Keto Diets and Children: Impact of Keto Diets on the Mind

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The ketogenic diet is making headlines and with all the attention, many parents are using it to help their children lose weight. Is a keto diet safe for children’s bodies? Is a keto diet healthy for children's brains? The mind-body connection questions I had led me to seek out Dr. Rhonda Donn. Donn is a teacher of anatomy, physiology, and orthopedics at Pacific College of Health and Science. Learn more about the ketogenic diet and its effect on children’s health in my interview with her:

In your experience, is a keto diet appropriate for children who are gaining too much weight too fast?

In my experience, a keto diet is not appropriate for children who are gaining too much weight too fast. While the ketogenic diet has shown benefits for specific conditions, such as epilepsy, the ketogenic diet can cause a lot of problems and deficiencies that can affect children long term.

Ketogenic diets do not provide sufficient nutrition for growing brains. There is such a high percentage of fat consumed (often upwards of 70-80% fat from total daily calories) on the keto diet. There is often no distinction made between the consumption of healthy fats and artery-clogging saturated fats. Also, the keto diet can be heavy on processed and salty foods. That does not contribute to long term health, nor does it help with long term weight loss.

Children must receive the complete complement of nutrients, including phytonutrients. This is typically not the case when on a ketogenic diet. If children don’t eat properly, this can cause depression, irritability, and/or confusion. Long term effects of improper nutrition include obesity, cardiovascular disease, high cholesterol, and a myriad of eating disorders. Without sufficient nutrition, it has been proven that the ability of the brain to learn new tasks and remember new skills will decrease. The ability to focus declines, memory retention decreases—and all of these factors affect children’s ability to learn and be successful students.

The type of foods consumed directly impacts the brain, because the research demonstrates interconnectedness between the brain and the gut. Constipation is another side effect noted in children who have been on the ketogenic diet. This is due to the lack of fiber-rich foods that help with GI tract motility. Low blood pressure is yet another concern for kids on a keto diet, along with kidney, heart, and nutrient disorders.

Another issue with keto is that there can be a loss of muscle mass (especially if someone is eating a lot more fat than protein). Even though there will be weight loss, you can actually lose a lot of muscle in the process, since muscles burn more calories than fat.

Further, because of the restrictive nature of the ketogenic diet, the long term weight loss is often unsustainable, as most people will regain weight once they are off of the diet. The weight gained once off keto typically occurs in a different ratio, making it more likely to regain fat rather than lean muscle. That can depress metabolism, which can lead to lifelong struggles. With continued weight fluctuations, unhealthy relationships with food can thrive.

What is the best way to help a child who has gained too much weight too fast?

The best way to help a child who has gained weight too fast is to utilize a multi-factorial approach. After ruling out any type of genetic disorder, it is imperative to have a child eat three meals a day, along with two to three snacks each day. This will help to normalize insulin secretions, which balances out blood sugar levels. A nutrient-dense diet is the best way to make certain that a developing child is receiving all of the macro and micronutrients needed. Additionally, making sure that a child is exercising each day is so important. Even during the restrictive times of COVID, just getting outside and moving each day is so critical to helping boost metabolism, which in turn will burn calories.

• Making diet and lifestyle changes as a family will help to ensure success, and prevent a child from feeling isolated or singled out. Ensuring that empty caloric foods, such as soda and candy, are removed from the home also helps to ease the transition.
• Getting sufficient sleep is also a very important strategy to help overweight children lose weight. Children who are sleep deprived are often overweight, as sleep regulates hormones that control appetite. When not getting sufficient sleep, the levels of leptin (the hormone that decreases appetite) will decrease, but the levels of ghrelin (the hormone that increases appetite) will rise. Further, if children are sleep deprived, they are more likely to be more sedentary, also contributing to weight loss.
• Having kids eat with the family, and not engage in “mindless eating” while watching television or playing with electronics also helps with normalizing portion control.
• Utilizing functional nutritionists, or traditional Chinese medicine (below) has also proven to be very beneficial.

What are a few eastern medicine traditions that caregivers can learn about that may help them reduce their child’s weight while creating a safe physical and emotional environment?

In eastern medicine, being overweight is often a sign of a greater health problem. The energy of the body, or “Qi,” is out of balance. TCM philosophy looks at the entire person, including emotional health, and how that is impacting the overall health of the body. Stress is seen as an impediment to normal Qi flow, and the normal constitution of the body. Engaging in activities such as mindful meditation is particularly useful. Also, modified movement exercises such as Tai Chi or Qi Gong can be taught to children, particularly children whose weight precludes them from more active forms of exercise. Mindful eating is very helpful. Additionally, acupuncture treatments have been clinically demonstrated to improve rates of decreasing obesity in children. Caretakers can learn certain acupressure points that have been taught to them by a licensed clinician. Those points will help to normalize the constitutional imbalances by improving the flow of energy throughout the body.

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Have you treated any families with children who have gained too much weight too fast? If so, what were the challenges and what were the successes in administering the treatments?

There are many challenges I have encountered in assisting families with kids that have gained too much weight too fast:

• Picky eaters: Many parents state that their kids are very picky eaters, and if their kids don’t eat that giant bag of chips, then they won’t eat anything, so they are glad that their child is eating something. It takes patience and persistence to change dietary habits. Interestingly enough, research has shown that a child might have to try a new food up to 10 times before accepting it. Cravings are another concern that can sabotage weight loss.
• Sedentary lifestyle: It can be challenging for some families to change to a more active lifestyle. This has to be a commitment not just for the overweight child, but for the entire family in order to maximize success. Many overweight children are easily winded and feel daunted by exercise. Understanding that there are different approaches, and making time to get out and move will be critical to help naturally lose weight.
• Unhealthy foods in the house, including fruit juice: This is a frequent challenge I have seen in practice. Well-meaning parents want their child to lose weight, but continue to buy unhealthy foods and make them easily accessible. If there were no junk foods in the house, that would certainly make it easier to adhere to a healthier diet. Also, a lot of parents mistakenly believe that drinking fruit juice is a very healthy alternative. Fruit juice does not hold the same nutritional value as whole fruit. According to the American Academy of Pediatrics, Fruit juice offers no nutritional benefits over whole fruit. Although fruit juice has more nutrients than other sugary beverages, fruit juice can contain just as much sugar and as many calories as other sweetened drinks, such as soda, fruit-flavored drinks, and soft drinks. Often times there are added flavors and colors in fruit juice. Too much sugar of any kind is not healthy. A 2019 study indicated that overconsumption of fruit juice among young children is linked to weight gain. A study in JAMA demonstrated that 100 percent fruit juice and sugary drinks both equally lead to an increased risk in early mortality. In contrast, whole fruits contain fiber and additional nutrients that are not found in fruit juice. As such, whole fruit leads to a slower caloric intake, which can decrease the risk of obesity.
• Skipping meals: In order to curb cravings and the desire for unhealthy eating, it is important not to skip meals. That can be a challenge for busy families. Making sure that time is carved out for consistency is very important. Further, families modeling these healthy nutritional behaviors also can prove challenging.
• Frustration: Not losing weight quickly enough can be very frustrating for families. A slower metabolism will slow down weight loss. Slow and steady weight loss gives the body more time to adapt to ongoing changes. This can be hard for families to accept, especially when seeing their child struggle. The goal is always to look not just at the short term goal, but at long term health.

Alternately, losing too much weight too fast comes with its own set of problems. I have had to explain to several families that if weight is lost too quickly, that too can lead to a host of health issues, including loss of muscle mass, menstrual irregularities, depressed metabolism, and nutrient deficiencies.

How do we prevent too much weight too fast in children?

The goal is not to have children feel deprived, but to allow occasional splurges. Cooking meals at home is preferred. Limiting food from a restaurant to no more than once a week will also help to regulate the full complement of nutrients required for healthy growth and development. Daily exercise is very helpful for normalizing metabolic factors. Meditating helps to quiet the mind, enabling one to focus on health. Not feeling singled out or isolated in any way also helps a child with self-confidence, and not feeling alone in his/her struggles. Having healthy snacks easily accessible, along with eating three full nutrient-dense meals a day also prevents excess weight gain. Utilizing complementary therapies, such as acupuncture/acupressure, can also be of great benefit to prevent weight gain too fast in children. Speaking with a clinical nutritionist or functional medicine provider can also help to guide families through these challenges.