Keto for Kids: Is It Safe?

The ketogenic diet is a highly effective weight-loss program that has adults singing its praises all over Instagram. Just check out the 7.2 million and counting posts with the hashtag #ketodiet. Which has many parents wondering, can the keto diet work its weight-loss wonders on my overweight child too? Well, not without some very serious potential ramifications. Keto for kids comes with precautions, but also shows promise…if done right. Here’s what you need to know.

The Original Keto for Kids

The ketogenic diet was originally developed in the 1920s for kids with epilepsy who weren’t responding to traditional antiepileptic drugs. When you eat a restrictive diet of ultra low carbs and high fat, you enter a metabolic state called ketosis and start burning fat, rather than sugar, for energy. Several studies confirm that the keto diet can reduce the frequency of seizures by as much as 50%. 

It appears that the high-fat, low-carb, moderate-protein keto diet provides clean-burning fuel in the form of ketones to the brain, which helps calm down brain excitability, improve energy metabolism, and protect with antioxidant properties.

Today, it’s used for seizure control, spasms, and other conditions in children, as well as being an adjunct to chemotherapy for kids and adults with brain cancer. In order to thrive, tumors need sugar. By drastically restricting carbohydrates, which convert to glucose (sugar) in the body, the keto diet helps to starve tumor cells in the brain. 

However, the keto diet used for medical conditions is approached very differently than the keto diet used for general weight-loss for adults.

The Doctor-Supervised Keto Diet for Kids

When the keto diet is prescribed for medical conditions it is always under the supervision of a doctor, registered dietitian, or registered nurse. Typically, the dietitian creates a meal plan made up of:

• 90% fat
• 6-8% protein
• 2-5% carbs

This low-carb high-fat diet is administered in the hospital or in a monitored outpatient setting for the first 2 weeks and is often given in the form of an all-in-one beverage. Gradually, solid food is reintroduced and the child is sent home with a specific set of instructions and close follow-up supervision. When conducted under medical guidance the keto diet has even been shown to be safe for infants and toddlers. 

While the keto diet seems to be safe as a treatment for specific medical conditions, doctors and nutritionists hesitate to give it a thumbs up as a weight-loss strategy for children and teens. 

Keto for Childhood Obesity

The keto diet severely restricts carbohydrates, which is a necessary macronutrient for growing and developing bodies. And therein lies the primary issue with keto for kids—the very real possibility of nutritional deficiencies.  

By drastically cutting carbs, we may not be providing adequate nutrition and energy for our children’s needs, which are different from those of adults. And we aren’t just skimping on carbs. We could also be limiting fiber and other essential vitamins and minerals from our children’s diets. 

The average child eats about 130 grams of carbohydrates a day. Taking that down to the keto-recommended 20-gram maximum can put children and adolescents at risk of:

• Electrolyte imbalance
• Dehydration
• Digestive issues
• Elevated cholesterol levels
• Low blood sugar
• Imparied development
• Nutrient deficiencies

There’s also the mental ramifications of putting a child on such a strict diet at such a young age. It subjects them to the diet culture and can affect their long-term relationship to food and their body. A softer approach might be better to help promote healthier eating patterns.

Following a strict keto diet may not be the best choice for your overweight child or teen, but that doesn’t mean we can’t follow certain keto principles to help counter the rising rates of childhood obesity and type 2 diabetes around the world. 

What We Should Take from Keto

What are the primary drivers of childhood obesity? Lack of physical activity and diets high in sugars/carbs and unhealthy fats from processed foods.

Most children are eating more carbs than necessary. If, for instance, your child takes in 300 grams of carbs a day, then a more reasonable 130 grams of carbs would be a healthful shift. While slashing carbs to 20 grams a day may not be reasonable for your child, cutting carbs and sugars in general is sound dietary advice. 

The keto diet, when followed properly, is a meal plan that emphasizes real-whole foods full of healthy fats, essential amino acids and vitamins and minerals like iron that are necessary for a child’s growth and development. Keto foods are free of refined carbs and food additives and can greatly improve mood and behavior. 

A less extreme version of this ultra low-carb diet, such as the Atkins diet, can help your child eat a more healthy, balanced diet. 

But let’s see what the science says…

Science Supports Keto for Kids

Despite most health experts not recommending keto for kids unless for medical reasons, science shows that, when followed under medical supervision, the keto diet is highly effective for weight loss in children.

A 2012 study published in the Journal of Pediatric Endocrinology & Metabolism measured the weight-loss effects of the keto diet compared to those of a low-calorie diet in 58 obese children over 6 months. The kids on keto lost more weight, fat mass, and waist circumference and enjoyed more significant improvements in fasting insulin levels than did the kids on the low-cal diet plan (1). 

Researchers concluded: “The ketogenic diet revealed more pronounced improvements in weight loss and metabolic parameters than the hypocaloric diet and may be a feasible and safe alternative for children’s weight loss.”

An earlier study published in 2010 compared a high-protein, low-carbohydrate (20 grams) diet (HPLC) to a low-fat diet. Forty-six severely obese children were prescribed one or the other diet for 13 weeks. Those on the keto diet lost more weight and experienced no serious negative side effects (2). 

Researchers concluded: “The HPLC diet is a safe and effective option for medically supervised weight loss in severely obese adolescents.”

And a 2003 study compared the effects of a low-carbohydrate diet to a low-carb diet (LC) on cholesterol levels in overweight adolescents. Twelve weeks on a carb-restricted diet led to more weight loss and improved cholesterol levels (3).

Researchers concluded: “The LC diet appears to be an effective method for short-term weight loss in overweight adolescents and does not harm the lipid profile.”

Positive results such as these indicate that a low-carb diet for weight loss such as keto is feasible for children and teens to follow, but only under the continual supervision of a pediatrician or registered dietitian and only when your child has gone through puberty to ensure that there is no risk to their growth potential. 

Try It Out with Some Tasty Keto Meals

You don’t have to go full-on keto to enjoy the flavor and health benefits of keto meals. 

Looking for keto dinner ideas? Here are 13 of our favorite keto dinners, including some vegan and vegetarian options.

If your kid has a hankering for a sugary dessert, try these much healthier keto fat bombs. 

If your family loves shrimp, then they’ll all love these 27 low-carb shrimp dishes. 

If you’ve got a picky eater start them off with this irresistible Keto Bacon and Mushroom Pizza!