Ketogenic Diet
Very Low Carbohydrate Diet
SPH-N433
Michelle Phan, Lisa Deane, Pearl Bohon
ENERGY REQUIREMENTS Using Mifflin St. Jeor for Females
10xweight (kg) + 6.25xheight(cm) - 5xage(years) 161 x (activity factor)
1.3 activity factor for lifestyle; not sedentary, not athletic or hyper-metabolic
Michelle Phan
Sex: Female
Weight: 56.8kg
Height: 167.6cm
Age: 22 years old
Energy Requirement: 1749kcal
10(56.8 kg) + 6.25(167.6cm) - 5(22) - 161 = 1345 x1.3
Lisa Deane
Sex: Female
Weight: 56.4kg
Height: 152.4cm
Age: 24 years old
Energy Requirement: 1606kcal
10(56.4 kg) + 6.25(152.4cm) - 5(24) - 161 = 1235x1.3
Pearl Bohon
Sex: Female
Weight: 60.3kg
Height: 165.1cm
Age: 20 years old
Energy Requirement: 1786kcal
10(60.3kg)+6.25(165.1cm)-5(20)-161= 1374 x 1.3
Average
Weight: 57.8kg
56.8+56.4+60.3 = 173.5/3
Height: 161.6cm
167.3+152.4+165.1 = 484.8/3
Age: 22 years old
22+24+20 = 66/3
Energy requirement: 1714kcal
1749+1606+1786 = 5141/3
MENU for seven days
Day
Breakfast
Lunch
Sunday
omelet
(two eggs+ C
spinach + C
onion)
broccoli and cheddar grilled zucchini
soup
rolls with goat
(1 C)
cheese filling
(4 rolls- 1
zucchini, c
goat cheese)
1 cheese stick
Monday
Omelet
(Two eggs + 2 oz
cheese + 1/2 C
spinach)
Baked tofu with
nutritional yeast
coating (1.5 C)
2 T peanut
butter
4 small stalks of
celery
1 Cheese stick
Tuesday
cheesecake
pancakes
(two eggs/two oz
cream cheese)
Chili (No beans) with coconut crusted
cheese
Mahi Mahi fish
(1 C)
nuggets
(7 oz fish)
Two squares of
sugar free
chocolate
C bone broth
Wednesday Omelet
(Two eggs + 2 oz
cheese + 1/2 C
spinach)
Caprese stuffed
avocado
(1 avocado + 4 oz
mozzarella + C
tomatoes +basalmic
vinegar drizzle)
stuffed
mushrooms
(five mushrooms
+ 4 oz cream
cheese)
cottage cheese
and berries
( C + five
berries)
Thursday
1 boiled egg
8 oz bullet proof
coffee
(1 T butter + 1 T
coconut oil +
black coffee + 1
T heavy cream)
Cream of
mushroom soup
(1.5 C)
Roasted brussel 2 oz cheese
sprouts (1 C)
2 T peanut
and braised tofu butter
with soy sauce
(8 oz)
Friday
2 boiled eggs, 1 T
peanut butter and
6 oz black coffee
with 1 oz cream
bacon wrapped
cheesy asparagus
(10 stalks + C
cheese)
pesto grilled
plain, full fat
shrimp (2 T pesto yogurt ( C)
+ 10 shrimp)
Saturday
8 oz Bullet proof
coffee
Lettuce wrap BLT
(four slices of bacon,
1 T mayo, 2 slices
tomato, 1 lettuce
wrap, 2 slices of
cheese)
zucchini pasta
and scallops and
cherry tomatoes
(2 zucchini + 4
scallops + C
cherry tomatoes)
TWO-DAY NUTRIENT REPORT
Dinner
spaghetti
squash pad thai
(2 C)
Snacks
turkey and swiss
cheese roll ups
(three slices
each)
The plan is based on a 1714 calorie allowance.
Nutrients
Target
Average Eaten
Status
Total Calories
1714 Calories
1755 Calories
Over
Protein (g)***
46 g
97 g
OK
Protein (% Calories)***
10 - 35%
Calories
22% Calories
OK
Carbohydrate (g)***
130 g
52 g
Under
Carbohydrate (% Calories)*** 45 - 65%
Calories
12% Calories
Under
Dietary Fiber
25 g
14 g
Under
Total Sugars
No Daily Target
or Limit
16 g
No Daily
Target or Limit
Added Sugars
No Daily Target
or Limit
2g
No Daily
Target or Limit
Total Fat
20 - 35%
Calories
71% Calories
Over
Saturated Fat
< 10% Calories
29% Calories
Over
Polyunsaturated Fat
No Daily Target
or Limit
7% Calories
No Daily
Target or Limit
Monounsaturated Fat
No Daily Target
or Limit
30% Calories
No Daily
Target or Limit
Linoleic Acid (g)***
12 g
14 g
OK
Linoleic Acid (% Calories)***
5 - 10% Calories 7% Calories
OK
-Linolenic Acid (%
Calories)***
0.6 - 1.2%
Calories
0.8% Calories
OK
-Linolenic Acid (g)***
1.1 g
1.5 g
OK
Omega 3 - EPA
No Daily Target
or Limit
8 mg
No Daily
Target or Limit
Omega 3 - DHA
No Daily Target
or Limit
36 mg
No Daily
Target or Limit
Cholesterol
< 300 mg
552 mg
Over
Minerals
Target
Average Eaten
Status
Calcium
1000 mg
1406 mg
OK
Potassium
4700 mg
2381 mg
Under
Sodium**
< 2300 mg
4396 mg
Over
Copper
900 g
1398 g
OK
Iron
18 mg
13 mg
Under
Diet Analysis
This diet did not meet the 2010 Dietary Guidelines for Americans. It meets
the energy requirements, but due to the diet restricting carbohydrates to
eight percent or lower it does not meet up with the requirements. The normal
guidelines call for forty to sixty five percent of the diet to come from
carbohydrates. It exceeds the protein requirements for a female that has a
lightly active activity level. This food intake will not cause any weight loss.
COST ANALYSIS - Costs from Kroger
Day 1
Item
Cost
Portion cost
Butter, Stick, Unsalted
1 TBSP + 1 tsp +1 tsp
$2.50/lb/box
32 TBSP/Box
$0.15
Coconut Oil
1 TBSP
$5.99/14 oz jar
$0.21
Coffee, Regular
8 fl oz
$8.99/12 oz bag
2 tbsp = 6 oz cup
$1.12
Heavy Cream
1 TBSP + C
$2.89/pint
32 TBSP
$0.90
Egg, Boiled
1 large
$2.19/dozen
$0.18
Mushroom, Button
1C
$1.99/8oz
$1.99
Yeast
1 tsp
$6.29/ 4.5 oz
25 TBSP
$0.08
Onion, Fresh
C
$2.49/3 lb bag
$0.15
Garlic
1 clove
$0.99/head
$0.10
Broth, Vegetable
1C
$2.99/32 oz
$0.75
Parmesan Cheese, Dry Grated
2 TBSP + 2 TBSP
$2.99/ 8oz
45 Tbsp
$0.27
Salt, Table
tsp + tsp + tsp
$1.19/26oz
491x.25tsp
$0.01
Pepper, Black
tsp
$3.19/4oz
$0.02
Brussels Sprouts, Fresh
1C
$2.49/1 lb
$1.25
Lemon
2 wedges
$0.79
$0.10
Oil, Olive
1 TBSP
$4.99/17 oz
15ml x 34
$0.15
Tofu, Extra Firm
6 oz
$2.50/14oz
$1.07
Soy Sauce
2 TBSP
$2.39/10 oz
20 TBSP
$0.30
Cheese, Colby Jack
2 oz
$5.49/12 ct
$0.46
Peanut Butter, Creamy
2 TBSP
$4.29/28 oz
$0.15
Total
$67.62
$9.41
Day 2
Item
Cost
Portion cost
Eggs
2
$2.19/dozen
$0.37
Cheese, shredded
2 oz/1/4 C
$3.00/8oz
$0.38
Spinach
C
$2.49/6oz
8C
$0.16
Olive oil
2 Tbsp
$4.99/17 oz
15ml x 34
$0.15
Tofu, extra firm
1C
$2.50/14oz
$1.07
Yeast
1 TBSP
$6.29/ 4.5 oz
25 TBSP
$0.25
Garlic Salt
1 tsp
$2.69/5.25oz
$0.09
Onion Powder
1 tsp
$2.89/2.62 oz
$0.18
Onion
C
$2.49/3 lb bag
$0.30
Cabbage, chinese (Bok Choy)
C
$1.99/lb
$0.50
Carrots
C
$1.99/10 oz
$0.60
Peanut butter, creamy
1 TBSP + 2 TBSP
$4.29/28 oz
$0.23
Broth, Vegetable
C
$2.99/32 oz
$0.38
Soy Sauce
1 TBSP
$2.39/10 oz
20 TBSP
$0.12
Vinegar, cider
1 TBSP
$2.79/63TBSP
$0.04
Onions, green
2 TBSP
$0.99/1 bunch
1 cup
$0.12
Squash, spaghetti
C
$3.99
$2.99
Chicken Breast
3 oz
$4.99/lb
$0.75
Celery
4 small stalk
$2.69/8oz
$0.50
Cheese, Cheddar
2 oz
$5.49/12 ct
$0.46
Total
$61.73
$9.64
Day 1
$9.41
Day 2
$9.64
Average Cost Per Day
$9.54
INDICATIONS FOR USE
The ketogenic diet consists of a nutrition plan based on low carbohydrates and adequate
amounts of protein while intake of fat is relatively high. The ketogenic diet is individualized
based on the condition of the patient with ratios of fat to carbohydrates and protein of 4:1, 3:1,
2:1, and 1:1. The idea behind an individual adopting the ketogenic diet is that in the absence of
carbohydrates or with a limited amount, the body has the ability to produce ketones for energy
(What is, 2014). Ketones are produced in liver from -oxidation of free fatty acids. This results
in an increase in the ketones circulating in the blood (Gibson, 2014). The diet was initially
developed at the Mayo Clinic 1921 for the treatment of epilepsies in children of which were not
responding to medicine. At this time, a ketogenic diet consisted of a decrease in carbohydrate
intake, fluids, calories, and protein. Fat intake made up about 90% of the total energy intake.
There are now four versions/modifications of the diet; the classic ketogenic diet (KD), the
medium chain triglyceride diet (MCT), the modified Atkins diet (MAD), and the low glycemic
index treatment (LGIT) (Kossoff, 2012).
The MCT diet had its inception in the 1970s. The results from the diet were higher serum
ketone levels than KD; however mineral deficiencies and fatigue after three months of being on
the diet were experienced. The MAD originated in 2003. The diet is not caloric, protein, or fluid
restrictive; however carbohydrate intake is decreased to 20 g/day for adults and 10 g /day for
children. In order to maintain a state of ketosis, fat intake is highly encouraged. Similar to the
KD, the MAD has been found to be effective in decreasing the occurrence of seizures. The LGIT,
published in 2005, allows for consumption of carbohydrates with a glycemic index of <50 in
order to maintain glucose levels. The serum ketone concentration increases at a minimal rate,
however, patients were observed to experience a 50% reduction in their seizures. Observations
made on epileptic patients who were simultaneously obese, experienced weight loss when
incorporating the MAD into their treatments (Kossoff, 2012).
Gibson, et al. stated that satiety regulating hormones such as CCK, ghrelin, and peptide
YY are modified in response to the decrease caloric intake resulting from energy restrictive diets
which provides explanation for why some have a hard time with losing weight and keeping the
weight off. Studies have demonstrated positive effects from the incorporation of the ketogenic
diet for individuals working to lose weight. The use of ketones as a fuel source can aid in weight
loss due to the appetite suppressing effects of being in the state of ketosis. Many modern diets
focus on limited energy intake in order for effective weight loss in overweight and obese
individuals (Gibson, 2014).
Metabolic syndrome consists of conditions and symptoms associated with a higher risk of
type 2 diabetes, cardiovascular disease, and cancer. All the symptoms associated with these
diseases result from a resistance to insulin. The ketogenic diet has been shown to decrease
insulin resistance and alleviate symptoms of metabolic syndrome. In theory, the incorporation of
the ketogenic diet before the onset of metabolic disease symptoms could prevent the
development of metabolic disease (Wilcox-OHearn, 2013).
SELF ANALYSES
Michelle Phan - This diet was rather difficult for me to follow since my usual
diet consists of a lot of carbs. I usually skip out on breakfast so having
breakfast made me satisfied, but there wasnt enough substance to hold me
until lunch. I had to mask that hunger with lots of water because I was saving
my snacks for before and after dinner since I usually get hungry during that
time. I think I had less energy on this diet because I knew I couldnt have
carbs so I had a constant appetite for it, which made me irritated and tired.
The foods in the diet were fairly easy to find, however a day of food cost a lot
more than what I usually spend. For me, it was incredibly difficult to eat such
a small amount of carbs. The people that successfully follow this diet must
have a lot of willpower. The one tip I would give someone wanting to follow
this diet is to start slow. I dont think it was a good diet for me because it was
basically a shock to my body that made me irritable. So if someone were to
start this, I would say if they eat a lot of carbs to start to slowly eat less and
less until they get to under 8%, because going from a diet of 65% carbs to
8% in a day is a complete shock. I think this would also help with reducing
the appetite for carbs, making it easier to follow. I would provide dietitians
and physicians with the same tip because if they were to prescribe this to
someone who eats a lot of carbs, it will be too hard for them to follow, which
will most likely result in noncompliance.
Lisa Deane - My typical diet does not consist of many carbohydrates from
grain sources, aside from rice, amaranth, corn tortillas, and the occasional
gluten free bread. I do consume the recommended amount of fruit and eat
yogurt daily. I did however find the transition to the ketogenic diet somewhat
difficult. I mostly found it difficult to make sure I had enough ketogenic
friendly foods with me while at school, given that I pack my lunch every day.
The two days that I ate ketogenic foods, I felt mildly hungry. This is because I
am used to consuming more fruits with my breakfast and snacks. If I were to
completely adopt this diet, I would need to figure out a way to make it
convenient for me in terms of the ease transportability of foods. I can
imagine the difficulty of those who have medical conditions, such as the ones
discussed in our paper, have with the transition from their normal diet to the
ketogenic diet because the average Americans diet relies on far more
carbohydrates than does mine. I can see how my body would eventually
accommodate the higher levels of ketones and lower levels of available
glucose and would possibly benefit me in terms of energy production and
weight loss. If dietitians or physicians are prescribing this diet as a treatment
for disease, condition, or just for weight loss, I recommend that they remain
sympathetic and patient with their patients because this is not a typical way
to eat for many people. For those who are thinking about implementing this
diet in their own lives, I recommend that they analyze their existing diet and
take note of the foods and type of foods that make up the majority of their
intake and ensure that they are aware of the changes ahead. They should
also research the diet and consult a dietitian or physician and make sure the
diet is safe for them.
Pearl Bohon - Following this diet was not as hard for me due to the fact that I
have previously tried this diet. The cost of this diet is around twice as costly
as my regular diet. This is because of the cost of butter, cream, and the
various other fats I used to make up the majority of my calories. I had
medium amounts of hunger, not much more than normal, but I did consume
significantly more water. It would be unusual to drink less than forty eight
ounces on this diet a day. I experience mild amounts of keto flu which is
where your body is going through so much urine output that you start
lacking electrolytes. Drinking a cup of broth easily solved this. My energy
levels were roughly the same, but have heard of others getting rid of brain
fog and having increased energy levels after becoming keto adapted. Two
days is often not enough to have your body go into ketosis if you continue
eating foods. I did find it difficult to eat many foods, as too many vegetables
meant going over on the carbohydrate intake. I also very severely miss a
crunch, like a chip. There is no real crisp texture on the ketogenic diet
without eating pork rinds or going off the diet. The monitoring is very difficult
as you have to be very precise on just exactly what you are eating. I would
find this almost impossible to follow if I did not cook my own meals. Its very
easy to empathize with those who follow a ketogenic diet. It is not an easy
diet to maintain and pretty hard to get into. The biggest tips I would give
would be to eat more of the fatty foods you like while trying not to focus on
what youre missing out on. For me that was me being able to eat as much
cheese as I wanted without thinking about all the bagels I cant eat. I would
also advise that they use the web to find awesome recipes for really amazing
foods. Dietitians need to be advising about the amount of fiber on the diet
and check to see if any vitamins are lacking. The amount of fiber on any
given day tends to be very low due to the low carbohydrate intake, excluding
beans, fruit, or potatoes. I would advise incorporating a lot of avocado, for
its fat content and its fiber content.
SUMMARY
The ketogenic diet consists of severe restriction of carbohydrates, adequate protein intake, and
about 90% fat intake. The diet has been shown useful for the treatment of epilepsy, metabolic
syndrome, and as a therapy for those needing to lose weight. Those interested in incorporating
the diet into their lifestyles should be aware of the cost that goes into preparing meals which
consist primarily of fat and protein. They should also consult a dietitian before switching to this
diet in order to determine whether or not the diet is safe for them and their health.
REFERENCES
(2014). What is the ketogenic diet? Retrieved from http://www.charliefoundation.org/exploreketogenic-diet/explore-1/introducing-the-diet
Gibson, A. A, Seimon, R. V, Lee, C. M. Y., Ayre, J. Franklin, J. Markovic, T.P., Sainsbury, A.
(2014). Do ketogenic diets really suppress appetite? A systematic review and meta-analysis.
Obesity reviews, 16, 64-76. doi: 10.1111/obr.12230
Kossoff, E.H, & Hartman, A.L. (2012). Ketogenic diets: New advances for metabolism-based
therapies. Current Opinion in Neurology, 25, 173-178. doi:10.1097/WCO.0b013e3283515e4a
Wilcox-OHearn, A., & Wlicox-OHearn, Z. (2013, May, 29). The ketogenic diet
for health. Retrieved from http://www.ketotic.org/2013_08_01_archive.html
