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Keto and Kids

Is keto and low-carb eating OK for kids?

Article by Mandy Pagano | 10 Jan, 2021

Article originally published on Ketovangelist.com on 2/14/17. It has been lightly edited for re-publication.

Within the keto community, there is a lot of chatter about- and controversy over- whether or not we should move our children over to a low-carb and/or ketogenic lifestyle. Some people insist children don't need to worry about insulin, shouldn't be "deprived" of the standard "kid food" experience, or even that they need lots of carbohydrates for proper growth. Other parents, concerned with the prevalence of poor dietary habits, and epidemic levels of obesity and diabetes amongst children in the West may be more open-minded about switching their children's food lifestyle to one that's more carb-conscious.

So, what's the deal?

Proper Growth and Health

There is a lot of misinformation about what children really need for proper growth and development. Contrary to what many think, starting your children on rice or oatmeal cereals and puréed fruits and sweet vegetables is not ideal (which is also why those foods are usually heavily fortified).

Children, especially infants and toddlers, need a significant amount of fat and iron in order to grow properly, most especially in the development of the brain, and this requirement continues well into childhood and adolescence. Fat is required to build nerve tissue as well as to absorb and utilize fat soluble vitamins, and iron is necessary for the health and development of a plethora of bodily systems.

Unfortunately, most "kid friendly" foods aren't naturally good sources of either fat or iron, which is why cereals, crackers, etc., are so heavily fortified. If we were wise we would be advising parents to feed their children good quality proteins (which are the best sources of iron and are often also a great source of dietary fat, especially DHA and omega-3 fatty acids) and vitamin-rich, fatty foods like mashed avocado.

Further, concern about carbohydrates in children's diets is not unfounded at all. According to the CDC, "obesity now affects one in six children and adolescents in the United States," and insulin resistance in children has skyrocketed in the past half century. Type 2 diabetes used to be coined an "adult onset" disease because children with this diagnosis were almost universally Type 1. Today a full one-third of all new childhood diabetes diagnoses are Type 2. Even more frightening is that there is very little in the way of clinical study of the medications typically used to treat adults with Type 2 diabetes and their effects (both efficacy and safety) on children, making pharmaceutical treatment very difficult and based largely upon trial and error.

We ketonians should be familiar with the hormone (insulin) theory of obesity. More and more evidence is validating the work of experts like Dr. Jason Fung, who is a huge pioneer is popularizing the idea that hormone imbalances, specifically that of insulin, causes obesity. High carbohydrate consumption and the chronically elevated blood glucose levels that follow are the primary cause of insulin resistance, which leads to obesity and eventually diabetes. Avoiding the causes of insulin resistance, and the subsequent health problems and obesity that follows, should be a priority for parents concerned about the health of their children.

So, What's a Parent to Do?

I realize this is contrary to a lot of popular opinion, even within the medical field, but a ketogenic lifestyle is not even remotely unhealthy for most children. Clean low-carb foods are rich in vitamins, minerals (like that iron they need so much of), and good quality fats, and keeping carbohydrate consumption low is known to combat insulin resistance (it's presence or the development thereof). And really, it's hard to argue that a diet low in sugars, free of additives, and high in essential amino acids and nutrients is somehow harmful to children. It is my opinion that keto is healthy for all people, and that's why I personally decided to have my own kids "go keto."

I will tell you right up front, it's been a long road, and a good deal of it has been a struggle. My two children are, as of this writing, seven and ten-years-old. I have personally been living a ketogenic lifestyle for one-and-three-quarter years, and so when I decided that I wanted the children to join me they were both older and had already developed a pattern of eating primarily sugar and carb-laden foods.

Our house rule at dinner time is- and has always been- that I make what I make and you eat it or starve (yes, I'm that mean mom). My children were notorious for turning their noses up at the healthy dinners I would cook, consisting of good quality meats and vitamin-rich vegetables, and would regularly choose to go to bed hungry. And why not? They knew that if they held out in the evening they could gorge themselves on carbage in the morning at breakfast. They were also pretty constantly hungry (of course, only until they should have been eating their healthy dinner, when they were suddenly and miraculously completely full) and always begging for a snack. Most days I felt like I spent three quarters of the day in the kitchen filling bowls with crackers, and I spent most of my evenings fuming that I worked so hard on a dinner that they didn't appreciate, much less eat. Not an ideal situation.

My eldest, who is especially picky, was the biggest challenge. At one point he relied so heavily on carbohydrates to fill his belly, and subsequently shunned most vegetables and almost all meats, that our pediatrician recommended we give him a daily protein shake so that he would get in the essential amino acids and vitamins he needed for proper growth. Again, this is obviously not ideal, and it caused me a huge amount of grief and concern for my son's health.

To be honest, I was desperate to stop the cycle of carb addiction and help them begin a healthier lifestyle. I personally struggled- and suffered- so much as an adult with a dependence on sugar and carbs (and all the physical problems that go along with it), and I never, ever want my children to go through that. I am their mother, their welfare and well-being is my responsibility, and so I decided that things must change.

How Did I Do It and What the Heck do They Eat?

I started my children's keto food journey by gradually eliminating the easy foods. Pasta, mac and cheese, bread products (waffles, pop tarts, and cereal) were things that I simply stopped buying. Once the children ate them all, we just didn't get anymore, and when they asked why I wasn't replenishing their favorites I took the time to explain why they were not healthy choices and- simply, of course- what they do inside the body. Since I've been keto going on two years and have talked to them along my own journey about why mom eats differently, they already understood that those foods mom exclude aren't healthy choices. What the elimination did was forced them to find something else to eat. Since I've done this, my children (yes, even the picky one) have decided they like quite a lot of meat (including some "exotic" ones, for children anyway, like steamed crab and shrimp or keto battered and fried fish) and the range of vegetables they will eat has expanded quite a bit.

Breakfasts are pretty easy. No pancakes, waffles, or cereal. I make keto "cereal" with mixed nuts, butter, and cinnamon that's been baked together into a kind-of granola that can be eaten with a little unsweetened almond milk. Or we make bacon and eggs (the side benefit being that I've been able to teach them to cook eggs themselves). If we need a quick morning meal I always have full fat, plain Greek yogurt on hand and so I mix in a little stevia and some dehydrated lime packet for my son, or some kind of extract (most frequently banana extract) for my daughter.

Instead of sandwiches with crackers, cookies, or chips for lunch, I keep full fat cheese slices or sticks, sliced meats (ham, chicken, and precooked bacon), olives, salted nuts, celery and nut butter, and pork rinds with salsa constantly on hand. I allow them to choose a good deal of what they eat at lunch, but they are limited to what we have, so they are always making a healthy choice. A lot of those foods also double as snacks, although they're usually pretty full and don't snack often between meals.

Dinner is whatever keto dishes I cook. Favorite vegetables are green beans, broccoli, and caulirice with butter or cheese. My daughter also really likes asparagus, and they both love raw spinach or shredded romaine as a salad so we eat those pretty frequently. Specialties that they like are keto pancakes or waffles, cheesecake fluff (I make about a hundred different variations with extracts and such), or one of my many delicious dessert recipes.

At This Point, Some of You Are Wondering About Fruit

I must confess, I do restrict fruit for my kids. As I have written about before, there is a misconception that because fruit is natural and has some vitamins it simply must be healthy. Unfortunately, the trade off between glucose and fructose content (the former of which will harm your blood sugar and insulin levels, and the latter increases triglycerides and small particle LDL cholesterol and has been linked to fatty liver disease and insulin resistance) and the actual quantity of available vitamins in most fruits is one I do not personally feel is worth making. To be perfectly frank, the nutrients found in fruits can always be found- and usually in greater concentration- in meats and fresh vegetables, especially the dark green and leafy kind, so I do not concern myself at all with the "lack" of fruit in their diets.

We do make exceptions for some non-traditional fruits: avocado and olives, for instance, are fruits and also rich sources of healthy fats; in the case of avocado, you get a plethora of potassium (even more so than bananas). We also use small amounts of tomato, another fruit that is very vitamin rich. As far as traditional fruits go, I make exceptions for berries, which are very nutrient dense and is perfectly in line with low-carb and ketogenic eating. My children aren't big fans of blueberries or blackberries, but they do love some strawberry, so I usually have a pint on hand. We limit strawberries to four or five normal-sized berries once every few days.

It should also be noted that the vast majority of the foods they're eating now are things they would have flat-out refused previously. Instead of thinking of their new dietary lifestyle as limiting, I consider it a gigantic expansion of their palates because it truly is! I also want to stress that I do not "count" their carbs, nor do I test them for ketones. I'm not offering them foods high in carbohydrate to begin with, and so the likelihood that they're consuming massive amounts of sugar is slim to none. I also do not want to make this experience miserable for them. I would greatly prefer that they grow up to have a healthy relationship with food. Therefore, unless there is a medical necessity for being extremely vigilant about ketosis and carbohydrates, I do not personally see a need to turn their new food lifestyle into an adult-style obsessive "diet." (You all know what I'm talking about.)

Other anecdotal positives I've noticed: (1) Both children wake up at a more regular time and are not dragging for hours in the morning. (2) They have more energy and focus, are no longer dragging in the late afternoon or cranky in the evenings. (3) They are not constantly starving and begging for snacks. (4) My son, in particular, was very, very slow in growth and since he has been eating ketogenic foods he has had quite the growth spurt. Where he was very, very thin to the point of being skinny before, he has filled out to a healthy weight and actually looks healthier.

That All Sounds Great! How Do I Get Started?

If you're the parent of an infant or toddler, I've got great news! You can start your children on a healthier, fat and iron-rich diet right now with relatively little fuss. The younger you begin feeding your children nutrient-rich, fatty foods, the less dependent they will be on carbohydrate-laden foods, and you will struggle less than you will if you start later in life. If their first foods are more savory and varied they are less likely to reject them as solids later on.

If you're the parent of older children or adolescents, I won't lie: you're probably in for a bit of a battle. Trying to change our tastes as adults who are conscious and accepting of the necessity of doing so is challenge enough. Making that decision for an older child who may not necessarily understand nor particularly care about the reasons for the change is much more difficult. The best advice I can give you is to be understanding and communicative, but also firm. Finding a range of low-carb foods that you can allow your older children to choose from will aid greatly in smoothing the road from carbaholic kids to ketonian kids. This also might take a bit of trial and error, but I will tell you from personal experience it is well worth the effort.

I will not tell you that this runs perfectly smoothly every single day. Even though my children are largely eating ketogenically, we still have days where they whine about not having their old favorites, or other things go wrong and we struggle to keep them on track. But just as I personally have had to make my way through and work hard to keto on, I fully acknowledge and expect that it's going to be a lot of work and persistence with my children as well. That's just part of a parent's job. I will not give up on teaching them manners, respect, and how to be good and decent people just because it's hard sometimes. In the same vein, I won't give up on teaching them how to be healthy and to make good food choices.

Every parent must weigh this kind of decision for themselves and, once it's made stick with it. Your children are worth every second of time and ounce of struggle it takes to keep them healthy!

[Author's Note: As of this republishing, I've been keto for almost six years, my children are now almost eleven and fourteen, and my husband is now about two years into his own low-carb journey. We still keep on keto-ing on, but as the kids grow closer and closer to adulthood, my husband and I decided to allow them to make more of their own choices. After all, as adults they will need to navigate the world of health and nutrition on their own. May as well get some practice now!

 My children have both settled into a very comfortable 90/10 when it comes to eating habits; they happily eat low-carb and ketogenic foods 90% of the time, and the other 10% (when they're out camping with friends or at a church youth function) they might choose to eat a "dirty keto" item, or "off-plan" entirely. Our family has found a very good balance of what works well for us and allows the kids to eat well the vast majority of the time, while also having some freedom to choose (with no fear that they must hide non-compliant choices from us).

Looking back, if I could add another tip to this piece it would be this: Don't be afraid to experiment in finding your own family's balance, especially with older children.]

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