Lucy Blackstone, Paediatric Dietitian, Band 6, Royal Manchester Children’s Hospital.
I am a band 6 paediatric dietitian and have been working at Royal Manchester’s Children’s Hospital for just over a year.
I have a rotational post so my first role has been in the ketogenic team alongside neurology and neurosurgery which are two areas that work really well together. I have enjoyed learning all about the ketogenic diet, and I love cooking so making recipes has always appealed to me.
However, using all of the weird and wonderful new ingredients and supplements within this restricted diet meant that some of my recipes probably weren’t as good as they could have been – hence why a colleague and I decided that 2 weeks on the ketogenic diet over the summer would help us to understand the restrictions and develop some recipes of our own.
Ketogenic Meal Planning
As I started day 1 of planning my ketogenic diet challenge, I thought ‘how hard can it be?’ I like to cook; I’m good at maths and I LOVE cheese. This would be a dream!
We chose to follow the modified ketogenic diet and worked out our plans to hit 1500kcal as follows:
| Meal | Fat | Carbohydrate | Protein |
|---|---|---|---|
| Breakfast | 30g | 5g | Normal Portions |
| Lunch | 30g | 5g | |
| Snack | 20g | 2g | |
| Evening Meal | 30g | 5g | |
| Supper | 20g | 3g | |
| Total | 150g | 20g |
I bought the essentials - cheese, bacon, sausages, cream, butter, courgette, cauliflower, almond flour, dark chocolate, chia seeds, pistachios and cashews. I looked at all of the food and immediately felt completely overwhelmed. I found that coffee with almond milk was terrible, as was coffee with double cream - so I decided to stick to black coffee. At this point, coffee in hand, I made a table of what I would eat for every meal and snack and this definitely helped me to calm down.
The challenges of achieving ketosis
I only started measuring my ketones on the third day, but it really got me down when they were so low. There was a whole treat table in the office and I wasn’t allowed any of it!! On day 5, I reduced my carbs to 15g by cutting all carbohydrates from snacks, and on day 6, I started a shot of betaquik® (40ml = 8g MCT) every evening before bed.
The only time I was officially in ketosis was during the weekend when I didn’t eat regular meals and was able to restrict carbohydrates to 4-5g per day. This, however, wasn’t feasible on a work day when I was required to concentrate more! I didn’t really feel any different when I was in ketosis, maybe a bit light-headed but that could also have been because it was really hot weather whilst I was on the diet. I think I needed to be in ketosis for longer than 2 days to be able to make a proper judgment.
| Ketone Readings | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | Day 8 | Day 9 | Day 10 | Day 11 | Day 12 | Day 13 | Day 14 |
| 0.4 | 0.4 | 0.5 | 0.4 | 0.9 | 2.9 | 4.6 | 1.8 | 0.9 | 0.8 | 0.9 | 1.1 |
"It took over my entire life for that fortnight and I now have a whole new respect for families who take this on, in particular if they also have other children to feed "
Throughout the entire fortnight I was incredibly thirsty, and unable to work out if it was, again, due to it being the hottest 2 weeks of the year or not. I found myself constantly obsessing over my numbers – counting up how many carbs I had left, how much fat I had eaten, and if there was any way of squeezing some more in. It took over my entire life for that fortnight and I now have a whole new respect for families who take this on, in particular if they also have other children to feed – I only had to think about myself and that was hard enough!
Now, after 2 weeks on the ketogenic diet I can tell you the main 5 things I learnt:
- It is really disappointing when you don’t get high ketones after trying so hard
- ‘Can’t you just have some more cheese?’ is a phrase I will never use again
- It is very important to plan in advance
- Trying to fit all of the fat into one single meal makes for a very greasy meal, a main and a pudding is the best format
- Don’t overcomplicated recipes, start small and as you get more confident with meals then start to experiment
This picture gallery below shows our proudest achievements:
Chicken and pepper courgetti
- 10ml oil
- 1 chicken breast
- 112g courgette
- 22g red pepper
- 30g cheese
- 13g onion
- 31g broccoli
= 5g carbohydrate and 15g fat
The verdict: This was really nice and tasty, the vegetables meant it was full of flavour and texture – one of my favourite meals!
Cauliflower rice with mozzarella
- 115g cauliflower rice
- Parsley
- 30g mozzarella balls
- 12g butter
- 1 rasher of bacon
- Squeeze of lemon juice
= 5g carbohydrate and 15g fat
The verdict: This was a really nice lunchtime meal at work, it was fresh and a nice change from all the heavy meals full of melted cheese and cream.
...And here is one of the meals we would rather forget - Tuna ‘pasta’
- ½ tin of tuna
- 10g full fat mayonnaise
- 112g courgette
- 13g onion
- 30g cheese
- 12g butter
= 3g carbohydrate and 30g fat
The verdict: I made this meal because I was fed up of chicken and bacon, I tried to get in my entire quota of fat to one meal and it was so incredibly greasy it made me feel sick. If I were to make this again I would hold off the butter and cheese and have a dessert instead.
Ground almond pancake
Didn’t hold together, poor texture and flavour.
KetoVie Cafe Mix pancake (served with Keyo® / cream and 22g raspberries)
Looked and smelt nice, had a nutty texture that I didn’t enjoy.
MCTprocal® pancake
My absolute favourite, nice texture and flavour, held together well and easy to cook. A perfect breakfast when fed up of eggs.
"I found the best plan was to keep it simple"
To summarise, I feel like following the ketogenic diet for a fortnight was eye opening. Although I knew the theory, I learnt so many practical tips that I have since found invaluable when discussing with parents and patients. I had a load of recipes I planned on trying out, but then some of the ingredients were so expensive I didn’t use them because I was worried it would be a waste - Almond flour ‘flurry’ = £10 a bag! I found the best plan was to keep it simple - making a pie using ketocare bread as a crust or using the ‘Lo dough’ at work or for a quick meal was great, and having cauliflower rice and courgetti was a real lifesaver.
"if there’s one single thing that I have learnt that I will never, ever forget - it is that you CAN get bored of cheese!"
However if there’s one single thing that I have learnt that I will never, ever forget - it is that you CAN get bored of cheese!
Betaquik®, keyo® and MCTprocal® are foods for special medical purposes and must be used under medical supervision. These recipes have been specifically designed for use in a ketogenic diet. Refer to labels for allergen and other product information.
Information
betaquik® Info: www.MyKetogenicDiet.co.uk/Betaquik
Keyo® Info: www.MyKetogenicDiet.co.uk/Keyo
MCT pancake recipe links:
Savoury Pancake Recipe
Sweet Pancake Recipe