Finding a diet that works for you can be a long, stressful process. But once you've settled on an eating plan, is it a good idea for the kids in your family to follow suit?
I decided to look into this after a new cookbook of keto-friendly recipes for children started to sir up controversy online. Many adults swear by the high-fat, low-carb diet for weight loss, though it's extremely restrictive and can bring on unwanted side effects. So it's understandable that people are concerned about whether keto provides children with the nutrients they need—and if putting a young person on any diet with so many restrictions is dangerous. It turns out, nutritionists are concerned, too.
The keto diet was created in the 1920s to help control seizures in children with a certain type epilepsy, Julie Upton, RD, tells Health. This was before the development of epilepsy medications, which are much more effective at controlling seizures. Unless a child was put on keto by a doctor and will be under the supervision of both a physician and registered dietitian, they should not be on the keto diet.
"The diet is too extreme, too limiting in carbohydrates—which provides energy as well as fiber, B vitamins, and many other essential nutrients," Upton says.
Cynthia Sass, RD, Health contributing nutrition editor, agrees. She says the keto diet "eliminates nutrient-rich, healthful foods, like whole grains, starchy vegetables (such as sweet potatoes, beans, lentils, and most fruits), and even limits the amount of non-starchy vegetables that can be consumed daily. In short, a keto diet severely limits exposure to vitamins, minerals, fiber, prebiotics, and antioxidants, which are all vital to growth, development, and overall physical and mental health."
The typical keto dieter gets approximately 55% to 60% of their daily calories from fat, 30% to 35% from protein, and 5% to 10% from carbohydrates. However, the recommended macronutrient breakdown for children between ages 4 and 18 say that 25% to 35% of total daily calories should come from fat, 10% to 30% from protein, and 45% to 65% from carbohydrates, according to the 2015-2020 Dietary Guidelines for Americans.
"Keto diets may be deficient in many nutrients present in carbohydrate-containing foods like fiber, B vitamins, potassium, vitamins A, C, and E, and many others," Upton says. Nutrient deficiencies can hinder development in children and cause a number of other health problems, as well.
Other possible side effects of the keto diet are flu-like symptoms, diarrhea, loss of muscle mass, and ketoacidosis (or acidic blood). The diet could also increase the risk of heart disease and diabetes, as high-fat diets like keto can raise cholesterol because the encourage the consumption of excess amounts of animal protein and inflammatory fats.
A 2018 study found that even children following keto for seizure control developed health issues related to the diet. These issues included micro- and macronutrient deficiencies, decreases in overall growth and bone health, increased cholesterol, and constipation, vomiting, and diarrhea.
Another reason keto is problematic for kids: The diet is generally not sustainable long-term. "Why would someone want to expose their child to an eating pattern that they can't live with for life?" Upton says, explaining that it might lead kids to develop disordered eating habits.
"I see adults who develop intense anxiety, shame, and guilt tied to certain foods after going on a keto diet and being unable to sustain the strict plan," Sass says. "What's worse, they often feel physically better after breaking down and eating healthy foods like bananas and oatmeal, but then feel like they've been bad or have done something wrong."
Rather than putting your kids on keto, teach them how to make high-quality, nutrient-rich food choices. Limit sugary and processed products and encourage them to eat fresh, whole foods instead. "Kids need nourishment, balance, sustainability, and a way of eating that simultaneously supports physical, emotional, and social well-being," Sass says. "A keto diet doesn't provide that."
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