Table 1.
Term | Abbreviation | Carbohydrate content, g/day and/or % daily intake of a nominal 2000 kcal diet | Comment |
---|---|---|---|
Moderate carbohydrate diet | 300–400 g or 26–45% | Western-pattern diets typically contain over 300 g carbohydrate/day | |
Low carbohydrate diet | LC, LCD | <130 g or <26% | |
Very low carbohydrate diet | VLCD | <30 g (some define 25–50 g) or <10% | Leads to nutritional ketosis if maintained beyond 4–7 days |
Ketogenic diet | KD | Fat:carbohydrate:protein ratio calculated on an individual basis for children with epilepsy | High fat and very low carbohydrate: a ketogenic diet usually refers to the strict nutritional intervention for medication-resistant paediatric epilepsy17,18 (although the term is used more widely now). First described in 1921.19 Paediatric application requires specialist neurological and dietetic monitoring. Protein restricted: gluconeogenesis reduces ketosis. Diet modified according to child's weight and growth. Response rates are significant: at 3 months 55% are seizure-free and 85% have reduced seizures.17 Two types of ketogenic diet:20
|
Keto-adaptation | After Phinney:23 metabolic switch from carbohydrate to ketones as primary fuel source, stabilising over several weeks | ||
Ketones | β-hydroxybutyrate (β-HB), acetoacetate, acetone | ||
Ketosis | Presence of circulating ketones β-HB 0.5–3.0 mmol/l; physiological response to starvation or carbohydrate reduction (‘nutritional ketosis’) | ||
Ketoacidosis | Distinct from nutritional ketosis: ketoacidosis defined as β-HB >20 mmol/l in the context of acutely destabilised type 1 diabetes, with severe hyperglycaemia and acidosis | ||
Low carbohydrate high fat diet | LCHF | May be ketogenic (carbohydrates <25–50 g/day) or non-ketogenic (130–50 g/day); similar to the modified Atkins diet (MAD)21 | |
Low carbohydrate ketogenic diet | LCKD, KLCHF | The terms LCHF, KLCHF, LC/KD and ketogenic diet have some overlap and may appear interchangeably in the literature |
Source: modified from Accurso et al.32