October 2, 2019

Why Kids Shouldn’t Go on the Keto Diet for Weight Loss

Plus alternate strategies for reducing BMI

A child with a milk mustache grinning while having a snack of an apple and cornbread

The ketogenic diet is trending, big time. This diet requires a super-high intake of fat and extremely low intake of carbs. It promises fast weight loss, which may make sense for adults who are well beyond puberty.


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But what about growing kids and teens? With childhood obesity at an all-time high, some parents may be asking themselves if keto is the answer to help their kids.

But is keto safe for kids? In a nutshell, no, says registered pediatric dietitian Kaitlyn Nowacki, MS, RD, LD.

Why keto’s not great for kids

The keto diet removes three of the five food groups that have essential vitamins and minerals kids need for growth. If kids cut out carbs, they could eat butter, bacon and eggs to their hearts’ (dis)content, but they’d be missing out on:

  • Dairy, which has vitamin D and calcium essential for growth and bone development.
  • Fruits, which are high in dietary fiber, vitamin C and potassium.
  • Grains, which fuel brain development and give kids the energy to grow, play and exercise.

“I wouldn’t recommend keto for weight loss in pediatric patients,” Nowacki says. “A weight management program like keto requires vigilant monitoring by a healthcare professional. Plus, growing kids aren’t the same as adults.”

“Quick-fix weight-loss schemes aren’t sustainable in children. It’s important to teach them healthy lifestyle choices and techniques (versus ‘diets’) to set them up for more success as adults.”

And, she warns that kids probably wouldn’t feel great after starting keto. They might experience:

  • Constipation: When you take away whole grains and fruit, you take away fiber. High-fat, low-fiber diets can make it hard for kids to poop.
  • Lethargy: Children following a keto diet may lack energy, especially in the beginning and if they aren’t taking supplements. The calories can be way below the amount growing children require.

There’s one scenario in which keto might be appropriate: Studies have shown that it can help control seizures in some children with epilepsy. But this should be prescribed and carefully monitored by a healthcare professional.

Hang on — there’s an obesity epidemic. Shouldn’t a parent act?

“There is absolutely an obesity epidemic among children. I see at least 30 kids per week who need nutritional counseling and have high BMIs,” Nowacki notes.

While BMI improvement is important for kids who have overweight or obesity, they may not need calorie-limiting diets to get there. Why? Because kids rapidly burn energy and can reach a better BMI by merely growing up. If the only thing they do is decrease excess calories (we’re looking at you, French fries and soda), that might be enough.

If a child or teen does need to restrict their food intake, a dietitian or healthcare provider should oversee and manage that process to keep the child safe. A weight loss plan for children must be tailored to a child’s specific needs.

Instead of dieting, try these tips

Nowacki suggests cutting out the bad habits that lead to weight gain by doing the following:

  1. Check that “occasional” treats are not “regular” treats. Fast food and dining out contribute added fat, calories and sugar to a child’s diet. “I have parents tell me that Monday and Wednesday were hectic, so they hit the drive-thru. Friday was dad’s birthday, so they went to the steakhouse and had cake,” Nowacki explains. “Parents should step back and make sure that what they think is an occasional indulgence isn’t something they are doing regularly.”
  2. Step it up. “Inactivity creates a perfect storm because if a child is inactive and mindlessly indulging in snacks that aren’t nutrient dense, like chips, they can end up with a massive calorie imbalance,” Nowacki says. “Over a year, that imbalance could mean excessive weight gain in an already overweight child.” Parents should encourage kids to step away from their screens and start moving. Whether it’s an organized sport or jumping on the trampoline, movement matters.
  3. Ask your child: Can you choose better? Help your child understand that food is fuel, and some foods provide better get-up-and-go. When they choose food, teach them to ask themselves if it’s good for their body. “A teen might tell me they had a salami sandwich, a fruit cup, soda and broccoli with cheese for lunch,” says Nowacki. “I encourage them to look at their food differently and ask what they might do to make the meal healthier.”

She suggests some simple switches:

  • Choose lower-fat deli meat like chicken.
  • Pick whole wheat bread rather than white bread.
  • Grab fresh fruit instead of the fruit cup.
  • Skimp on the cheese sauce or skip it altogether.
  • Choose water rather than soda.

While these tips are helpful guides, concerned parents should request support from a registered dietitian or pediatrician. “There are too many unsubstantiated facts and less-than-credible viewpoints online,” says Nowacki. “Don’t jeopardize your child’s long-term health by relying on a web search.”

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