A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]
If you are struggling to eat enough or are eating too much, nutrition counseling may help you get essential nutrients, such as protein, vitamins, and minerals into your diet and maintain a healthy body weight. Ask your health care team for a referral to a registered dietitian or nutritionist. Dietitians and other members of the health care team work with people to meet their nutritional needs.
Focus on exercise: The most compelling studies favor physical activity for mental acuity, says Gary W. Small, M.D., the director of the UCLA Longevity Center and a coauthor of The Alzheimer’s Prevention Program ($14, amazon.com). A study from the Annals of Internal Medicine found that people who were fitter at midlife had a 36 percent lower risk of developing dementia later in life than did their less-fit peers. “When people exercise, the areas that control memory, thinking, and attention increase in the brain,” says Small. “Regular exercisers also have less of the abnormal protein deposits in the brain that have been linked to Alzheimer’s.” That’s not to say that diet has no impact, says Small: “It’s just that the effects of exercise are more pronounced based on the evidence we have now.” Foods rich in omega-3 fatty acids (such as fish, nuts, and flaxseed) and antioxidant-rich fruits and vegetables (like strawberries and spinach) have been shown to improve brain health, while refined sugars and processed foods can have the opposite effect.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
When you’re eating the foods that get you there (more on that in a minute), your body can enter a state of ketosis in one to three days, she adds. During the diet, the majority of calories you consume come from fat, with a little protein and very little carbohydrates. Ketosis also happens if you eat a very low-calorie diet — think doctor-supervised, only when medically recommended diets of 600 to 800 total calories.
Add spices or chilies to your food for a flavor boost that can help you feel satisfied. "Food that is loaded with flavor will stimulate your taste buds and be more satisfying, so you won’t eat as much," says American Dietetic Association spokeswoman Malena Perdomo, RD. When you need something sweet, suck on a red-hot fireball candy. It's sweet, spicy, and low in calories.
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