Yes! Children can be on the ketogenic diet. It is a nutrient-dense diet that not only provides the nutrients needed for growth, but also can help with chronic health conditions that too many of our modern children suffer from.
I’ve had my kids on ‘keto’ off and on since my daughter (now 11) was 3. They’ve thrived. See above? They’ve not only lived, but grown and been able to enjoy things such as Mammoth Hotsprings at Yellowstone National Park (pictured).
Your doctor may object:
In literature about the ketogenic diet, when a ketogenic diet is referred to they nearly always are talking about the classic 4:1 diet, which restricts protein, calories, and liquids. We talk more about the 4:1 diet here.
On the 4:1 ketogenic diet there is evidence that growth is slowed and there is a higher rate of kidney stones for children who are adhering to it (source), which makes sense with the reduction in protein and calories and liquids below a child’s typical requirements. Adequate liquids are now encouraged to prevent dehydration, kidney stones, and constipation, though some of the data showing increased risk of kidney stones may not reflect children who were on this current recommendation.
The diet that I’m calling ‘keto’ here, and is designed to put the person in ketosis (where we’re getting the ‘keto’ from), is called the ‘Modified Atkins Diet’ in most medical literature. In the Modified Atkins Diet (MAD) the benefits of the body being in a state of ketosis are seen, and it is thought that the unrestricted protein and calories will prevent the children’s growth from being stunted. (source)
New data recommends (again, talking about the MAD) a minimum of 1.5 g/protein per 100 calories to prevent growth retardation, as this has shown to be correlated with on-track growth in children on the MAD diet long term. (source)
Calorie guidelines for children
These are the daily calorie recommendations for average weight/heigh children of these ages. When a range is given, it depends on activity level. Female children have lower calorie needs than male children once they reach 5 years, averaging 100-300 calories/day less for the same amount of activity, other than ages 19-20, which I have noted the significance differences in.
2 years: 1000
5 years: 1200-1600
10 years: 1600-2200
15 years: 2200-3000
19-20 years (male) 2600-3000 (female) 2000-2400
If in doubt, when nutrient-dense food is given, I go by the child’s hunger more than their ‘suggested calories’ to account for growth spurts and time when they are busier or distracted and don’t eat as much.
If you have questions about your child’s specific nutrient intake, please seek help from a qualified medical professional.
Water Weight Loss
Weight loss when starting a diet intended to heal growing children can be scary. When children are put into the state of ketosis, their inflammation will go down, as well as the water that was attached to the glycogen in their muscles will be released.
For my own children, I weighed them during this process and my two that were about 80 lbs both lost just under 3 pounds, and my 35-pounder lost 1.5 pounds the first 5 days. How do I know it’s water weight? Because if it was fat, they would have lost the equivalent of over 5,000 calories (my little guy) or 17,500 for my olders. There is no way they ran a calorie deficit in this amount in just 5 days ;)
Encouraging weight gain
If you have children that need to gain, keto can help with this. This is a very calorie-dense diet that reduces inflammation of the gut and is easily digested.
Often these children who have trouble gaining *don’t feel good* when eating, so they aren’t interested in eating much. In the case of underweight children who crave refined carbs, the dopamine hit they get from eating the simple sugars may override enough of the discomfort of eating, making these nutrient-void foods the only ones they accept. In addition, if their gut flora is off balance, the gut flora may be sending signals to the brain to keep consuming simple starches and sugars.
The best way to encourage weight gain is to heal the gut. By balancing the gut flora, these children will start craving healthy foods that are good for their body – not the demanding bacteria in their gut. Healing the gut will help reduce inflammation.
A second counterintuitive approach to healing the gut for children who are having a hard time gaining is to encourage a nice long ‘fast’ over night. When the gut is less full, and the body can digest the food that’s in there completely and then it can repair an inflamed or leaky gut better. If the gut is inflamed, food may be passing right through without being absorbed. In addition, growth hormone raises during periods of fasting
If you feel like your child may have a leaky or inflamed gut, including collagen and chicken stock in their food as much as possible can help have easily-absorbed nutrients available for the body to make needed repairs.
For more conversation about picky kids who need to gain weight, please see my Picky Eating Solution where we talk about a 3-step whole-body approach that turns picky eating around in a week or less.
For more conversation about healing leaky gut, please see my Gut-Healing Starter Pack that focuses just on this.
There is one precaution with keto and children who are under their ideal weight, though, and you will need to decide if the risks outweigh the benefits – being in ketosis is a natural appetite suppressant. This will vary from person to person for how much this affects them, but if your child seems even affected by this appetite suppressant property, you may find that the GAPS or SCD diets are a better fit for healing the gut and encouraging weight gain.
Encouraging weight normalization
Less of a problem than being underweight, but still concerning, is the rate of childhood obesity. Recent data suggests that 1 in 5 school-age children (age 5-18) are classified as obese.
Some doctors will be concerned about children with a high weight for height under school age, but until about age 5 I personally would not limit a child’s calories or encourage them to lose weight in any way. I have heard of moms with breastfed babies as young as 4 months old being told to space out feeds, or not feed on demand at that age because their baby was ‘too big’. Personally, I completely disagree with this advice, though I understand that it comes from a place of being concerned about future health problems in the children.
Because SO much brain development and growing happens in 0-5, I think that having an abundance of calories, even if they are stored as fat for a while, is a good problem to have. More often than not, a growth spurt, picking up a new fascination with a sport or activity, and normal development will even out children’s weight as they approach school age! In fact, I’ve seen the above-mentioned 4-month-old, he turned into a bright, thin young boy with a passion for baseball by the start of kindergarten, and his mom certainly did not restrict any of his calories.
In any case, once a child is at school age carrying extra weight can contribute to health problems, social and self esteem issues, and a decreased ability to play actively, which is so important for not only their physical development but also the brain development!
The whole family adopting a whole-foods ketogenic diet can help these kids grow into their weight. Since children are growing, I wouldn’t personally recommend weight loss, but rather slowing the gain to match their needs as they grow in height.
If others in the family struggle with health issues or weight issues, the ketogenic diet could be a great solution to everyone’s problems all at once!
One more note to parents of children with issues being over or under weight:
Please do not blame yourself for this! There are many things that contribute to children with weight issues. Many of you feel judged (body weight is not an invisible health condition!), but it’s not uncommon for children within the same family to both struggle with gaining weight, and with being over weight – and the parents are doing the exact same thing with all their children! Sometimes it’s a gut-flora issue, or an energy issue, or the personality of the child to either be active or sedentary. Sometimes the kids grow a lot as toddlers, and the weight never has time to accumulate, and sometimes kids grow more in their teens even, and ‘grow into their weight’.
Recipes kids will love
- Tacos in cheese shells
- Fathead Pizza
- Fathead Pigs in a Blanket
- Peanutbutter-Chocolate Fat Bombs
- Coconut-Lime Fat Bombs
- Beef Breakfast Sausage
- Coconut flour crepes
- Almond flour ‘sourdough’ puff pancake
- and much more available in the Keto Families Class!
This article is a part of our Keto Families class, but it’s kind of untalked about information, so I wanted to share it publicly as well. For help doing keto with your family, or serving keto-friendly foods to some family members without making two completely different meals, click here to learn more about Keto Families.
5 Delicious Keto FatBombs
Sign up to get my 5 Best Keto Fatbomb Recipes sent right to your inbox! Plus a bonus pizza recipe :)