Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]

From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
I put the shavings in my stainless still 1/4-cup measuring cup on the smallest hob of my electric stovetop until they melt and keep adding more shavings until I fill the 1/4 cup. In the summer my coconut oil is always melted in the tub anyway so I’d have to refrigerate first if I wanted to measure it solid. As a matter of fact, I keep a jar of coconut oil in the fridge during the summer because I like to spread it on toast instead of pouring it – but it gets REALLY hard in the fridge! Way more than butter.
I was wondering if you have created some flour mixes to replace all purpose. Like a keto flour mix of sorts. I am also wondering, if with any other gluten free flour mix, the amounts of binder like xantham gum, guar gum, or gelatin would apply following the same rules of a non-keto flour mix. I found this recipe but haven’t tried it: https://donnareish.com/low-carb-flour-mix/
Hi Cathy, are you adapting these recipes yourself or are they already developed using coconut flour? From experience, it takes a lot of attempts to get it right (but fun too, it brings out the scientist in me). Coconut flour requires a high number of eggs for volume, thickening, protein, binding, and structure. I would be worried if there was too much avocado in there as that is just adding a soft ingredient that gives no structure. The sweet potato would add volume but unless there is enough eggs and coconut flour in the recipe, again it won’t add to the solidity of the final recipe. Psyllium I add purely to get a better crumb texture. It swells and thickens and helps bind all the other ingredients together nicely. Scones – they won’t have risen because of the lack of gluten (yay), but I quite like heavy scones as a personal choice. I started baking using recipes that had already been developed using these low-carb flours, and start by adjusting the flavours only not the ratios of the bulk ingredients. You will soon get the hang of them. Start with my flourless berry sponge, I use these ratios all-the-time! Yum.
Moreover, two recent meta-analyses sought to investigate the effect of LCD on weight loss and cardiovascular disease risk. Sackner-Bernstein et al. (19) compared LCD to LF, among overweight and obese men and women. The authors found a significantly greater effect of weight loss in the LCD vs. the LF diets (-8.2 kg vs. -5.9 kg). The impact of diet on cardiovascular risk factors was split, with LCD resulting in significantly greater improvements in HDL cholesterol and triglycerides, while the LF resulted in significantly greater improvements in LDL and total cholesterol. From this the authors concluded that LCD were a viable alternative to LF diets and recommended “dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of [low] CHO diets.” A significant limitation of this meta-analysis, however, was the authors’ definition of low-carbohydrate as a daily CHO consumption less than 120 grams. This value, while well below the standard recommendation of daily CHO consumption, still far exceeds the strict recommendation of KD (≤50 g/day), therefore the results of this meta-analysis must be approached with caution.
I was on the ketogenic diet for 6 months to support my husband, who is on it permanently for epilepsy. The diet totally messed with my hormones, which my doctor and my husband’s nutritionist sadly confirmed was a possibility. I am continuing to eat low-carb, but the ketogenic thing unfortunately seemed to work against me as a 49-year old pre-menopausal woman.
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