Epilepsy and the Keto Diet

This article from SeizureSync.com is a succinct summary of epilepsy & the keto diet for beginners.

It’s a good read if you’d like a very brief overview of what keto is, what the science says, how to follow a keto diet, and people’s experiences, in a less than 5 minutes read.

Seizure Sync

Disclaimer: Please consult with your doctor before starting the keto diet, or considering dropping or reducing your daily medication intake.

For most, epilepsy is something that is completely manageable with the introduction of medication. But not everyone wants to take medication every single day.

It’s tough to carry around an array of pills with you at all times. There are side effects to certain medications, such as drowsiness, reduced concentration, personality changes, and reduced IQ . Taking medication is stigmatized. A large number of people don’t want to be seen taking medication all the time. It can make you feel like a patient.¹

An avenue explored by a select number of people with epilepsy that has worked very well is following a diet. More specifically, the keto diet. The Keto diet is popular among people exploring alternatives to medication with epilepsy, and has been shown to reduce, and even eliminate day-to-day medication…

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Tahini Buns (Gluten-Free|Vegan|Low-Carb)

This is a beautiful recipe for Gluten Free Vegan Keto Bagels by The Herbivore Post, adapted to make buns and with added spices.

I cannot tell you how amazing these little buns are! In fact, the day I tested them out, an aunt and uncle popped by unannounced, and they were astounded at the ingredients, and at how it smelled and looked like actual bread! They’re not Keto but they tried it and quite liked it as well – Score!

The original recipe for bagels can be found on The Herbivore Post website, however I tweaked it to make buns and added paprika, cayenne pepper and Himalayan salt to the mixture as well. And a few pumpkin and sunflower seeds on top.

This is going to become a staple I feel!

Ingredients

For the Tahini

  • 3/4-1 cup sesame seeds
  • Optional: 1-3 tbsp olive oil (or any neutral oil)

For the buns

Dry Ingredients:

  • 3 tbsp flax meal 
  • 1/4 cup psyllium husk powder
  • 1/4 cup almond flour
  • 1 tsp baking powder
  • 1/2 tsp salt
  • Spices to taste: I used Paprika and Cayenne Pepper (approximately 1tsp each)
  • Optional: Seeds e.g. pumpkin, sunflower, sesame, chia.

Wet ingredients:

  • 1/2 cup Tahini
  • 1 cup water

Method

1. Pre-heat the oven to 190C (375F) and prepare a baking tray with greaseproof paper. I added some extra coconut butter to the paper.

2. Measure out 3/4-1 cup Sesame Seeds for your Tahini (ignore the measurement in the picture!!!). This will give you more than the required 1/2 cup of Tahini required for the recipe, and you can have some extra to create delicious keto salad dressings!

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3. Dry toast the sesame seeds in a pan to release the oils. Keep stirring as they burn easily, once they get a bit of colour and you get a toasty smell, take them off the heat and cool.

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4. Blend the cooled sesame seeds in a grinder or food processor. Once it gets towards the end, add the oil (1-3 tbsp) to get the smooth consistency if required.

5. Take 1/2 cup of the Tahini and add 1 cup of water: Mix well. (If there’s oil in Tahini it might separate and that’s fine).

6. Take a large bowl and add the dry ingredients: Flax, almond meal, psyllium husk powder, baking powder, and salt.

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7. Mix the wet ingredients (Tahini and water mixture) to the dry ingredients in step 6.

8. Add any spices if you like. As mentioned I added paprika and cayenne pepper. And mix well.

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9. The dough will quickly come together and you will get a dough ball that looks like this:

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10. Cut the dought into 4 pieces.

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11. Roll the dough between your hands into bun shaped balls and decorate the top if you like with seeds of choice. I used pumpkin and sunflower seeds. ketotahinibuns (15)

12.  Bake for 45 minutes at 190C (375F) and wash up while you wait! You will get these at the end!ketotahinibuns (16)

13. This is what the insides look like.

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14. And this is how I ate mine!!!

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Macros

(The macros I calculated per serving are slightly different to that in herbivorepost but they’re great)!

  • Energy: 254.7 kcal
  • Net Carbs: 3.2g
  • Fat: 23.7g
  • Protein: 5.4g
  • Magnesium: 96mg
  • Zinc: 2.1mg
  • Calcium: 123mg

Crumbly Coconut Granola (Low Carb | Keto | Gluten Free)

Mornings are not an epileptic’s friend!

It’s when many of us are vulnerable to seizures. Mine normally occur when I’m incredibly tired and sleepy, so first thing in the morning is primetime for the seizure gremlins to attack.

It’s therefore vital that my mornings are peaceful and stress-free. Most people don’t like being disturbed in the AM, but I should probably come with a DND warning sign before 8 am and a matcha latte.

I’ve really missed grabbing a quick cereal, yogurt and fruit-to-go

It does seem like Keto breakfasts are ‘mostly’ soft and/or warm and generally take a lot of time and effort to prepare. There seems to be a lot of ‘cooking’ involved to get those macros in. Precious time which most people don’t have.

This Low-Carb Crumbly Coconut Granola recipe came about on my quest for a cold, crunchy ‘Keto Cereal’! I just couldn’t deal with the cravings anymore, and there was nothing in the shops that catered to my needs.

Granola in the shops tend to have sugar or honey, or gluten. This is a homemade solution to my dilemma, bearing in mind that I also needed a high fat intake in addition to low-carb – hence the coconut oil.

Granted, it kind of looks like sand, but it TASTES like a Keto breakfast from heaven! Especially if you’ve been eating bacon and eggs everyday!

A great meal-prep recipe for the working week

It might take some time the first time round, but once you get the hang of making granola, and if you have the ingredients lying around, it shouldn’t take too long the next few times.

The best thing about making any type of granola is you could make a large batch and keep it in an air-tight container for a few weeks (if it lasts that long! I’d give it a few days).

Other benefits of this Granola

  • The texture of this granola also means that it’s great as a crumbly topping on other desserts (I had it on top of my panna cotta yesterday!).
  • An average portion (5 tbsp) has just 3.1g net carbs and 27.5g fat. 
  • An average serving also has 114.3 mg Magnesium and 299.7 mg Potassium  – two minerals that Keto-ers often find challenging incorporating into our lifestyle.

So without further ado, here we go:

Ingredients

Makes 45 tablespoons (average serving = 5 tablespoon)

You will need:

  • Flax Meal: 1 cup
  • Coconut Flour: 0.5 cup
  • Almond Flour: 0.5 cup
  • Coconut Oil: 0.5 cup
  • Vanilla stevia liquid: 3-5 drops (OR other sweetener of choice and vanilla essence or vanilla bean powder).
  • Pumpkin seeds: 0.25 cup
  • Sunflower seeds: 0.25 cup
  • Dried coconut flakes/chips: 0.25 cup
  • Walnuts: 8
  • Cinnamon powder: 0.5 tsp (optional)

Method:

  1. Preheat the oven to 160C (320F) and prepare a baking tray by lining it with parchment paper for your granola.
  2. In a large mixing bowl, add the flax meal, coconut flour and almond flour.

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3. Measure out 0.5 cup of Coconut oil.

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4. Melt the coconut oil in the microwave or over a low heat.

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5. Add the melted coconut oil into the flax-coconut-almond mixture.

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6. Add Vanilla stevia drops to taste (approximately 3-5 drops). Alternatively, add vanilla essence or powder and sweetener or choice.

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7. Stir the mixture well until it starts the come to together – it should start to look like slightly damp sand.

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8. Measure out nuts and seeds of choice. I used pumpkin seeds, sunflower seeds, chopped walnuts and dried coconut.

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9 (optional). Add cinnamon.

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10. Mix the nuts, seeds and cinnamon into the granola mixture well.

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11. Grab the baking tray you prepared in the beginning. Add a tiny bit of coconut oil to it (you can never be too careful!) and pour the granola mixture onto the parchment paper, spreading it out and flattening it down.

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12. Bake in the oven at 160C (320F) for 15-20 minutes, or until the mixture has toasted and is golden-brown in colour. Take it out of the oven every 5-10 minutes to give it a good stir. (Note: You could increase the temperature up to 176C / 350F but keep a close eye on the granola mixture as it is finer than usual, so I like to keep the temperature lower and just increase it at the end for a final toast!).

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13. Remove from the oven, cool and store in an air-tight container!

GranolaFinal

Granola. Yogurt. Berries – Enough said!

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Macros:

1 serving = 1 tablespoon

  • Energy: 61.03 kcal
  • Protein: 1.34 g
  • Total Carbs: 2.1g
  • Fiber: 1.48g
  • Net Carbs: 0.62 g
  • Fat: 5.5 g
  • Magnesium: 22.86mg
  • Potassium: 59.94mg
  • Selenium: 1.81ug
  • Zinc: 0.32mg

An average portion = 5 tablespoon

  • Energy: 305.15 kcal
  • Protein: 6.7g
  • Total Carbs: 10.5g
  • Fiber: 7.4g
  • Net Carbs: 3.1 g
  • Fat: 27.5 g
  • Magnesium: 114.3 mg
  • Potassium: 299.7mg
  • Selenium: 9.05ug

Zinc: 1.6mg

High Potassium (>200mg), Low-Carb Foods

Since starting the Keto lifestyle, I’ve been monitoring my nutrition (or trying to anyway) and I’m very aware that I could be suffering from nutritional deficiencies especially given that my appetite has decreased significantly and as a result my food consumption has reduced.

I’ve been using an app called Cronometer (the free version might I add) to track what I eat and monitor what I need to against my macros, and it has come to my attention that (as I suspected), three things that I do struggle to meet each day are electrolytes – magnesium, potassium and sodium.

This is quite common in the keto and other low-carb diet and could explain my extreme low energy levels at present! Adding to that I’ve been under excessive stress due to a recent shoulder surgery and other personal issues.

So although an easy way to boost magnesium is through supplements (a 400mg pill is 100% of the RDA), and sodium can easily be added to your diet through salt-water / lemon-salt-water / bone broth etc, POTASSIUM is not so readily available in supplement form as too much of it can be toxic.

Prior to going keto this was not something that I’d thought about given that I was eatingt bananas and potatoes in abundance!

High Potassium (>200mg) & Low-Carb Food List

It’s safest therefore to make sure you’re getting enough potassium from food first as you won’t be able to get it from supplements. I therefore decided to compile a go-to list of high potassium keto-friendly  low-carb foods, i.e. foods with over 200mg potassium per reasonable portion. Click here for the Excel version of the list.

KetoPotassiumFoodsNutrition

Potassium Tactics

I also decided on a few ‘Potassium Tactics’ for myself based on a potassium range of 2000 – 4700 mg (the Estimated Daily Minimum – Adequate Intake).

Following these tactics, I should be able to achieve my target amount of potassium whilst keeping within my carb limits.

Potassium food tactics:

  • Eat 1 cup of Yogurt & Keto Coconut Granola every day = 380 & 300 mg respectively
  • Eat 6 Vegetables from the list inc. Avocado = 1920-3233 mg
  • Eat 2 proteins = 460-971gm
  • Smaller amounts from other foods (mainly vegetables, nuts, seeds and proteins) not listed.

Additional:

  • Supplement = 200-400mg
  • Eat a few squares of dark chocolate / Drink cacao milk = 100-240mg
  • Eat almond / peanut butter = 200mg
  • Optional: During carb-cycling days – Sweet potato= 224mg

Please do contact me if there’s anything you feel that needs to be added to the list, bearing in mind that it needs to contain over 200mg of Potassium in a reasonable portion. There are a lot of other high potassium foods e.g. with over 100mg potassium that aren’t listed, as that isn’t the purpose of this table.

I hope this helps some of you struggling with Potassium!

MatchaMonday – Keto Bullet Matcha Milk / Latte!

This recipe came about as I was looking for an alternative to the Bulletproof Coffee and my version of the Bulletproof Chai Latte. I’m sensitive to caffeine and should avoid (high doses of) it, but I needed something which had a bit more of a kick to start the day, without the jitteriness from coffee.

Tea, caffeine & epilepsy

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Before I start, note that caffeine and epilepsy aren’t exactly the best of friends, and all teas do contain some amount of caffeine so epileptics do need to drink it with caution.

However, tea is my weakness and I’m from a part of India where we love our tea but I try and limit myself to 1-2 cups a day.

Depending on the serving, a serving of Matcha contains approximately 35mg caffeine. This normally isn’t enough to make you feel “wired” like coffee does. Bearing in mind that an average cup of filter coffee has 145mg of caffeine, and a cup of instant coffee can have up to 170mg per cup.

The caffeine in Matcha is also absorbed differently due to ‘catechins’ which are antioxidants and known to have many beneficial health properties. Caffeine molecules in Matcha bind to catechins and are absorbed slowly over time. Whereas caffeine molecules in coffee go straight to the bloodstream leading to a high followed by a crash within a few hours. With Matcha however, the caffeine is absorbed over the course of up to six hours.

This is a literature review of the beneficial effects of green tea – many of which are related to catechins, particularly epigallocatechin-3-gallat content. Recently it has been suggested that Matcha has greater benefits than other green teas as indicated in this study. This is due to the concentration of epigallocatechin gallate (EGCG) available from drinking matcha which is seen to be 137 times greater than the amount of EGCG available from China Green Tips green tea, and at least 3 times higher than the largest literature value for other green teas.

So overall, I think the nutritional health benefits are worth it! 

Keto Bullet Matcha Milk / Latte

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Apart from Matcha, the key ingredient in this brain boosting Matcha Milk is MCT (Medium Chain Triglycerides) Oil.

  • MCT’s are found in coconut oil, but also in palm oil and high fat products such as cheese and butter.
  • MCT’s are considered to be good fuel for the brain because they are smaller and easily metabolised.
  • MCT oil is a manmade supplement produced from coconut oil, palm oil or safflower oil.
  • This study highlights that MCTs offer neuro-protective benefits for a range of diseases including epilepsy as well as dementia, Alzheimer’s, Parkinson’s, stroke and traumatic brain injury.

Ingredients

1 serving

You will need:

  • Matcha green tea powder: 1-2 tsp
  • Almond Milk: 1 cup
  • Vanilla Stevia drops: 1-2
  • MCT Oil: 1 tbsp
  • (Optional) Butter of choice: 1 tbsp
  • (Optional) For a bit of a twist, sometimes I like to add 1/2 a teaspoon of Cinnamon to my Matcha milk / latte.

Method:

  • In a bowl, whisk the matcha powder in some warm water.
  • (Warm the almond milk if you’d like a warm milk).
  • In a high-speed blender, add the almond milk, matcha, vanilla stevia and MCT Oil.
  • Blend for 30 seconds – 1 minute – A froth will have formed on top when you stop, and the matcha should be well combined.
  • Pour into your mug and serve hot or cold!

Macros:

1 serving (Excluding butter)

  • Energy: 161 kcal
  • Caffeine: 35-70mg
  • Protein: 1.9 g
  • Net Carbs: 1.69 g
  • Fat: 17.15 g
  • Vitamin A:938 IU
  • Vitamin D: 100 IU
  • Vitamin E: 10mg
  • Vitamin K: 58 ug
  • Calcium: 208mg

Low-carb Chocolate Covered Nuts

There are a few things that I find very frustrating on the keto lifestyle with epilepsy at present. These are namely:

  • Brain fog.
  • Tiredness and lethargy.
    (Note: for people who don’t have epilepsy reading this, this probably won’t affect you apart from the initial induction / ‘Keto flu’ period. For those of us with epilepsy, this is why it might be prolonged.).
  • Watching people eat bread, chips and desserts when I’m out!

But then again there are many things that I’m loving about the experience so far. A few of these are:

  • Discovering new things about my body every day.
  • A pretty impressive digestive system – the fibre in the keto diet must be working its magic! It only lets me down when I eat too much lactose.
  • Reading and learning about a whole new world of diet and nutrition.
  • Discovering new foods, recipes and getting creative in the kitchen.
  • The knowledge that I’m feeding my body nutritious food.
  • Building willpower and the comfort of knowing that I’m capable of creating delicious keto alternatives to bread, chips and desserts (this knowledge keeps me going when I’m out watching others eat carb-loaded foods! I have the good stuff waiting for me back at home in my kitchen).

So you see, there’s a lot to love about lifestyle, and the pros outweigh the costs!

Natures Fat Bombs – Nuts!

Nuts are my snacking staple. They’re high in fiber and numerous micro-nutrients, and there’s so much you can do with them. They’re great as an on-to-go snack, in desserts, and really are natures fat bombs.

Because I find it really hard to hit my fat macros, I find that some nuts in particular are ideal to munch on, namely Pecans and Brazil Nuts. But days when I feel like I’ve had too many calories as well, my go-tos tends to be almonds, pistachios, peanuts or hazelnuts.

Below is some useful nutrition information for various nuts:

NutNutrition

The only thing that tops nuts on my snack list is CHOCOLATE! And boy am I glad that Dark Chocolate is legit on the keto diet!

The benefits of dark chocolate and its miraculous properties deserves a whole post to itself so I’ll save that for another day, BUT the reason I’m writing this is because this post is all about chocolate covered nuts – my ultimate keto comfort snack.

My new chocolate discovery – Montezuma’s !!!

As I was working in a coffee shop the other day, I got peckish and unfortunately this popular coffee shop chain largely still does carb-loaded goods. Even the salads in this cafe were “pasta salads”. So I ventured to the supermarket to stock up on sneaky snacks to sustain me whilst I worked.

I was very excited to find this, hidden away in the chocolate aisle:

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And I was even more thrilled to discover the nutritional values.

Wait for it…

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The nutrition label says that 100g (i.e. the WHOLE BAR) has just 8g of carbs, and 17g of Fibre.

Now on Keto as we’re calculating net carbs (Carbs minus fibre), does this mean this bar of chocolate is actually negligible in terms of net carbs (-9)? Drop me an e-mail with your thoughts on this because I could be wrong, but until I have more clarity – I’M INDULGING!

As can be expected with 100% cocoa dark chocolate – it’s bitter AF. So much so, they’ve put a warning on the back of the package which has almost become a tagline for the brand – “For that dramatic cocoa hit. Don’t say we didn’t warn you!” This is great I think, because a little goes a long way when you’re looking for your cocoa high!

Which brings me to my next point – it’s not cheap. I got this bar for £2.50. However on Amazon you could buy in bulk and save some that way. And I look at it as an investment for all the keto chocolate goodies I could make.

On top of that, you are paying for a top-quality British product. I cannot describe in words how smooth the texture of the chocolate is. It really is incredible and something one needs to touch and taste for oneself.

Low Carb Chocolate Covered Nuts

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Natures Fat Bombs (Almonds and Pecans!!!) covered in Montezuma Dark Chocolate. P.S. Thank you mum for holding the nuts!

So I wanted to make my chocolate investment last for a while (and there’s no way I could eat a block of 100% dark chocolate so I would have to sweeten it up Keto style.)

Hence here is a very sweet and simple recipe for chocolate covered nuts! These are great on their own, or as a crunchy topping on something else.

Note: ANY Dark Chocolate will do, just make sure it’s at least 85% dark chocolate so as not to throw you out of ketosis.

Ingredients

13 servings (1 serving = 5 nuts)

You will need:

  • Nuts (I used 25 pecans and 40 almonds for this recipe, and the macros reflect the same).
  • ¼ tsp Himalayan salt
  • 25g Dark Chocolate
  • 2-3 drops Vanilla Stevia

Method:

  • Melt the dark chocolate in the microwave for 30 seconds (or until melted).
  • Stir in Vanilla Stevia and adjust sweetness to taste.
  • Add nuts and salt to the mixture and stir well ensuring all the nuts are covered with the chocolate.
  • Place some parchment paper on a plate, and place the chocolate covered nuts on the parchment paper.
  • Place the plate in the fridge to cool and allow time for the chocolate to re-harden around the nuts.
  • Once the chocolate has hardened, remove from the parchment, and store in an air-tight container in the fridge.

NOTE: To boost the “Fatbomb” quotient per serving, you could add a tablespoon of MCT Oil to the chocolate mixture.

Macros:

One serving of 5 nuts (pecans & almonds):

  • Energy: 84.7 kcal
  • Protein: 1.8 g
  • Net Carbs: 0.3 g
  • Fat: 8 g

Berry Cheesecake Frozen Yogurt

The temperature has been steadily creeping up in London recently, and today it reached a sunny ☀ 29°C! I find it incredibly difficult to eat enough and hit my macros when it’s warm outside. I know my tactic ‘should’ be to eat higher fat/calorie food. However, this recipe isn’t that. It’s my summer comfort food – FROZEN 🍓 YOGURT (FroYo) – which is keto friendly if berries are on your list.

Berries on Keto

As a fruit lover (I went through a raw vegan phase once upon a time), the hardest thing for me to let go on this diet has been fruit. If this was a zero fruit lifestyle I don’t think I could have done it, so the fact that berries are allowed are a saving grace. I’m of the mentality – Measure it. If it fits in your macros, it’s OK! 👌 If I could, I think I could happily survive on berries.

Just for your information, according to Cronometer (which is the app I use to measure and monitor my nutrition), summer berries have the following Net Carbs:

  • 1 cup strawberry halves: 8.7g
  • 1 medium strawberry: 0.7g
  • 1 cup blueberries: 17.8g
  • 1 blueberry: 0.2g
  • 1 cup blackberry: 6.2g
  • 1 blackberry: 0.2g
  • 1 cup raspberries: 6.7g
  • 1 raspberry: 0.1g

As it’s summer and berries are very much in season in the UK, I intend on incorporating them in my diet until they’re not! (and then freezing enough to last me the winter 😏).

Meal prepping desserts

As a dessert addict, I think meal prepping applies as much to desserts as it does to breakfasts, lunches and dinners. Especially for someone with a sweet tooth like mine as you really need to watch your macros. The carbs can creep up on you on anything sweet. Meal prepping is an opportunity to control your portions.

I think this good weather called for some frozen yogurt prepping in a massive batch, so I made a large LOG of frozen berry cheesecake yogurt.

This made approximately 10 portions which I then cut up and froze and can de-frost and blend with some additional yogurt or nut milk as and when I desire!

Besides being a fabulous dessert or snack, I think this makes a great base for a breakfast. You could turn it into a strawberry cheesecake smoothie, or even a quick hearty breakkie bowl with a homemade keto ‘cereal’ made from nuts and seeds.

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Hiding my fat (in my food)

As I’m always seeking ways to “hide” fat in my food without it overpowering the flavour of the food, this recipe has some avocado hidden in it which gives it some creaminess, but nothing else. Love it or hate it, you can’t taste or see it at all.

I wouldn’t say the cream cheese is “hidden” fat because it’s supposed to be a cheesecake FroYo after all, so you should get a hint of cream cheese, but in terms of fat content – you do get a significant amount of it from the cheese. If the amount of fat isn’t enough for you going by the macros below, I would just increase the amount of cream cheese rather than anything else.

Increasing the amount of avocado might make it overpowering, and increasing the amount of yogurt might affect the amount of carbs. But play around and use your judgement!

I blended it with some almond milk and sprinkled hemp seeds on top one day which boosted the protein and fat without affecting carbs *win win*!

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Ingredients

1 log (10 servings)

You will need:

  • 1 freezer friendly loaf tin
  • Fresh or frozen strawberries: 2 cups
  • Fresh or frozen blueberries: 0.5 cup
  • Greek Yogurt: 1 cup
  • Cream Cheese: 45g
  • Avocado (ripe): 1 large / approximately 120g
  • Vanilla Stevia (or other sweetener): 2-3 drops (adjust as required).

Method:

  • Blend strawberries and greek yogurt in a food processor until well combined. (Note: If you intend on eating some of it immediately, use frozen strawberries).
  • Add cream cheese, avocado, and vanilla stevia and continue processing for a few minutes until the FroYo mixture is a consistency you would like.
  • Taste and adjust at this point as required.
  • Prepare a loaf tin by lining it with parchment paper.
  • Add blueberries to the bottom of the loaf tin.
  • Pour the FroYo mixture into the loaf tin and freeze for 2-3 hours, stirring every 30 minutes if possible.
  • Once the block of FroYo is solid, cut it into servings and re-freeze for future use!
  • To defrost and devour just let it stand out for a bit, or to turn it into more of a soft FroYo, add a bit of yogurt or nut milk and blend.

Macros per serving

(1 log = 10 servings)

  • Energy: 74.8 kcal
  • Protein: 1.7g
  • Net Carbs: 4.9g
  • Fat: 5.7g
  • VitaminA : 160.8 IU
  • VitaminC: 19.9 mg

Salmon Spinach Miso Soup

This recipe is ideal for anyone dealing with Keto Flu, short on time, or just seeking your daily dose of vitamins and minerals from food sources (check the macros below)!

It’s well known that keto-ers can face issues with potassium. It’s one mineral that I am currently struggling with as I write this. Also, as it’s nearly that time of the month, I’m facing a tripply whammy of epilepsy, keto mood swings, and pms.

So for the women out there, this is a good one! I figured I better take precautions to ensure that I’m getting enough potassium from dietary sources as on top of everything else, low potassium levels can lead to menstrual cramps, and I get baaaad cramps due to PCOS. My epilepsy is also further triggered by hormones, and I could do without an episode at this point in time.

Anyway this super simple Salmon Spinach Miso Soup takes less than 10 minutes to prepare (perfect for when you’re not feeling well 🤒). 

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Ingredients

You will need:

  • 2 cups of chicken bone broth (homemade preferably)
  • 1 tsp miso paste
  • 0.5 tsp cayenne pepper
  • 2 cups of chopped spinach
  • 100g salmon
  • 80g egg tofu or soya tofu
  • 2 tsp sesame seeds (optional)

Method:

  • Heat the bone broth over medium heat with miso paste and cayenne pepper until well combined.
  • Once the broth starts boiling, lower the heat and add the spinach first to wilt it down.
  • After 1-2 minutes add the salmon and tofu. Cook in the boiling broth for a further 2-3 minutes and then serve. (Both will carry on cooking in the hot broth once you take it off.)
  • Taste and add extra salt to taste of needed.
  • Sprinkle sesame seeds on top and serve piping hot!

Macros

Full Recipe / 2 servings:

  • Energy: 420 kcal
  • Protein: 40.5g
  • Net Carbs: 4.5g
  • Fat: 25.2g
  • VitaminA : 6053 IU
  • VitaminD : 977.3 IU
  • Potassium : 1218 mg
  • Magnesium : 110.5mg

‘Keto Flu’ and the Epilepsy Dilemma

The keto diet can be mentally and physically very challenging. Even more so if you have epilepsy (or any other disability or illness for that matter).

Before diving into any diet or lifestyle change, it’s wise to make yourself aware about the pitfalls and any difficulties you might face.

The ‘Keto Flu’ isn’t actually a “flu” per se (it’s not contagious!!!). It’s a wide range of symptoms that people can experience when going through the induction phase of the ketogenic diet, and it can feel very exhausting on the body and mind.

The reason?

Your body is is going through ketosis, withdrawing from sugar and carbs and converting glucose for energy and instead learning how to burn fat for fuel. If you’re currently experiencing bad Keto Flu, it could possibly be a symptom that your body was heavily dependent on sugar and carbs. Logic says that the more it has to adapt, the harder withdrawal is.

So although it might seem like you’re sick, you’re not, you and your immune system are just recovering from the beating it has taken!

Signs of a Keto Flu

Symptoms of the keto flu can feel similar to a regular flu and more. Some of them are listed below in alphabetical order:

  • Arryhthmia (Heart palpitations)
  • Blood Pressure – High or Low
  • ‘Brain Fog’ – i.e. lack of mental focus
  • Coughing
  • Cramps
  • Digestive issues: constipation, diarrhea
  • Dizziness
  • Drowsiness
  • Fatigue, tiredness, lethargy
  • Headaches
  • Insomnia
  • Irritability
  • Nausea

How long will it last?

I’m a part of a few Keto and epilepsy social media groups, and the overall consensus on the duration of Keto Flu is that well, there is no consensus.

Whilst some people are fortunate to not experience the Keto Flu, some may only get it for a few days, whilst some have reported feeling poorly for 3-4 weeks.

However long it is, it is temporary, train the mind to think positive! Once you’re in ketosis and your body has adapted to burning fat (ketones) for fuel, your energy will increase and the symptoms should ease.

Tips to avoid / deal with Keto Flu

lemonade
Keto Ginger Lemonade with mint
  • Sufficient electrolytes: Sodium, Potassium, Magnesium. These can come from a number of sources:
    – Food & beverages: I monitor my macros using Chronometer because it shows me units such as vitamins and minerals, and I can then adjust my food intake accordingly.
    – Himalayan salts: add it to your food, water, or directly under your tongue when you’re feeling weak.
    – Drink homemade bone broth.
    – Supplements as required.
    – Dead Sea Salt / Epsom Salt / Magnesium Salt baths.
  • Stay hydrated!
  • Lots and lots of H2O. The diet is dehydrating, so it’s important to stay hydrated. I find this to be quite challenging personally.
  • Eat more fat! Remember fat = energy on this diet, so review your macros if needed to increase the amount of fat in your diet.
  • Limit your protein to an adequate amount – just enough for your body to do what it needs to – again, watch those macros. If you’re watching your calories (if you’re trying to lose weight, I would focus on cutting the carbs and increasing the dietary fat for energy, and then filling the remaining recommended calorie intake with protein.)
  • Sufficient nutrition: The Keto diet isn’t lacking in nutrition, although there might be some individual areas of contention. I really like this article on compoundsolutions.com which highlights food sources of micronutrients in the ketogenic diet.
  • Prepare for a few days off!!! Bear in mind that Keto Flu will probably strike 3-4 days after you start the diet, so it would be a good idea to take a few days off to spends a few days in bed with Netflix. Prepare comfort Keto food in advance so you don’t have to worry about cooking on those days. Pre-keto, my mum would make me chicken stew and ‘Gola bhaath’ (rice porridge). So I had the same, but with cauli-rice instead and it worked a treat! And lots and lots of bone broth – I cannot stress its importance.
  • Take any other medications you’re on, on time. If you forget your anti-epileptic (or other medications), it can affect your side effects of both your drug, your condition, as well as keto flu. Set a reminder and alarm on your phone for each day.

Keto Flu & The Epilepsy Dilemma

Personally, I got diarrhea and a dodgy tummy about 4 days into the lifestyle (which only lasted for about 2 days). But the problem with having epilepsy AND doing the Keto diet, is that ‘Brain Fog’ and tiredness seems to be a constant, and it’s been a good few months on the diet now.

I’m on a medication called Zonisamide (Zonegran) and like all medications it has side effects. The side effects of Zonegran include ‘flu symptoms’ (!!!), light-headedness, trouble concentrating, tired feeling, loss of appetite, problems with thinking or speech and drowsiness. There are more but I’ve just picked some of the side effects I’ve experienced, which also tally with Keto Flu side effects. (As I’m taking all the necessary precautions, I don’t think it’s a rare case of the keto flu lasting more than a month!)

What I’m hoping for is that as time goes on and my body becomes stronger and gains more energy with the help of the Keto lifestyle, this will enable me to counter the side effects of Zonegran (maybe even reduce the dose) and thereby solve the dilemma. Watch this space!

My one other tip for those with epilepsy going through the Keto Flu (in addition to the above):

  • Allow yourself to sleep and rest. And then sleep and rest some more! Your BRAIN already works double-time trying to keep up with normal life, now it’s working triple-time trying to figure out what you’re doing to the body, and both your brain and body needs the rest. Give yourself a break!

Have you experienced the Keto Flu with epilepsy? Write to me and tell me about your experience!

 

 

Why I decided to go Keto

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The reasons for me going on the ketogenic diet boiled down to two reasons:

  1. The scientific evidence correlating between the ketogenic diet and epilepsy management: I’ll do a separate post on this.
  2. My dad: He’s very persuasive in his own way.

My epilepsy history in a nutshell

I have had epilepsy since my early-mid teens, that’s more than half my life! My sister had it too but she grew out of it. I was diagnosed with ‘Juvenile Myclonic Epilepsy’ but it’s now classified as ‘Generalised Epilepsy’ as I didn’t grow out of it and my seizures changed from myclonic jerks to Grand Mals.

My triggers are classic: lack of sleep, stress, early mornings, too much caffeine and alcohol. (It’s probably a good thing I’m not a banker, I wouldn’t be able to hack the trading floor :-/ *respect*)!

I used to be on a medication called Epilim (Sodium Valproate) for most of my life, until in 2014 at the age of 29, I had a seizure in Delhi airport whilst travelling on an early morning flight. It was a turning point in my life in that if that seizure hadn’t occurred I would probably still be on Epilim, oblivious to its’ effects on my body.

Because my parents are doctors, and my GP is a family friend, I trusted them and whatever medications I was on. I guess they trusted the knowledge of their friends as well. I hadn’t had regular follow-ups and in hindsight, even when I was seen to, I never really felt comfortable being seen to by friends of the family – they were more interested in conversations with my parents than with me the patient. So they were very quick conversations, and to be honest, I don’t remember much.

In Delhi the doctors were shocked I was on Epilim as a woman of child-bearing age. So they put me on Keppra. Mum flew down and I was taken back to London where I recovered and saw a neurologist. Keppra didn’t suit me at all, it was two weeks of hell (moody, angry, hair falling out, lethargic – there’s a reason they call it the crazy pill!). So I was titrated on to Lamictal over a 5 month period and I returned to India for work. Lamictal worked for about a year and a half, and then it slowly lost its effectiveness.

The big change

I returned to London in November 2015 with the intention of spending time with family and getting healthy. After two years of using Lamictal and experiencing a few seizures, a new neurologist I had started seeing suggested titrating on to Zonegran.

So I started the process in November 2016. However it was in early January 2017 that we had to make an appointment to see my neurologist urgently. December 2016 had been a bit tumultuous with numerous seizures, including one on New Years Eve (at home). They were scary because they were of a different kind in that I was still conscious and more like small convulsions that seemed to go on for hours, as opposed to a Grand Mal seizure where I blacked out. Needless to say my parents were worried. My mum was hysterical and dad even brought an Oxygen machine home!

My neurologist reassured me that this was actually a good sign in that the  Zonegran was blocking the seizure from developing into a full blown Grand Mal, and I was having those types of seizures because I was on a very very low dose (it was probably around 50mg at the time), and I was simultaneously coming off Lamictal. As we planned to increase the amount of medication over the coming months, this should ease off (and I’m pleased to say it did – I’m currently on ONLY 175mg Zonegran morning and evening and no Lamictal).

I was also going through a stressful time on the work front having started working on a new project in the deep-end which might have added to the seizures. He was kind and for the first time in my epileptic life (15+ years?) someone talked me through all the different kinds of treatments available. He talked about the different medications available, surgery (I’m not at that stage, and hopefully won’t be), and the Ketogenic Diet.

My dad being the mad doctor that he is, suddenly woke up at that point when my neurologist mentioned the ‘D’ word. My dad loves anything to do with food as medicine, and this was a Eureka moment for him. Not so much for me though. I love my potato, bread, rice and dessert too much, and can’t don’t do diets (!!!). The thoughts was not appealing at all (at that point in time).

So my dad took it upon himself to research the diet and use himself as a guinea pig starting the next day. He figured he needed to lose some weight anyway he said, he has high blood pressure.  I rolled my eyes as he tried to convince me (unconvincingly). I didn’t know it at that point, but my dad was going on the diet to lose weight because he was going to have a heart surgery for a heart valve replacement. It was planned but I would only find out later. (The diet did help him, and that probably deserves a whole separate post).

The day I decided to go Keto

I had 3 months to go until the medication transition and even if I wanted to, I couldn’t start a diet until the end of March 2017 at the earliest. I unfortunately had a Grand Mal seizure in a public space on 4th April 2017 and my dose was increased thereafter. I also had shoulder surgery scheduled in mid-April 2017 which had to be postponed, to April 20 2017. The timing fell into place and it was after this seizure that I thought I had nothing to lose and would start the Ketogenic diet. (Although I did have a carb-up at the hospital after shoulder surgery!!!) I knew that I’d be recovering at home for a while and could afford to deal with ‘Keto Flu’.

The problem with anti-epileptic medication is that it’s trial-and-error, and the last few years I feel like I’ve been pumped with drugs, and even then if might stop working (as with Lamictal in the past). If the Keto diet has a 50% chance of success with managing my seizures, I’ll take that!

It’s been nearly 12 weeks since that Grand Mal seizure that made me go Keto, over 9 weeks since my shoulder surgery, and now seeing as I’m able to use both arms and type (thanks to physiotherapy), I thought I’d share my journey as I learn.

In this blog I expect to share keto experiments from the kitchen (both my own as well as adaptations of other recipes which I shall link). I’ll also share tips and information on managing keto and epilepsy.

If you have any ideas / requests / contributions for the blog, or would just like to get in touch and have a chat, please write to riagoesketo@gmail.com