The Latest Daily Routine

As we have said before, we’ve really been learning-as-we-go with this diet business. Our daily meal routine has evolved, so I thought I would post our current methods.

During the first few months of the diet, we used a paper and pencil method. We had a small spreadsheet of commonly used foods and their break downs hanging on the fridge and would look up other foods as needed. Each meal was built on the fly with benchmarks for carbs, protein and fat at various times of the day. I knew the breakdowns for typical portions of common foods, so I could build a meal intuitively then add it up, adjust, and check the exact ratio. Each meal was juggled independently. It worked fine and provided us with flexibility, but after the last seizure (11 weeks ago!) and meeting with the dietician we started a more efficient long-term method for meal planning.

Snapshot of the KetoCalculator for meal planning

I first saw the KetoCalculator tool and started an account for Nora a few months ago when I met with Nora’s dietician to tighten up the way we administered her diet. I was reluctant to use it because only particular major brands of foods are available (for more on my reluctance, see About the MKD). But I also learned that the dietician must add all of the foods made from my recipes, and that just seemed like too much work for her and for me.   So we only use the official KetoCalculator as a reference to check the official break-downs for particular foods when necessary, but not as a meal planning tool.

Instead of the official KetoCalculator, Ted devised our very own KetoSheet spreadsheet in Excel. It’s the same idea as the official online tool, but we can customize and adjust it ourselves. We share it with each other via GoogleDocs so that we can both use the most updated version on our own computer, anytime. This lets us enter the number of grams for each food, see the breakdowns, the running total, and make slight adjustments to hit the right ratio for each meal.

Our shared Excel KetoCalculator showing my next plan for breakfast and morning snack, with running totals in yellow at the bottom.

It’s interesting to play with it to build a meal–we can move the ratio with tiny adjustments, like an extra gram of butter or one less gram of raspberries. Making slight adjustments to the paper and pencil method meals meant erasing, re-writing and re-adding. When we adjusted her ratio to 3.5:1, up from 3:1, I realized that I had a great intuitive sense for meals built at the 3:1 ratio. Changing the ratio meant a lot more time fussing over the right measurements for each food. It has really streamlined the process and I think it has helped Ted build meals from scratch as well. We share the meal planning load more evenly now.

After determining what Nora will eat at her next meal with our personal Excel KetoSheet, we write these values down in our little book-o-days. We now have four little notebooks sitting on the shelf full of daily meal records. That’s our permanent running log of Nora’s meals. It’s also far more portable than a laptop. Then we take the little book with the foods and quantities to the kitchen for quick reference when building a meal. We can also look back to previous days and copy a meal for a quicker process.

Gram scale and daily meal record notebook.

Next to the kitchen! We finally got a one-tenth gram scale and are very happy with it. I was afraid that I would spend a lot of time shaving off bits of food to hit the tenth-gram value, but it’s not too fussy. It’s actually kind of fun, especially when you hit it on the first try. There’s a silver lining.

With the meal plan and scale at the ready, we make up the meal. We have several small bowls, some of them silicone for easy mixing and scraping out of things like butter and cream cheese. I also have a few tiny bowls for presenting small amounts of food.

It’s all pretty routine now, but it still takes at least an hour or two to feed Nora each day.

We have a few standard breakfast combinations. The best one at the moment is a pecan breakfast cookie adapted from the KetoCookbook. The original uses ground pecans and butter, but I substituted coconut oil so that we do not have to present coconut oil separately in the meal. Nora doesn’t particularly like eating coconut oil straight or mixed in cream cheese. My next version will be made with hazelnut flour because Bob’s Red Mill has a pre-ground hazelnut flour, so I won’t have to grind the nuts myself.

Nora’s mid-morning snack is B^3 with either 8 grams of apple slivers or 15 g of baby carrots (depending on whether Anders has decimated our apple supply without our knowledge). Nobody better mess with her morning snack. She has come to expect it every day.

Typical lunch and snack: Tuna salad, flacker, cinna-butter, strawberry, avocado, macadamia nuts, and a PBJ muffin. Cytra (the solution to reduce her blood acid level) to drink.

Lunch varies. We have started using more macadamia nuts lately to help boost the ratio with healthy fats. We have also started to rely on butter much more than cream. Lunch always includes flacker and butter, which Nora eats up happily. We also have plentiful raspberries from our garden this time of year, so she eats several small portions of raspberries per day, usually around 10 g each, or 3-4 berries (only 0.57 carbs per serving!). I know, it sounds like so little to the rest of those, but those raspberries are precious sweet rubies to Nora.

On days when we both work, we put together the morning snack, lunch, and afternoon snack for her babysitter. We calculate, weigh and assemble it the night before so that it’s all ready to go.

Dinner and bedtime snack are calculated based on the running total for the day and the foods we have available. There are plenty of food options so we can always put together and easy meal. Or we can easily add something new to our KetoSheet if the rest of us are having something that we don’t often eat. Recently I’ve added pork shoulder, bratwurst, ling code and snap peas, edamame and watermelon to the KetoSheet. I look up values of generic foods on and cross reference it with the official online KetoCalculator if I have any doubts. I create a new line in our spreadsheet and copy and past the formatting from an existing line. Then I add the new food and calculate the carbs, protein, fat and fiber per gram. Bingo-bango, I’ve got a new food to play with. Who says we shouldn’t play with our food?!?

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About Christy Anderson Brekken

In no particular order... Instructor and Researcher, Department of Applied Economics, Oregon State University. Educational background: University of MN Law School, 2005. MS in Ag and Resource Economics, Oregon State University, 2011. Teaches: Agricultural Law, Environmental Law. Mother: brilliant 9 year old boy; brilliant 6 year old girl with benign myoclonic epilepsy on a modified ketogenic diet therapy. Married to: Ted Brekken, OSU Department of Electrical Engineering. Ride: Xtra-cycle Edgerunner with kid seat; 400-pound cargo capacity. Grew up: Devils Lake, ND. Lived in: Minneapolis/St. Paul, MN, Pohang, South Korea, Trondheim, Norway, Corvallis, OR. Interests: Cooking, knitting, eating, yoga, laughing, hiking, traveling, staying sane.

9 thoughts on “The Latest Daily Routine

  1. Are you able to make Noras meals without having her drink heavy cream? I have just recently started the diet with my son at a 4:1 but all his meals are calculated with 8oz of heavy cream at each meal plus 4 ounces at each snack (2x a day). Its impossible to get him to drink it. The ketocalculator also seems impossible to me.

    • Hi Jessica, it’s hard to get started and figure out what is going to work. Nora used to drink a lot more heavy cream, but not 8 oz per meal. Your son must be older and eating a lot more calories? Because that seems like a lot. Nora used to drink heavy cream at least twice a day. We would warm it and mix in a tiny bit (1/8 teaspoon) cocoa powder. You could use bit of no-carb sweetener, but she didn’t need it and we were wary of those sweeteners at the start of the diet. You can also make a vanilla steamer with a touch of vanilla extract instead, and we tried strawberry extract once too. Some flavors, like strawberry, are available without sugar alcohols and are diet-approved, but be careful when you shop. I spent many an hour at the grocery store when we were getting started. But if he doesn’t like it now, he will either have to get over the hump and get used to it or you will find other things that work for him. One thing that has made the diet workable is Nora’s amazing compliance (and if you knew Nora, you would agree that her cooperation on this is amazing).

      But we have found other ways to sneak in fat that are not so tough to swallow (yeah, pun intended). It took awhile, but now she will eat macadamia nuts. They are a 5.2:1 ratio by themselves, so they can be used with lower ratio foods to inch up the ratio at a meal. We also use English Double Devon Cream (if you search the blog I have a past post about it). It’s English clotted cream, so for the same quantity you get almost twice the fat. We mix it with cream cheese or greek yogurt for a fat boost (both of those ideas are in the blog). Nora also just eats a lot of butter now. I buy European style butter by the case because it has a touch more fat per serving than regular butter. We also feed her things that are naturally high in fat anyway so that a lot of extra fat isn’t required to get the ratio. I can’t say enough good things about Flackers. They are crackers made out of flax seeds, with a natural ratio of 1.3:1 and very little carbs. Full of all the great healthy fats. Lots of avocado. Interestingly, we don’t make bacon very often anymore!

      I hope some of those suggestions help. I didn’t find the KetoCalculator very user-friendly either. I’m sure it takes awhile to get used to it. I bet we would be using it too if we had been trained and Nora had the hospitalized induction, but we created our own systems before we got to 3.5:1. Good luck. Happy to offer suggestions, but always check on flavoring and other things with your dietician. Oh–I also realized that Flackers are not in the KetoCalculator (right?). I asked our dietician to add it because she was not aware of them until I told her. I have not checked yet to see if they are there.

  2. Thank you so much for all the help and advice! My son just turned 10 so yes, he takes in a lot of calories/fat. I’m hoping he can get over the hump.
    I can’t thank you enough for getting back to me!

    • Jessica–We know what you are going through and we are so happy to help. We went to Nora’s Keto-Clinic appointment today, and on the way back we were talking about how compliance has not been a problem for her. I think it helps that she was so young when she started, because a 3 year old is not in control of her own food anyway. But it also might have helped that we were kind of on our own trying MAD right away. It was hard to feel like we were starting from scratch in a lot of ways, but I think I’m seeing the benefits now. We didn’t start with someone creating a meal that we had to deliver–we were creating meals that we thought she would eat. We’ve always approached it from her perspective as much as possible. It’s easy for a dietician or a ketocalculator to tell you to serve up and tell him to drink 8 oz of cream. It’s tough to actually do it. Have you bought the Keto Cookbook yet? (Also in a blog post–it’s available on Amazon). The color pictures are amazing. It gives you a different idea of how to do this diet–the idea of how to still enjoy eating.

  3. I have been reading a few posts and find them quite interesting. Personally I have not much knowledge about the Ketogenic diet, but I will likely write an article about it.

    Keep up the good work you are doing.

  4. Hi Christy, I’m writing to comment on a recent post that you wrote about KetoCalculator. “This happened to me as well. Another reason I don’t use the ketocalculator anymore. I have my own spreadsheets with the calculations built-in that I keep on dropbox so it’s on every computer as well as mobile devices. This is too important for me to trust that it won’t disappear again.” ….The meals don’t
    dissapear, they are temporarily hidden until the dietitian verifies them. I’m always willing to adjust the program based on feedback . I spend at least 2 hours daily updating the databases within KetoCalculator. We are gearing up for an upgrade after our graduate student completes her thesis on her survey of users of the program. We’ve worked hard at making it a user-friendly program. Sincerely, Beth Zupec-Kania

    • Hi Beth,

      I don’t think I wrote that sentence exactly, and am wondering if another commenter did. I tried searching the comments but didn’t see it come up with a quick search.

      In any case, we never used the ketocalculator for Nora’s meal planning. It’s not that we tried and gave up. Going back to the original Nora story, we did MAD first and developed our own systems before we were given a ketocalculator password. So I don’t have experience with losing meals on the ketocalculator, but maybe others do. My husband developed our own Excel spreadsheet version based on our experience and commonly used foods. Once we were so deep into our system, it seemed like an unnecessary pain to ask our dietician to add our foods and recipes, and so much work to enter it all into the ketocalculator when our system was getting our desired result–a seizure-free kid!

      I’m so glad that other parents have the ketocalculator to work with, and know other parents like it. As with any system or program, it will take a certain amount of investment in learning how it works and getting it set up. It’s a lot for a parent to learn while dealing with a child with epilepsy who is adjusting to new foods. It’s overwhelming. I just hoped to convey that we are doing it a little differently than others, and other parents will use the ketocalculator in the same way that we use our Excel spreadsheet. The rest of the daily routine is going to be similar for everyone: calculating, weighing, serving.

      Now that I have a ketocalculator password, I do look up individual foods to find benchmark values if I am adding a new food or checking on my calculations. It’s a nice back-up for our system. Thanks for keeping it updated, it’s a huge job, I’m sure.


  5. Nowaday with all this junk food everywhere it is more than ever important that we cook healthy at home. This site helps us all. I just would like to thank you guys for this great job you are doing.

  6. Hi, Christy. Could you possibly share your spreadsheets? We are one week into the MAD for our daughter, Heather who so 40 years of age.


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