Nutrition

Keto for kids? Experts say not so much

Boy eating high protein meal

The first thing you might do when you’re on a diet is to get rid of temptation.

Usually, that means tossing chips, sugary sweets, sodas and more. But if you’re on diets such as keto, Whole 30, paleo or low-carb, a lot more shouldn’t be in your cabinets. But here’s another wrinkle: What if you have kids?

Many of these diets have become popular thanks to their focus on whole foods. So you might assume they’re great for kids too.

“Some of the restrictions on these diets, like reducing the consumption of added sugars, are beneficial,” said Maciel Ugalde, a registered dietitian at the Children’s Hospital of Georgia. “But these diets can also restrict grains, legumes, dairy—which are really important nutritional foods that kids should be having.”

So what exactly is the problem with these diets for kids? Here’s a closer look:

Keto

What is it:  The keto diet promotes high fat, moderate protein and very low carbohydrates.

The issue: This diet has only been shown to help some children with epilepsy control their seizures. It requires a trained multidisciplinary team to initiate, manage and monitor how it is implemented as this diet can be very restricted in carbohydrates, to the point that even medications need to be assessed for their carbohydrate content. Additionally, this diet needs to be supplemented with a multivitamin. Side effects of this diet can include constipation, gastroesophageal reflux, acidosis, renal stones, slow growth, hyperlipidemia and vitamin deficiencies.

Paleo

What is it: The paleo diet aims for foods that may have been eaten during the Paleolithic era, about 2.5 million to 10,000 years ago. This includes lean meats, fish, fruits, vegetables, nuts and seeds.

The issue: Foods like dairy, legumes and grains are limited on this diet since they wouldn’t have been available to Paleolithic era humans. So this diet offers the same challenges with carbs as the keto diet. “Plus, dairy is out of the picture,” said Ugalde. “Children need calcium for bone growth since childhood and young adulthood are the primary bone-building years.” And with this diet’s focus on meat, there could be risk of eating too many saturated fats, which isn’t good for kids or adults, she added.

Whole 30

What is it: The Whole 30 diet promises to “reset” your health by eliminating inflammatory foods from your diet for 30 days, including added sugar, alcohol, grains, legumes, dairy, carrageenan, MSG, sulfites, baked goods, junk foods or other treats. Its mantra is: “When in doubt, leave it out.” Then, you slowly reintroduce foods, paying attention to how each food may impact your health, with a goal of pinpointing and avoiding foods that make you feel less healthy, whether that’s bloating, breakouts, lower energy, etc.

The issue: With its focus on elimination of entire food groups, Whole 30 still causes concern, even though technically it’s just a 30-day diet. “You still run the risk of kids not getting the appropriate nutrients and the calories they need, which ultimately can impact growth and health,” said Ugalde.

Low-Carb

What is it: True to its name, the low-carb diet limits carbohydrates including sugars, starches and fibers found in grains, fruits, vegetables and milk, instead focusing on foods high in protein and fat. There are many different kinds of low-carb diets available, all designed for weight loss.

The issue: Carbohydrates are the primary source of energy to all cells, including our brain and muscles. It is recommended that 45 percent to 60 percent of calories are sourced from carbohydrates. “We have to take into consideration that kids are growing and being active, they need energy to continue to do these things,” Ugalde said. “If they follow a low-carb diet, this could affect their growth and energy levels.”

What if my child is overweight?

If your child needs to lose weight, one of these “popular” diets still isn’t the best choice.

“Children really shouldn’t be on these diets,” Ugalde said. “So if your child is overweight, the best thing to do is to get guidance from a dietitian.”

With her families, Ugalde recommends that parents provide children with a variety of foods from all MyPlate food groups. These include whole grains, fruits, vegetables, low-fat dairy, beans and legumes, and lean proteins. It’s also important to understand the portion sizes your child needs. To keep meal planning easy, she suggests focusing on serving at least three different food groups per meal and two per snack, making sure to cover all food groups in a day. So breakfast could be a veggie omelet with toast (protein, vegetables, whole grains), a snack could be an apple with peanut butter (fruit and protein), lunch could be a turkey sandwich with an orange and milk (meat, whole grains, fruit, dairy) and dinner could be grilled chicken, mashed potatoes, green beans and milk (meat, vegetables, dairy).

Having a healthy environment at home where healthy foods and drinks are easy to access, and high-calorie ones are out of sight or not available at all is another way you can help your child manage his or her weight.

Last but not least, have fun with your children! Find a physical activity that you both enjoy and do it together as a family at least 30 minutes per day.

How do I balance my diet with my child’s?

Children see their parents as role models and imitate them to learn everything. Eating is no different. The way parents talk about food, cook meals and eat can affect children’s future relationship with food and their eating habits.

If you as a parent are set on following a specific diet, get some guidance on what your child should be eating for adequate growth and development. Provide them with well-balanced meals at home to meet their needs. This doesn’t necessarily mean you have to prepare two different meals. “It could just mean having available the foods or food groups that the parent is restricting on his or her diet, and including those on your child’s plate,” Ugalde said.

Also, avoid labeling a food as “good” or “bad” as your perspective on food influences your child. “You don’t want them to get negative connotations to some of these foods, or to feel shame if they eat, say, a cookie at school like a normal kid,” said Ugalde. “This could create other problems down the road, such as eating disorders.”

Bottom line? No matter what diet you choose for yourself, make your family’s eating more about making healthy choices and enjoying all kinds of foods in moderation.

“Kids, after all, are very different from adults,” said Ugalde. “They’re still growing, and they need a variety of nutrients and adequate calories to be healthy.”

The Children’s Hospital of Georgia has the largest team of general pediatricians, adolescent medicine physicians and pediatric specialists, including dietitians, in the Augusta area. Make an appointment at augustahealth.org/kids or call 706-721-KIDS (5437).

About the author

Children's Hospital of Georgia

Children’s Hospital of Georgia is the only facility in the area dedicated exclusively to children. It staffs the largest team of pediatric specialists in the region who deliver out- and in- patient care for everything from common childhood illnesses to life-threatening conditions like heart disorders, cancer and neurological diseases.