1. The Spectrum of Ketogenic Therapies fat exonerated
Beth Zupec-Kania, RDN
The Charlie Foundation for Ketogenic Therapies

2. Objectives 1. Describe biological fuels & metabolic impact
2. Define “Spectrum of KD Therapies”
3. Identify resources
4. Test your knowledge

3. Biological fuels on ketogenic diets
1. Fat
2. Carbohydrate
3. Protein
2014

4. Processed carbs; high-carb & high GI
2014

5. Natural food carbs – low carb, low GI

6. Glucose curves on high carb diet
LEVEL
Carbohydrate: Hi GI
Carbohydrate: Low GI
Protein
Fat
150
100 70 60
1 hour
2 hours
3 hours
4 hours
5 hours

7. Glucose curves on ketogenic diet
LEVEL
Carbohydrate: sugars
Carbohydrate: complex
Protein
Fat
150
100 70 60
1 hour
2 hours
3 hours
4 hours
5 hours

8. Ketone production reduces insulin need

9. Biological fuels and epilepsy Masino & Rho
Adenosine: Masino & Rho

10. Spectrum of diet therapies – 1000kcal
Ratio Fat gm Pro gm Carb g
Ketogenic 4: 3: 2: 1:
Mod Atkins 1:
LGIT 1:
MCT Diet 1:
Regular diet 0.2:

11. Carbohydrate 1. Not an essential nutrient.
2. We can make glucose from protein and fat.
3. USDA guidelines:
gm/d
2015 is up for discussion:
USDA is accepting comments thru 4/15
health.gov/dietaryguidelines

12. Define “low carb” diets
“Level of carbohydrate below which there is a fundamental shift in your body’s fuel use away from glucose as primary fuel nutritional ketosis and ketoadaptation.” Art & Science of Low Carb Living. Jeff Volek RD, PhD

13. But how much carb?
Adults - 50 gm/d complex carbs = BHB 1mmol/L Volek et al
Children gm/day complex carbs = 4-6mmol/L O’Connor Abstract AES

14. Carbohydrate additives
Corn syrup solids
Cornstarch
Dextrin
Dextrose
Disaccharide
Fructose
Glucose
Glycerin
High-fructose corn syrup
Invert syrup Lactose Levulose Maltodextrin Maltose
Mannitol
Molasses Monosaccharide
Polydextrose
Polysaccaride
Propylene glycol
Sorghum
Sorbitol
Starch
Sucrose
Sugarcane
Syrup
Xyloitol
Xylose

15. Carbohydrate catastrophes on keto diets
Diet beverages
2. Medications
3. Dextrose or Propylene glycol in IV
______the impact on metabolism & health
Share the ways in which the CF is…..
6-8gm

16. Fat exhonerated!

17. Fat exhonerated!
Three metanalysis including a total of 1 million people concluding no association between saturated fat intake and cardiovascular disease.
Ann Nutr Metab, (1-3): p
Am J Clin Nutr, (5): p
Am J Clin Nutr, (3): p

18. Fat – how much, what type?
Main sources of fat in US diet are seed and nut oils however these are also high in omega-6
Too much omega 6 can interfere with omega3 metabolism.
Essential fatty acids can be met -1% of energy

19. Fat – how much and what type?
“50:50 mixture of saturated fat and olive oil approximates composition of human body fat”
J. Volek, RD, PHD

20. Questions that we don’t have answers for
How long to use ketogenic therapies?
How deep into ketosis?
For epilepsy?
For other conditions?

21. Resources to support you
Conference Ap – PPTs, Keto Primer, education documents
Charlie Foundation for Ketogenic Therapies
Charliefoundation.org
KetoConnect.org
Academy Nutrition & Dietetics: practice guidelines pending
International League Against Epilepsy – Dietary Committee

22. Experience is the best teacher!

23. It’s a new way of eating

24. Test 1 - Waffles

25. Test 2 - Hot cereal

26. Test 3 – Green smoothies

27. Test 4 – Mac-n-Cheese

28. Test 5 – Spaghetti & sauce

29. Thank you to the Abrahams family !