frequency in diabetic mothers and exposure of pregnant female rats to high ketone levels can
increase the risk of these same neural tube defects, suggesting that ketones may be a cause (6).
Additionally, it appears that glucose is the primary fuel for the developing fetus (7).
Considering the above data, as well as the potential harm which might occur to an unborn
child, a ketogenic diet is not considered appropriate during pregnancy. In fact, any diet whose aim
is weight or fat loss is inappropriate during pregnancy as diet should be optimal to support the
developing fetus and the mother.
Epilepsy
Although the ketogenic diet has shown great impact in the treatment of childhood epilepsy,
the diet used for epilepsy is significantly different than the diet described in this book.
Additionally, implementation of the ketogenic diet for therapeutic purposes requires medical
supervision. Under no circumstances should individuals attempt to implement the ketogenic diet
for the treatment of epilepsy without medical supervision.
Adolescents
Although the epileptic diet is used in children under the age of 10, its use in adolescents is
less well studied. From the standpoint of fat loss, the pediatric epilepsy diet is used for weight loss
if necessary, by adjusting calories (8). Additionally, the protein sparing modified fast has shown
some benefits in treating morbid childhood obesity (9). Although adolescent obesity is increasing,
parents should be careful in self-administering diets, due to the possibility of stunted or altered
growth. Due to the lack of data on the CKD, and due to the hormonal fluctuations which occur,
its use is not recommended in adolescents.
Summary
There are certain medical conditions which either directly preclude the use of the ketogenic
diet, or that warrant serious consideration prior to beginning such a diet. While there is no data
for a majority of disease states, individuals should exercise caution prior to making any large
scale changes in diet. When in doubt, the proper medical authorities should be consulted and no
self-diagnosis should be made.
References Cited
- Bistrian B. et. al. Nitrogen metabolism and insulin requirements in obese diabetic adults on a
protein-sparing modified fast. Diabetes (1976) 25: 494-504. - Grey NJ and Kipnis DM. Effect of diet composition on the hyperinsulinism of obesity.
New Engl J Med (1971) 285: 827 - Clore JN et. al. Evidence for increased liver glycogen in patients with noninsulin-dependent
diabetes-melliture after a 3-day fast. J Clin Endocrinol Metab (1992) 74: 660-666.