Revision as of 08:53, 19 November 2014

The Ketogenic Diet does not typically provide a complete intake of all required nutrients, so supplementation is recommended, especially salt, selenium, fiber, and vitamins.

1 Sodium (Salt)

Some authorities recommend increased salt intake because low carbohydrate diets cause of the kidneys to excrete sodium. This "natriuresis of starvation" may be due to low insulin^[1], increased dopamine excretion^[2], or elevated Glucagon^[3]. If both carbohydrate and sodium intakes are limited then the body will secrete aldosterone^[4] which will cause the kidneys to excrete potassium and conserve sodium^[5]. This loss of potassium can cause Muscle Cramps and heart arrhythmias, as well has the loss of Muscle Tissue. Personally I found higher salt intake to be critical during the Ketogenic Diet or my blood pressure would drop too low.

2 Selenium

Insufficient intake of selenium can result in a weakening of the heart muscles (cardiomyopathy), and the ketogenic diet may not provide a sufficient intake^[6]. Good sources of Selenium that could be used on a ketogenic diet include are Brazil nuts, tuna, beef, chicken and turkey, but supplementation is normally recommended.

3 Fiber and Constipation Supplements

Constipation is a common issue with low carbohydrate diets as they can be low in fiber. Recommended approaches to reducing constipation include MCT oil, avocadoes, prunes, exercise and good hydration, or even a mild laxative such as Miralax^[7]. Personally, I've found the ketogenic diet to produce a change in stool consistency even with a comparable fiber intake, which may be due to the way that non-fiber carbohydrates pass through the digestive system and are metabolized by the intestinal flora.

4 Vitamins

For children using the Ketogenic diet for seizure control, daily supplementation with calcium, vitamin D, zinc, selenium and multivitamin/mineral is required^{[8] [9]}. There are anecdotal reports of scurvy (Vitamin C deficiency) while on ketogenic diets.

5 Omega-3

For children on the Ketogenic diet for epilepsy, the recommended range of Omega-3 is 0.6-1.2% of their total fat intake^[10]. The FDA recommends the Omega-3 intake from fish not exceed 3 grams/day.

6 MCT

MCT can be added to a ketogenic diet to improve the ketone levels by adding 5-25 grams per meal or per day^[11]. (Coconut oil is normally 60-70% MCT^[11].)

7 Carnitine

Carnitine is critical for the metabolism of fat, and generally the body will make enough, but there may be cases where supplementation is required^[12]. It is possible to test for carnitine deficiency, which, if used, should be repeated every 3-6 months^[13]. If carnitine levels are <15, then extra carnitine is often given, especially if combined with symptoms of sleepiness or sluggishness^[14].

8 Oral Citrates

Taking Potassium citrate (Polycitra K) can reduce the risk of kidney stones by 7x^[15], probably by reducing urine acidity.

9 See Also

• The classifications and types of Low Carbohydrate Diet.
• An introduction to the Ketogenic Diet.
• My experiences with ultrarunning on the Ketogenic Diet
  • How the Ketogenic Diet can be used for the treatment and management of disease.
    • Using the Ketogenic Diets to mitigate and treat Epilepsy
    • How Ketogenic Diets might help with Cancer
    • A look at the possible mechanisms of action of the Ketogenic Diet
  • Health Risks of the Ketogenic Diet
    • Health Checks for the Ketogenic Diet
    • Supplements for the Ketogenic Diet
  • The time frame and changes that occur with Ketoadaptation
  • What are Ketones
    • How to measure Ketones
    • What ketone levels to aim for
  • The pros and cons of the Ketogenic Diet for athletes
    • The Science of Ketogenic Exercise
  • The Types of Ketogenic Diet
    • The "traditional" Ketogenic Diet based on the Ketogenic Ratio
      • The ways the Ketogenic Ratio can be calculated
        • The different definitions of Net Carbohydrates
    • Low Glycemic Index Treatment
    • MCT Diet
      • MCT
    • Modified Atkins Diet (M.A.D.)
• My Ketogenic Recipes
• Non-Ketogenic Low Carbohydrate Diets

10 References

1. ↑ P. Stenvinkel, A. Ottosson-Seeberger, A. Alvestrand, J. Bolinder, Effect of insulin on renal sodium handling and renal haemodynamics in insulin-dependent (type 1) diabetes mellitus patients., Acta Diabetol, volume 32, issue 4, pages 230-4, Dec 1995, PMID 8750761
2. ↑ R. Swaminathan, G. Cope, M. Sheltawy, MR. Lee, JK. Wales, Dopamine excretion during natriuresis of starvation., Int J Obes, volume 7, issue 1, pages 31-5, 1983, PMID 6840964
3. ↑ C. D. Saudek, P. R. Boulter, R. A. Arky, The Natriuretic Effect of Glucagon and Its Role in Starvation, Journal of Clinical Endocrinology & Metabolism, volume 36, issue 4, 1973, pages 761–765, ISSN 0021-972X, doi 10.1210/jcem-36-4-761
4. ↑ Phd Stephen D. Phinney MD, Rd Jeff S. Volek Phd, The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable, 2011, publisher Beyond Obesity LLC, isbn 978-0-9834907-0-8, Page 312
5. ↑ Christopher J. Lote http://www.amazon.com/Principles-Renal-Physiology-Christopher-Lote/dp/0792360745 Principles of Renal Physiology], 22 June 2012, Springer, ISBN 978-1-4614-3785-7
6. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1826
7. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1790
8. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1338
9. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2490
10. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1820
11. ↑ ^{11.0 11.1} Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1812
12. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1793
13. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1799
14. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2258
15. ↑ Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1778