First things first: your stomach is made up of good and bad bacteria, which scientists like to call microbiota or gut flora. And it's important that you keep it in check, as if you were keeping a seesaw level. "Microbiota is considered the body's garden, and it has a controlling influence over a lot of important bodily functions, including metabolism," says Gerry Mullin, M.D., author of The Gut Balance Revolution. Studies show that a diet full of fat and refined carbs (think white bread and potatoes) and low in fiber (fruit, vegetables, beans and oats) disrupt the balance, and the seesaw starts to tip in favor of weight retention and fat accumulation.
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When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common but disappear within two weeks. The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar and handling illness. The level of parental education and commitment required is higher than with medication.
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 calories 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.
I used to be 100 pounds heavier than I am now. My eating habits were out of control and pretty much the epitome of mindless. I am A.D.D., I have two kids under four, and I work full time, so eating without constant distractions just doesn't happen. But over the years I’ve learned what it takes for me to lose my weight... and most importantly, keep it off.