably full, which helps you avoid 'picking' in between meals. Highly recommend!
With the help of keto-friendly ingredients, you can easily make yourself some delicious, fluffy pancakes. There are, in fact, several ways to make fantastic keto pancakes, but our favorite is the Faux “Buckwheat” Pancakes made with almond flour and flaxseed meal. Try them for yourself if you want low-carb pancakes that taste just like the real thing.
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]

Not in the mood for cake? Brownies definitely come second on that list of delicious treats that we want once we turn to a ketogenic diet. You can easily make keto brownies that you can fully enjoy without having to fight against the craving to have more. Besides using almond flour and other mixtures of flours, you can make them out of avocado as well.
There’s nothing like pouring a bowl of low carb cereal with almond milk for an easy morning breakfast. These low carb granola and low carb muesli recipes are made from nuts and seeds resulting in a nourishing sugar free, gluten free, and grain free breakfast option. Because they are very nutritionally dense, enjoy a small portion. Enjoy a spoonful on full fat Greek yogurt or ice cream.

This post may contain affiliate links to products we believe in, which means that even though it doesn’t cost you anything extra, The Keto Queens will receive a small amount of money from the sale of these items. Also, please know that nutritional information is provided as a courtesy calculated from the nutrition plugin API and we cannot guarantee its accuracy.
When it comes to crunchy keto cereal, you can make it with nuts, pork rinds, coconut, nut butter, nut flour, sunflower seeds, hemp seeds, chia seeds, and so on. Some recipes require eggs to help bind the the cereal together, and others don’t. You can make them into flakes or just leave them chunky like granola. You can even make low carb hot cereal for a comforting breakfast on a cold day.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
Hey! These look amazing and I’m definitely going to try them. Right now, I only have sugar free macadamia nut milk on hand, no almond milk. How important do you think the almond milk is? Or is it really just an issue of needing a liquid for the recipe? Or I could also use heavy cream to sub in for the almond milk. Which do you think would work better? Thanks for this recipe, can’t wait to try!
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].

Merra G, Miranda R, Barrucco S, Gualtieri P, Mazza M, Moriconi E, Marchetti M, Chang TF, De Lorenzo A, Di Renzo L. Very-low-calorie ketogenic diet with aminoacid supplement versus very low restricted-calorie diet for preserving muscle mass during weight loss: a pilot double-blind study. Eur Rev Med Pharmacol Sci. 2016 Jul;20(12):2613-21. [PubMed: 27383313]
Out of 63 comments so far, only 3 people actually said that they tried the recipe, and only one of those rated it. Yet there were 16 other ratings from 3 to 5 stars from folks who didn’t make the recipe but weighed in to ask a question or say some form of “these look great, I’ll have to try this”. And there were 10 questions about using some particular thing or other to replace the gluten, even though it was clearly spelled out from the beginning that nothing could be used as a substitute. Yes, you are a saint, lol!
The benefits above are the most common ones. But there are others that are potentially even more surprising and – at least for some people – life changing. Did you know that a keto diet can help treat high blood pressure, may result in less acne, may help control migraine, might help with certain mental health issues and could have a few other potential benefits?
In regard to serum measurements, the mean fasting glucose decreased by 17% from 9.08 ± 4.09 mmol/L at baseline to 7.57 ± 2.63 mmol/L at week 16 (p = 0.04) (Table ​(Table4).4). Serum sodium and chloride levels increased significantly, but only by 1% and 3%, respectively. Uric acid level decreased by 10% (p = 0.01). Serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001). Increases occurred in both high-density lipoprotein (HDL) cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (10%) but these changes were of borderline statistical significance (p = 0.08 and p = 0.1, respectively). The following blood tests did not change significantly: total cholesterol, potassium, bicarbonate, urea nitrogen, creatinine, calcium, thyroid-stimulating hormone, and hemoglobin.
I have spent weeks reading and learning about the Keto diet plan, downloading random recipes that my husband might even try, and have been overwhelmed with all the information. I was pleased to find your system and how organized everything seems to be. The only question I have is will I be able to “temporarily suspend” my subscription if I find there are more recipes than I have time to prepare. I want to only do about 3 per week and repeat them as leftovers, since I have very little time after working a 12-hour shift, to do much cooking. Once I “catch up,” I would reinstate my subscription. Is that an option? Looking forward to trying out your program.

1 cup of almond milk (or milk of choice); 1/3 cup quinoa flakes (purchased at http://www.nuts.com); sweetener of choice; pinch of salt; toppings of choice (usually nuts or berries or banana). Heat the milk in medium saucepan. When it comes to a slight boil, drop in the flakes and salt. Remove from heat, stir and let the cereal cook for about 3 mins. Give it a final stir after 3 mins. It will be thicker and creamier and ready to serve.
GRAINS: A classic breakfast choice is some kind of whole grain. That's wholegrain—refined grains have had most of the fiber and other nutrients milled out of them, leaving a refined carbohydrate that bears a striking nutritional resemblance to sugar (although it's usually fortified with small amounts of iron, B vitamins and folate). Because you can subtract the grams of fiber (they have no significant impact on blood sugar) from grams of total carbs in whole grains, the high fiber content lowers the net carb content significantly.

So rather than giving one-size-fits-all dietary advice or weaponizing the word “balanced” it might be better if the medical community suggested that there are Individual differences that need to be considered. This might also help those lay folk who have had success with one dietary lifestyle or another also realize that what’s valid for them may not be good advice for others.


If you prefer your cereal hot, try this grain-free version from Wildway, a favorite of Aimee Aristotelous, RD, a certified nutritionist and author of The Whole Pregnancy. "It contains real food ingredients, [is] certified gluten-free, paleo-friendly, soy-free, and sweetener-free," she tells us. Not a fan of hot cereals? She also recommends the brand's grain-free granola.


Out of 63 comments so far, only 3 people actually said that they tried the recipe, and only one of those rated it. Yet there were 16 other ratings from 3 to 5 stars from folks who didn’t make the recipe but weighed in to ask a question or say some form of “these look great, I’ll have to try this”. And there were 10 questions about using some particular thing or other to replace the gluten, even though it was clearly spelled out from the beginning that nothing could be used as a substitute. Yes, you are a saint, lol!
1. These cookies are lightly sweetened. If you want them sweeter add more Sukrin Gold (2 tbsp) or add a little stevia glycerite (1/4 tsp) and taste. 2. All ovens are different and baking temps and/or times may need to be adjusted. If you have a wall oven, you might want to cook at 325 degrees F. The cookies might have to go a little longer if you do. 3. Be careful not to pack the almond flour and oat fiber. Packing ingredients leads to using more and can result in dry baked goods. 4. For a flatter, softer cookie use 4 oz of sliced almonds instead of 5 ounces and bake for slightly less time. Also use a room temperature egg instead of a cold egg. 5. Ingredient substitutions may affect texture, moisture content, and cooking time.
Hi Kelly, All packaged foods will have a nutrition label that list the macros per serving, including fat, protein and cabrohydrates. Net carbs, which is what most people look at for low carb and keto, are total carbs (the amount on the label) minus fiber and sugar alcohols, as explained in the article above. I have a low carb food list here that gives you a full list of all the foods you can eat, and the net carbs in each. You can also sign up above to be notified about the meal plans, which are a great way to get started.
It can sometimes be difficult to find a cereal that actually fills you up till lunch, so a keto-compliant granola can be the answer. This one is deliciously crunchy and has a warming flavor from the cinnamon and tastes great with your favorite nut milk. Nuts can be a great source of goodness and energy, so this can also be eaten as a snack when you need a little something to keep you going.
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.
So glad to hear that I’m not the only one that’s not dropping pounds/inches like gangbusters…I’ve been “pretty” low carb/keto, lift twice a week and cardio 3 other days and nothing…nothing happens. I’d like to lose 10-15 pounds and just can’t seem to get anywhere…55…post menopausal. I’d say that my carbs are generally around 30 per day or less and I do IF. Love to hear your thoughts.
Carolyn Ketchum writes All Day I Dream About Food, a food blog that focuses primarily on low carb, gluten free recipes. She has a Masters in Physical Anthropology and Human Evolution from Arizona State University and has an extensive background in higher education administration. She currently lives in the Boston area with her husband and three children. You can check out her experiments with low carb baking at All Day I Dream About Food.
I’ve tried a ”ton” of low carbs foods...so trust me when I tell you how good this stuff is. If your low carb or keto...Sola products are sanity in a bag with a taste authenticity comparitative to their high carb counterparts. You won’t be disappointed so go ahead and order extra. I like to put it in my yogurt, cottage cheese, protein shakes, sugar free pudding, etc. It’s the jam with almond milk by itself too.
Shirataki Noodles: There are people who like this pasta, but I don’t know many of them. You probably should try it yourself just in case you’re one of those few who likes them. With essentially zero calories, carbs, fat, or protein (in other words: void of nutrition whatsoever), these “noodles” are made with yam flour (konnyaku) and water. There are a variety of brands and you can find them just about everywhere these days. In your grocery store, you’ll probably find them within the produce section. Even stranger is that they are packaged in a bag full of water. What’s the downside to a pasta that has basically zero carbs? They smell gross. They taste gross. The texture is gross. Ick. You’re encouraged to rinse them thoroughly in an effort to rid them of their funky taste and smell, but I found that no amount of rinsing was good enough. If you’re someone who does like these noodles, please let us know how you managed to make them edible!

Thank you for such a through list. I have been wondering how to count the spices used in cooking and now I know. I do have one question though that I can not find the answer to. When breaking down the macros for a recipe how do you count items that are listed as having fewer than 1 carb? Do you just count it as one? I am in a stall and wondering if I am not accounting for enough carbs.
Made these donuts this morning, and they are delicious. The simplest and one of the best low carb donut recipes that I have tried. I did add a scoop of whey protein powder for structure, and that worked great. I used Swerve in the donuts and a small amount of Truvia (which contains a little sugar–but okay in this tiny amount per donut) for the topping. I got 8 donuts out of the recipe, but I think I actually could’ve gotten 10. I have two 6-cavity nonstick Wilton donut pans like the ones pictured in your link. Great recipe, Maya. Thanks!

This study examined the relationship between low-carbohydrate diets, all-cause death, deaths from coronary heart disease, and cancer in 24,825 people. Compared to those in the highest carbohydrate group, those who ate the lowest carbohydrates had a 32 percent higher risk of all-cause death over six years. In addition, risks of death from heart disease and cancer were increased by 51 percent and 35 percent, respectively.
Gluten Free (GF): This can definitely be gluten-free if you do not add the gluten and you are sure your oat fiber is completely gluten free. Again, just like the Family-Friendly and the THM E mix options given above, if you are not after low carb but simply after healthier and gluten-free baking options, you may omit the lower carb flours (oat fiber, golden flax, etc.) and use part oat flour or part gluten-free flour. (Bob’s Red Mill Gluten-Free Flour is the lowest carb gluten-free flour I have found—by many carbs in some cases!) Also, you can do the option of making it as is and using half Basic Low Carb Flour Mix and half gluten-free flour for a healthier alternative to just gluten-free flour (which is often made with corn starch, rice flour, and other “white” flours).
Move over, cream- and butter-laden mashed potatoes—there’s a new side dish in town. This mashed cauliflower takes on the consistency of potatoes after getting chopped up in a food processor or blender (or use a potato masher to get chunkier “potato” pieces and work on your upper arm strength!), so get ready to enjoy a favorite comfort food minus piles of carbs. The garlic and chives add an extra dimension of flavor that's sure to be a hit.

The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]
I really appreciate this article. I have done low Carb for the most part for over 15 years and was able to keep my weight down. Now that I have gone through menopause is just keeps getting harder. I try doing keto but tend to fall off the wagon a lot and go back to low Carb or Weight Watchers. Simple ideas would be great. I think some keto bloggers make it seem that you have to create difficult recipes. Thanks for all you do.
I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
As ingested CHO is broken down by the stomach and absorbed through the small intestine, rising blood sugar creates a feedback loop which results in secretion of insulin. The primary role of insulin is to “dispose” of excess blood sugar by signaling tissues to “uptake” more glucose from the circulating supply. In this manner insulin serves a prominent role in glucose regulation. This concept also provides the basis for the glycemic index, a concept which attempts to quantify the impact CHO foods have on blood sugar response. For example, foods rich in simple CHO (i.e., “sugars”), which are absorbed quickly, trigger a rapid rise in blood sugar (and subsequently insulin response), whereas foods rich in complex CHO, such as fiber-rich legumes, exert a relatively blunted response on blood glucose.
I too have been following you for a long time, trying your recipes and loving most of them. I am 4 days into the keto diet. I have not looked at the scale yet, but I kinda feel like my clothes fit a bit better. I am not in ketosis though…I was glad to hear that it took you a bit longer to get there so I don’t feel like I am doing it wrong. I am 62 and 5 foot 2 and I just can’t seem to keep my protein low enough. Too much meat I am guessing. I am trying to stay at 1330 calories, 105 grams of fat, 20 carbs, and 76 protein. I am very interested in learning what you eat in your typical meals for the day. I use the free version of My fitness pal.
Fanatic? Someone with T2D, a disease usually claimed to be progressive and a never ending stream of problems and medications, was REVERSED. That’s something to shout from the rooftops. The drop in medication use alone, but the big pharma companies would prefer that people’s stories of reversing (well, putting it into remission) T2D get called fanatical instead of insightful.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
Thanks for posting about the psyllium Sarah,, I tried psyllium flakes 10g and they turned out great. Not even very fragile. It just gets thick so the batter doesn’t self-level, I had to do my best, and the thick spots required 1 extra minute in the oven. Used immediately in a skillet lasagne- just ground beef, jar of pasta sauce, mozz cheese and cream cheese. Definitely wouldn’t have been much of a lasagne without the “pasta”! So these noodles are my hero 🙂
These donuts were moist and tasty! But mine did not rise on the one side- they were flat like a bagel.. I was kinda depressed 🙁 What did I do wrong? I used new everything- I even bought the pan you suggested. When you say fill up the donut pan 3/4 to the top- is that almost to the top of the donut pan? Maybe I didn’t put enough in each of them? Thank you for any suggestions you may have.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]
Taken together, these results demonstrate a positive effect of LCD/KD on body composition. While KD may not be superior to other dietary strategies aimed at weight reduction, the evidence does suggest that it may be equally effective. Nevertheless, the International Society of Sports Nutritionists, in their Position Stand on the effects of diets on body composition, suggest the KD holds little benefit over higher CHO diets, with one notable exception; KD may enhance appetite control (1).

One of the common problems with eating a ketogenic diet is that your system can become a bit less regular than normal, so one of the best ways to sort it is to up the fiber. This cereal is loaded with fiber and can be really helpful to reset your system. It also has a hint of chocolate, making it kid-friendly too. Just serve this with your choice of milk for a healthy and filling breakfast.

I made these this morning but subbed coconut milk in for the almond milk since I didn’t have any on hand. I also used a little less sugar substitute since I hate that cooling effect it has and I added some ground cloves and nutmeg. They were SO good! I’ve tried a few keto recipes and have not had too much success, but this one is GREAT! Even my son who is super picky really loved them.


Although the KD has shown promise as an alternative dietary strategy for weight management, it should be approached with caution. Acutely, the KD causes physiological changes which may manifest as the “keto flu,” a set of symptoms which commonly includes headache, nausea, gastrointestinal upset and fatigue. A recent study by Urbain et al. (22) illustrates this point, as they state, “Consistent with other studies, our subjects complained about headache, gastrointestinal symptoms, and general weakness mainly during the 1-week metabolic adaptation phase to a KD.” While these symptoms typically resolve within the first one to two weeks, this may present an unpleasant barrier for many individuals to overcome.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
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