Calorie intake should be approximately 75 percent of the recommended calorie level for a child's age and ideal weight. The level may be higher for an especially active child. Calorie levels are listed in the "Calculating the Diet" section.
Ideal weight should be based on recognised standards, while factoring in individual circumstances such as recent weight loss or gain and the size of a child's frame.
Most children are stated on a 4:1 ketogenic ratio. Very young (under fifteen months) or very fat children may be started on a 3:1 or 3.5:1 ratio of fat:protein + carbohydrates. Older adolescents can also be started on the 3:1 ratio to provide greater variety and quantities of food. If ketones cannot be maintained, they can later be switched to a 3.5:1 or 4:1 ratio.
Liquid levels should be approximately 65 cc. per kilogram per day, with a little more liquid given to especially active children or children who live in hot climates, and a little less given to children who get very little exercise. As a rule of thumb, a child should not drink more cubic centimeters of liquid per day than the number of calories in his diet.
The diet must include a minimum of one gram of protein per kilogram of body weight per day to fulfill the body's needs for tissue repair, defense mechanisms, and growth. More protein may be included on 3:1 and 2:1 diets.
The ketogenic diet must be supplemented daily with calcium and a sugar-free, lactose-free multivitamin. Only with these supplements can the diet be nutritionally complete.
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