Throw Back Thursday, 2.5:1

Tonight I was emailing a parent who had contacted us for help with getting started with the Modified Atkins Diet (MAD). I shared the links to the information that Doernbecher gave us when we started ( They basically told us to go to it, and away we went. MAD is a very DIY diet treatment, at least when we started.


The parent’s specific question was how we documented Nora’s diet when we got started, so I took a picture of one day from the first food log that we kept, dated 12/15/11.

Excuse the handwriting and the food stains. We stood at the kitchen counter and wrote down everything Nora ate, along with the grams of carbs, protein and fat (each column of numbers). Then added up down the column to see total carbs, protein and fat and to calculate the ratio (fat/(carbs+protein)).

We got those numbers from a nutrition database and nutrition fact panels, and had a little “cheat sheet” for commonly used foods that we kept on the fridge. After a few weeks, I knew a lot of them off the top of my head.

In those days of MAD we were estimating and using common measurements, like 1/2 T of cream or 1/4 avocado, rather than weighing everything in grams. Everything was much less precise. Although we could see a difference in her seizures at the time, we didn’t yet have complete control.

Little notes found their way onto the page too: three small myoclonics and one medium myoclonic in the morning, along with feeling tired and hungry. Ketone readings at different points during the day.

On the back side of this page, I noticed that the final ratio for the day was 2.5:1. Just where we are now. And ready to step down to 2.25:1 tomorrow, still seizure free. What a difference 2.5 years made.

Print Friendly, PDF & Email
This entry was posted in Nora's History, Tips and Tricks by Christy Anderson Brekken. Bookmark the permalink.

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.

2 thoughts on “Throw Back Thursday, 2.5:1

  1. Our 20 month old grandson getting ready to begin a ketogenic diet, he was diagnosis with tuberous scerosis at three weeks old, he has been on different meds and although we are grateful that he isn’t having as many as he did, he still is having at least two seizures a day.
    I am trying to educate myself and husband because we have Luke twice a week I love to cook and was hoping to find some type of substitution to make little cheerios. I know it sounds silly but he is very picky and when he is with us if all else fails i know he will eat those.

    • Hi Patty,

      I’m sorry to say that I don’t have a Cheerios substitute. I can’t imagine making tiny O’s! But there are lots of fun cracker recipes out there that you could shape into O’s if you have some time and patience, or you could find little cookie cutters to do something similar. Check with parents & dietician about getting carb limits and ratios right. You probably want to weigh out snack-sized portions of dough, then put each baked batch into its own little container so that you can deal out a snack size when needed.

      Here’s some ideas:
      Almond crackers (3.2:1 ratio)
      Goldfish crackers (2:1 ratio)
      If your family has the Keto Cookbook, there is a Cheddar Cracker recipe at 4:1 that we love and really relied on for Nora. They are so delicious. It’a about equal parts ground macadamia nuts and shredded cheddar cheese with a bit of egg white to bind it and salt. The recipe is in the cookbook, and if you don’t have it yet it would be great for the family–such good recipes with pictures!

      Good luck! Your grandson is lucky to have you making snacks for him!

Leave a Reply

Your email address will not be published. Required fields are marked *