The document outlines a seminar on the ketogenic diet, detailing its history, types, metabolic mechanisms, benefits, and risks, particularly in relation to epilepsy treatment. It discusses how the diet works by promoting ketosis, different types of ketogenic diets, methods for measuring ketone levels, and who can or should avoid the diet. The conclusion emphasizes the importance of balanced nutrition and cautions against long-term exclusive adherence to the ketogenic diet.

1. Department of Food & Nutrition
College of Community Science
Dr. Rajendra Prasad Central Agricultural University , Pusa
Credit Seminar
on
KETOGENIC DIET
COURSE INSTRUCTOR
Dr. Gitanjali Chaudhary
Asst. Prof.
Dept. of Food & Nutrition
PRESENTED BY
Sushma Mongbijam
2006202005
M.Sc Food & Nutrition
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2. Pleas click to edit text
Content
• Keto Diet • Who can use Keto Diet ?
• Historical Perspective • People who should avoid Keto Diet ?
• Types of Ketogenic Diet • Risk
• Ketogenic Diet Ratio • Should Ketogenic Diet be recommended..?
• How does Ketogenic Diet work? • Case Study
• How to start a Keto Diet ? • Conclusion
• Keto Friendly Foods • References
• Keto diet’s benefits
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3. Fat is broken down in the body as the
acetones ,beta- hydroxybutyrate
and acetoacetate.
The Ketogenic Diet is very low in
carbohydrates and high fat diet.
The macronutrient ratios for a standard
Ketogenic Diet are 75% fat, 20% protein,
and 5% carbohydrate.
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4. KETO- DIET FOOD
PYRAMID
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5. HISTORICAL PERSPECTIVE
The first scientific study on fasting for the treatment of epilepsy was done in France in
1910. This study reported that seizures stopped during absolute fasting.
In 1921 Dr. Wilder, at the Mayo Clinic, tried using a Ketogenic Diet to treat patients with
epilepsy. He had been using this same diet to prolong ketosis in diabetic patients.
By 1924, Dr. Peterman, at the Mayo Clinic, was using the diet regularly, and the
treatment became widely used in the 1930s.
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6. After World War II, Dr. Livingston at Johns Hopkins studied almost 1000 patients
using the Ketogenic Diet and reported excellent seizure control.
Toward the end of the 1980s, interest in the diet was revived by Dr. John Freeman
at Johns Hopkins, who reported a study in 1992 showing that the diet produced
complete seizure control in 30% of children with previously uncontrolled seizures.
Cont…
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7. Types of Ketogenic Diets
1. Standard Ketogenic Diet (SKD): It typically contains 75% fat, 20% protein and only
5% carbohydrates.
2. Cyclical Ketogenic Diet (CKD): This involves periods of higher-carbohydrates in
between the Ketogenic Diet cycles, for example, five Ketogenic days followed by two
high-carbohydrate days as a cycle.
3. Targeted Ketogenic Diet (TKD): This diet permits adding additional carbohydrates
around the periods of the intensive physical workout.
4. High-protein Ketogenic Diet (HPKD): This diet includes more protein and the ratio
around 60% fat, 35% protein and 5% carbohydrates .
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8. Ratio of macronutrients (Grams of Fat: Grams of Protein + Carbohydrate).
 Typically ranges from 2:1 – 4:1 , higher ratios typically result in higher
ketosis.
 Individuals will respond differently to the same ratio.
KETOGENIC DIET RATIO
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9. • In Ketogenic Diet , the proportion of fats is raised significantly and the
proportion of carbohydrate is greatly reduced.
• It is also necessary to control the total intake of food.
• The body is forced to metabolize fat in place of carbohydrate.
How does Ketogenic Diet work ?
• It usually takes 3 – 5 days for the body to go into ketosis after starting the diet
• ketones can be detected in the urine, and can be recognized by a characteristic
smell of the individual’s breath.
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10. 1. When our body doesn’t have enough glucose to power cells, levels of insulin
decrease.
2. Fatty acids are transported to the liver, where they’re oxidized and turned into
ketones.
3. Ketones can cross the blood-brain barrier and provide energy for brain in the
absence of glucose .
Ketosis
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11. Ways to measure ketone levels
Acetoacetate
1. Can be measured
through urine with a
ketone urine strip.
2. It turns various shades
of pink or purple
depending on the
ketone level.
Acetone
1. Can be measured with a
ketone breathe meter.
2. The meter flashes out a
colour to know whether
in ketosis or not and how
high the level of ketones
are.
β hydroxy butarate
1. They are measured using a
blood ketone meter, which
works similarly to a
glucometer.
2. A blood ketone level above
0.5mmol indicates that the
body is entering ketosis.
3. Blood Ketone range of 1.5
– 3.0 mmol/litre is ideal.
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12. Ketone Urine Strip
Ketone Breathe Meter
Blood Ketone Meter
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Blood Ketone mmol/l
Normal /Negative Less Than 0.6
Low to Moderate 0.6 To 1.5
High 1.6 To 3.0
Very High Greater Than 3.0
Source :Healthline, 2018

13. 1. Dietary units determine how many grams of fat, carbohydrate and protein the patient will
receive on a given ratio
2. They are based on calories/gram in the respective macronutrients .
Calculating the Diet
Ratio Fat content Carbs & Protein
Calories
2: 1 2 gm x 9 kcal/gm = 18 1 gm x 4 kcal/gm = 4
3: 1 3 gm x 9 kcal/gm = 27 1 gm x 4 kcal/gm = 4
4: 1 4 gm x 9 kcal/gm = 36 1 gm x 4 kcal/gm = 4
Source : Nutricia Keto University,2015
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14. • Calculations for each day’s meals are based on a participant’s age, height, weight,
and activity level.
• The amount of food prepared for each Ketogenic Diet meal is a much smaller
volume than a regular meal.
• The Ketogenic Diet is deficient in vitamins.
Cont…
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15. How to start a Keto Diet..?
Before the Initiation
1. Set initial goals prior to admission for the Ketogenic Diet .
2. Set schedule of meals and snacks to be eaten at the table .
3. Try high fat foods such as heavy cream, butter, avocado, mayonnaise.
4. Limit high carbohydrate drinks such as juice, soda and sports drinks.
5. Try alternatives such as diet caffeine free soda or sugar free sports drinks .
6. Week prior- contact family.
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16. Diet initiation
• The diet may be initiated at home in older children when closely supervised by a
Dietitian or Ketogenic team to guide them.
• In young children, or those at higher risk of hypoglycemia or dietary intolerance, the
diet is often initiated in the hospital under more controlled settings.
• Fasting is not recommended.
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17. INITIATION PROTOCOLS
Days Per Oral (Fat: Protein+
Carbohydrates)
Day 1 1:1
Day 2 2:1
Day 3 3:1
Day 4 4:1
Source : Nutricia Keto University,2015
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18. • It is recommended to decrease the ratio in patients with gastrointestinal intolerance.
• Calorie restriction to promote ketosis is not recommended.
• The diet requires patients to maintained calcium and multivitamin supplementation as the
diet is inherently nutritionally incomplete.
Cont…
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19. Duration of Ketogenic Diet
• The diet should be followed for a minimum period of 2 to 3 months, with achievement of at
least moderate (> 80– 160 mg/dl) urinary ketosis to determine of the diet is effective.
• If the diet is effective, it is usually continued for 1 to 2 years and then gradually weaned.
• The side effects of the long term use of the diet must be carefully weighed.
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Levels of ketones in urine mg/dl
Small level Less than 20
Moderate level Between 30 & 40
Large level Above 80
Source: Medical News Today,2021

20. KETO FRIENDLY FOODS
Meat
Egg
Cooking oils
fish
Nuts
Full cream
avocado
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21. Indian Keto Diet
Vegetarian
Milk , Paneer , Cheese, Yoghurt, Butter
Beans & Pulses
Vegetables (Stir Fry)
Avocado
Soya
Non Vegetarian
Egg, Mayonnaise
Poultry
Fish
Meat
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22. Benefits of Keto Diet
1. Reduces appetite.
2. Lead to more weight loss at first.
3. A greater proportion of fat loss comes
from abdominal cavity.
4. Triglycerides tend to drop drastically
5. Increased levels of HDL cholesterol
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Source :National Cholesterol Education Programme,2001
Triglycerides level Values in mg/dl
Normal Less than 150
Borderline high Triglycerides level 150-199
High Triglycerides level 200-499
Very high Triglycerides level More than 500

23. 6. Reduced blood sugar and insulin levels.
7. May lower blood pressure.
8. Effective against metabolic syndrome.
9. Therapeutic for several brain disorders.
Cont…
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THE ENERGY NEEDS OF THE BRAIN
Glucose
An adult requires 200g of glucose/day.
2/3rd of which i.e. 130g specifically needed by
the brain to cover its glucose needs.
ketones
Liver increases the production of ketones when
low car intake falls below 50g/day.
When carbs are eliminated /minimized ,ketones
can provide up to 75% of the brain’s energy
needs.

24. Who can use the Ketogenic Diet ..?
1. Children between the ages of 1 to 6 years.
2. Adolescents and Adults.
3. Individuals with seizure.
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25. People who should avoid Ketogenic Diet
Type 1 Diabetes
Pregnant &
lactating women
Thyroid
Disease
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26. SIDE EFFECTS
Hypoglycaemia
Osteoporosis
Hyperacidosis Pancreatitis
Hypercholesterolemia
Kidney Stones
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27. What led to the actress’s renal failure?
Due to Keto Diet, her kidney failed and breathe her last
"It may also worsen the kidney functioning of those who already have kidney diseases.
The theory is that higher intake of animal food products can make your urine more acidic i.e. increase
level of excretion of calcium from your urine,“ - Salil Jain, Director-HOD, Nephrology and Renal
Transplant, Fortis Memorial Research Institute in Gurugram.
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28. Should Ketogenic Diets be
recommended?
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29. CASE STUDY
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30. OBJECTIVE
1. To know about the effect of a Ketogenic Diet on our body.
2. To know about the mechanism of the Ketogenic Diet in treating neurodegenerative disorders.
3. To know about the mechanism of the Ketogenic Diet in reducing the weight of our body.
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31. METHODOLOGY
• A variety of research has also been undertaken including dieticians who tend to
support the positive benefits of using Ketogenic Diet , to manage losing of weight as
well as other health problems that could result from overweight.
• The qualitative methodology has been adopted considering the secondary sources of
data. The data are from past literary work, official reports, government websites, as
well as researches conducted by NGOs
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32. RESULTS & DISCUSSION
1. No specific diet is acceptable for all because personal metabolisms, genetics,
body shapes, habits, sense of taste and personal opinions vary.
2. Ketogenic Diet can perform well for overweight and obese people or at threat of
coronary heart disease.
3. Ketogenic-diets may be used to help in loosing weight and boost health, mood,
etc but this needs a lot of effort and therefore must be accompanied by eating
healthy.
4. Ketogenic-diets could therefore never be the right choice for professional
athletes as well as those seeking to create massive quantities of weight
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33. CONCLUSION & RECOMMENDATION
1. It is essential not only to concentrate on consuming high-fat foods but also to
provide a daily collection of fish, meat, veggies, berries, leafy greens required to
have sufficient intake of nutrition, minerals, and vitamins that have been excluded
from the diet.
2. Potential signs of acute creatine supplementation, which can last weeks to months,
such as nausea, exhaustion, poor attitude, tiredness, indigestion, vomiting, and
constipation should be managed with medical check-up by specialists as well as
nutritionists.
3. People who suffer from diabetes or inject insulin or oral hypoglycaemic drugs risk
serious hypoglycaemia whether the medication is not correctly balanced until
beginning the diet.
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34. Material and methods
Participants 16 semi-professional male soccer players.
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36. • Exclusion criteria included a body fat percentage over 32%, (determined via dual energy
X-ray absorptiometry, DEXA), cardiovascular, respiratory, gastrointestinal, thyroid or any
other metabolic diseases, weight change ±2 Kg over the last month, adherence to special
diets, use of nutritional supplements (except a daily multivitamin-mineral) and use of
medication to control blood lipids or glucose and goal-keepers.
• During the study protocol players were asked to keep their normal and constant
training schedule (8 h of training/week) during the study period.
• Subject were randomly assigned to a very low carbohydrate Ketogenic Diet (KD n = 8)
group or Western Diet (WD n = 8) group, through an online computer generated
sequence
Cont…
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37. Result :
1. There was a significantly higher decrease of body fat (p = 0.0359), visceral adipose
tissue (VAT) (p = 0.0018), waist circumference (p = 0.0185) and extra-cellular
water (p = 0.0060) in KD compared to WD group.
2. Lean soft tissue, quadriceps muscle area, maximal strength and Resting Energy
Expenditure showed no changes in both groups.
3. Respiratory Exchange Ratio decreased significantly in KD (p = 0.0008).
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38. Conclusions:
• This is the first study investigating the effects of a KD on semi-professional soccer
players.
• In the study KD athletes lost fat mass without any detrimental effects on strength,
power and muscle mass.
• When the goal is a rapid weight reduction in athletes, the use of a KD should be
taken into account.
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39. Final Message
• Moderation is the key to be used.
• Long term can increase morbidity , mortality & rarely
sustainable.
• 50% carbohydrates, 20-25% protein, 25-30% fats with
plenty green leafy vegetables will be sustainable in the
long term & less risky.
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40. Reference
• https://www.researchgate.net/publication/340836452_The_Effect_of_Ketogenic-Diet_on_Health
• https://nunm.edu/2019/02/ketogenic-diet/
• https://www.medicalnewstoday.com/articles/319196
• https://jissn.biomedcentral.com/track/pdf/10.1186/s12970-021-00459-9.pdf
• https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/actress-mishti-mukherjee-passes-away-due-to-kidney-
failure-reports-cite-keto-diet-to-be-the-reason/articleshow/78474318.cms
• https://www.news-medical.net/health/History-of-the-Ketogenic-Diet.aspx?showform=printpdf
• Lee Crosby, Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks,Clinical Nutrition, Frontier in
Nutrition.
• https://www.researchgate.net/publication/328904847_Ketogenic_diets_Boon_or_bane
• A. Antonio Paoli,2021, Effects of 30 days of ketogenic diet on body composition, muscle strength, muscle area, metabolism, and
performance in semi-professional soccer players, Journal of the International Society of Sports Nutrition
• Indian J Med Res 148, September 2018, pp 251-253 DOI: 10.4103/ijmr.IJMR_1666_18
• https://www.healthline.com/nutrition/10-benefits-of-low-carb-ketogenic-diets
• Radhika Dhamija, Susan Eckert, Elaine Wirrel,Review article
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