When Nora first started a diet therapy, we began with the least-extreme diet that has worked for treating epilepsy: the Modified Atkins Diet (MAD). As part of my education, I borrowed the Atkins weight loss book from the library (the man knew how to sell an idea) and several Atkins/low-carb cookbooks. This is a modification of a recipe from one of those sources.

I made it quite a long time ago (which in my world, is 2 or 3 months). Nora requested it again last week, so I made it up for her. She really likes it. I don’t like the taste of the rice protein powder, but my taste doesn’t matter one bit!

Nutritional information for Cheddar Bread. Based on 8 servings. Analysis by www.caloriecount.com

Cheddar Bread

1/3 c (37.4 g) Bob’s Red mill Soy Flour
1/3 c (42.6 g) Source Natural’s Brown Rice Protein Powder
1/2 tsp baking powder
2 large eggs
1 Tbsp (14 g) Greek Gods Traditional Plain Greek Yogurt*
1 Tbsp (14 g) English Double Devon Cream*
2 tbsp (27 g) olive oil
38 g shredded cheddar cheese

Preheat oven to 375. Butter 8×4 inch loaf pan.

Combine soy flour, rice protein and baking powder in a small bowl.

With hand mixer, combine eggs, yogurt, double cream and olive oil until smooth. Add dry ingredients and beat until just combined. Fold in half of cheddar.

Pour batter into pan and sprinkle remaining cheddar on top. Bake 25 minutes or until cake tester comes out clean.

Refrigerate.

*The original recipe called for sour cream, and I did make it with sour cream the first time. This time I did not have any sour cream at home, so I substituted and adjusted the recipe. If you want to use sour cream instead, substitute 2 T for all of the yogurt and English Double Cream. Re-calculate nutritional information.

As always, I gave you the brands that I used for each ingredient. If you use a different brand of soy flour or protein powder, you should adjust your nutritional information accordingly. I don’t see why whey protein powder wouldn’t work, but I have not tried it.

Nutrition based on 8 slices, at 30 g each. Nora normally eats a smaller slice, maybe 15 g. But I have found that if I make portion sizes too small in this recipe analysis tool, it will drop small values, like fiber. We both use the fiber number to see the “net carbs” in a food, and to keep track of how much fiber Nora is getting daily. So sometimes my recipes intentionally show larger portions, and I re-calculate based on this info for Nora.

Nora’s typical 15 g serving would be:
0.65 g net carbs
2.35 g protein
4.1 g fat
0.25 g fiber

And I would normally serve with a teaspoon of butter. The bread is not crumbly (hmmm, could it be the fat and cheese?) so it is nice to put a slice in the toaster (carefully) or under the broiler after taking it out of the fridge. Nora really digs the “toast” consistency.

The caloriecount website gave this recipe a B-! That is the highest rating I’ve seen for any of Nora’s recipes. Normally, they get a D. Good points are always that they are low in sugar (yeah) and bad points are that they are high in saturated fat (yeah too). It is interesting to always see how this external “health” and weight loss site views the diet that is so effective for my kid. If only they knew.

Nora needs several supplements everyday, some multiple times a day. It’s tedious to crush tablets and add them to foods on a meal-by-meal basis, so here’s one of my time saving processes to ease the daily grind.

Peanut butter (B^3) and apples (10 g = 1.25 g carbs) is Nora’s morning snack, and nobody better mess with it. It’s also a great fat and supplement delivery system.

First, I make a big batch of B^3 (that’s B-cubed, aka, B*B*B for those not math-inclined). Peanut butter, sunflower seed butter, and butter. Give it a bit of body and fiber by adding some flax:

Nutrition information for 1 Tbsp B^3 from www.caloriecount.com

B^3
1 cup butter
1/2 cup Adams 100% Natural Peanut Butter
1/2 cup Sunbutter Organic Sunflower Seed Spread
1/2 C Bob’s Red Mill flax meal

Soften by bringing all ingredients to room temperature, then blend well. I am careful not to whip too much air into the mixture, as I measure it by the tablespoon. Of course, it may also be weighed for precision.

I think this completely filled up a quart jar last time I made it. Refrigerate and it will keep a long time. At 1 tablespoon a day, it lasts a while.

The B^3 is now ready to be made into 1 tablespoon servings and loaded with supplements. It’s a great delivery system because the taste of the supplements is masked by the nut butters.

Adding supplements to B^3

Nora gets 1/4 of an adult Centrum every day (her diet does not guarantee her the required vitamins and minerals), 1 tablet of carnitine (an amino acid that helps with processing fats), and 200 mg of folic acid (helps with thinning hair due to the medication). She also gets calcium supplements, but we do not add them here. Any chewable kids vitamins have carbs to make them tasty, so those are out of the picture for Nora. Of course, we can’t expect a 3 year old to swallow pills, so we crush them into a powder with a small mortar and pestle and incorporate them into her food.

I start an assembly line process by measuring 1 tablespoon of B^3 into 4 small dishes. I crush 1 day’s supplement tablets into a powder and add it to each bowl of B^3. That way, she gets a consistent daily dose. I mix in the supplements and put the little bowls in the freezer to harden.

Frozen B^3 + Supplements

When the mixture is hard (it does not have to be frozen solid), I use a melon baller to scoop it all up into a little ball.

Then I put each ball into a container and keep it in the refrigerator. That keeps the mixture solid enough to stay separate, but gets pliable quickly when it is ready to eat.

It is a bit of work, but I love having little balls of B^3 to grab out of the fridge when I’m preparing each day’s meals. Meal preparation is enough of a chore without getting out 3 more supplements to add to Nora’s food. We can put a few week’s worth in the fridge and keep it on hand.

Finished B^3 + Supplements

Productivity is happiness. Maybe that statement is a little too strong. Concentrated tedium is preferable to daily tedium.

This diet has not been challenging enough, so Nora’s now going raw food vegan too.

Happy April Fools Day!

I did find a fabulous hummus-substitute for Nora on the raw food vegan website of some of our favorite musicians, Jónsi of Sigur Rós and his partner Alex. Together they make music and art in Reykjavík, Iceland, and shared some of their raw food vegan recipes on their website. Click on the cool hand-drawn cookbook on the right to “flip” through the recipes. They’ve also made videos to demonstrate their “cooking” techniques (remember–this is raw food). I find it touchingly earnest and adorable somehow.

Macadamia nuts are often used in the ketogenic diet because they have a tremendous amount of “good” vegetable fats and low carbs. And they are totally delicious and cost their weight in gold (almost). I keep them in the fridge to be sure to keep them fresh. Nora has not been a huge fan of eating the nuts themselves, but I’ve tried to get them into her diet in other creative ways, like this.

I like the idea of putting Macadamia Monster Mash in half of a small pepper and broiling some cheese over the top (damn, I forgot about that vegan thing. And that raw food thing). But because Nora is only 3, she still isn’t a big fan of mixing her foods. One day she will appreciate a more complex presentation.

Here’s the recipe (I amended it a bit for Nora’s taste) and video for Macadamia Monster Mash:

Macadamia Monster Mash

Nutrition Information for Macadamia Monster Mash. From www.caloriecount.com

200 g macadamia nuts (about 1 cup, but for the diet I weigh it for precision)
1 tsp dried parsley
1 Tbsp lemon juice
1/3 c water

Mix in food processor or blender until creamy.

0.5 g net carbs
0.7 g fiber
0.7 g protein
6.3 g fat

The original recipe adds a clove of garlic and salt, which will slightly alter the nutritional information.

Nutritional information is based on a 12 g serving, about 1 tablespoon, but I weigh it on the scale instead of measuring it with a tablespoon.

Served on a flacker or low-carb tortilla, roll a little ball of Madacamia Monster Mash in some shredded cheddar cheese, spread on a slice of turkey and roll it up, or just eat it with a spoon. I’ve also mixed her coconut oil into it for easy serving.

One little sidelight: when I was making the recipe the first time, I realized that although water does not add any macro-nutrients, I need to specify the amount of water that I use in the recipe to get the correct nutritional information per serving. Why? Because the water adds weight/mass to the serving, in a sense “diluting” the other ingredients. A 12 g serving with water has different values than a 12 g serving without water. Details, details.

Yesterday was baking day again, and Nora requested this Hazelnut Applesauce Bread. It’s the 3rd time I’ve made it–a hit! Nora enjoys it for breakfast, topped with a mixture of her morning coconut oil mixed with a bit of butter.

The recipe calls for baking it in a small loaf pan, but I find it a little unwieldy to store and cut in that form so I tried baking it in a wide shallow baking pan instead. It came out nicely. With all of the fat, the edges get kind of browned and crispy. Mmmm.

This recipe is an adaptation of Candice’s Low Carb Almond Flour Applesauce Spice Pound Cake [11/13: her site has moved and that recipe seems to be gone: http://tmstrevival.wordpress.com/]. If you look at her recipes, she always uses Splenda or another no-carb sweetener. We try not to add any of those sweeteners to Nora’s diet. It’s unclear whether they interfere with ketosis for her, and we don’t want to take any chances. I also don’t care for their flavor (they always have a bitter edge to me). I try to choose recipes with naturally sweet and delicious ingredients so that extra sweeteners are not necessary. Nora is not accustomed to sweet things anymore, so this bread (and her other baked goods) taste sweet enough to her. We call it “applesauce bread” for the sales pitch, and the applesauce does add a nice touch of sweetness, with the nutty taste and cinnamon flavors as well. We are going for flavor, not sweetness.

The original recipe calls for almond flour. The first time I made it, I was out of almond flour but had ample hazelnut flour. Did you know that 99% of all hazelnuts grown in the United States come from the the Willamette Valley in Oregon–right here where we make our home? And when you move to Oregon, you learn that hazelnuts are also called “filberts.” Know the local code to find the local deliciousness.

It is possible to substitute any nut flours for these kinds of recipes, but remember to always re-check the nutritional information. To boost the fiber and cut a little more carbs, I also substituted 1/4 cup flax meal for some of the nut flour, which I do with most recipes.

One additional word of caution for keto-families, which applies to all of my recipes with nutritional information: Make sure to re-calculate nutritional information for the ingredients that you use if they are different from mine. I use Bob’s Red Mill nut and seed flours. Check the nutritional information for the applesauce you use and make sure it is unsweetened. If you are grinding your own nut flours (which you can do in a coffee grinder), you can weigh the quantities to be sure of your measurements. I am measuring things in cups here, but as you know that creates more room for error. If you measure according to the recipe, weigh, and calculate based on weight you will get more precise nutritional information for the recipe that you feed your child.

I also use an online recipe analyzer because we don’t use a keto-calculator (we are on a “modified” keto diet without as much rigor as administered by most neurologist’s offices). My nutritional labels are for your reference to determine if you want to try a recipe.

Hazelnut Applesauce Bread

Hazelnut Applesauce Bread. Nutritional analysis from www.caloriecount.com

3/4 cup unsalted butter, room temperature
5 large eggs
1/3 cup UNSWEETENED apple sauce
1 teaspoon pure vanilla extract
1.75 cups Hazelnut Meal/Flour
0.25 cups flaxseed meal
1 T Organic Coconut Flour
2 tsp baking powder
1 teaspoon ground cinnamon
1 teaspoon ground ginger
1/2 teaspoon ground nutmeg

Preheat oven to 350F

Grease & flour a 8”x4” loaf pan with butter and dust with coconut flour.

In small bowl combine hazelnut flour, coconut flour, baking powder and spices. Set aside.

Beat butter with an electric mixer until fluffy and smooth. Add eggs one at a time, beating well after each addition. Add vanilla extract and apple sauce and continue to beat until smooth.

Add hazelnut flour mixture to egg mixture. Mix on low until combined. Then turn mixer up to high and beat until smooth.

Pour into prepared loaf pan and bake at 350°F for about 1 hour or until done. (When I made it in the wide shallow pan, it cooked for about 45 minutes).

Let cool in pan for about 10 minutes then take out and and cool on wire rack. If you don’t take it out of the pan, it will solidify in there and will break if you take it out when cold. There is a lot of butter in this recipe and it does solidify.

Note that 1 serving is 16 g (I cut and weigh each piece of bread). It’s a rather small but dense serving. The recipe creates 48 servings at 16 g each, so it’s wise to freeze half of a loaf because it will get moldy before we use all of the 48 servings (unless the rest of the family is eating it too!)

A 16 g serving contains:
0.7 g net carbs
0.8 g fiber
1.4 g protein
6.2 g fat

Just like crepes, only keto! Yum!

Krepe Kids

We usually fill them with ham and cheese and roll them up. But the coconut meal gives them a little more body than a real crepe, and they are a little spongy too, so they are kind of a cross between a crepe and a pancake.

They make a great meal because Anders and Ted like them too (but they have too many eggs for me. My own little food glitch).

Tonight Nora had some extra carbs coming, so we filled them with cheddar and 18 g of apple slices! She normally gets about 10 g of apple at a time. What a treat. Of course, she wanted to separate it and eat the apples first, so I let her eat 1/2 of the apples, then made her eat 1/2 of the crepe. Although I didn’t hear any complaining and she ate up every bite.

They would also work great as a dessert or breakfast crepe with some sliced strawberries and whipped cream. Nora claims to dislike whipped cream, but it is because I ruined it by trying to hide her medicine in it once. And she never forgets. Whipped cream will be ruined for her forever. What a shame.

I can also make a batch of batter, which makes about 6 crepes, and use 1/2 at one meal and save the rest for another meal. That helps with the meal-time-crunch on some days.

I have had some problems with getting them to turn out right. It’s the flipping. Tonight I got it right, so here’s my procedure: I use my small frying pan and melt plenty of butter (1/2 T) over medium. Just when the butter gets bubbly, I make sure that it is coating the pan and pour 1/4 cup of batter all around and turn to coat the pan with batter. Maybe it helps if the batter is cold to start–I haven’t experimented on that point much. The batter and butter will co-mingle (good for those ketones). When the crepe is getting quite dry on top, loosen all around the edges. If it’s working, it should be able to move freely in the pan. Then flip and cook to brown on the other side. Right after flipping, put in the fillings to melt cheese and warm everything up. Roll immediately; they will begin to break if you try to roll them when cool. Or just fold in half or serve as a pancake.

And note that these are also gluten free! Coconut meal makes them taste sweetish and contains a lot of fiber. For anyone who wants to try a lower-fat version, use milk instead of heavy cream.

Nutrition facts for Keto Crepes. 1 serving = 1/4 cup of batter. Analysis from caloriecount.com

Keto-Crepes
Makes 1.5 cups of batter = 6 servings of 1/4 c batter each
4 eggs
1/4 tsp pure vanilla extract
pinch nutmeg
1/4 C heavy cream
1/4 C water
1/4 C Coconut Flour (Bob’s Red Mill)
1/2 Tbsp butter

See procedure below.

Keto Crepes under the gram recipe, updated 2/24/2014.

In grams, makes 7 servings, 49.4 g each:

28 g Organic Coconut Flour
200 g eggs
0.5 g pure vanilla extract
0.1 g nutmeg
60 g Heavy Whipping Cream
50 g water
7 g Butter

Whisk eggs, vanilla, nutmeg and cream. Sift and stir in coconut meal. Let stand 5-10 minutes for coconut meal to absorb the liquid. Thin with water to your desired consistency.
Heat frying pan to medium and melt butter. Pour 1/4 C batter into hot pan, spreading to desired thin and cover bottom of pan.
Cook until top is drying, flip and fill with ham and cheese, etc.
Remove from pan and roll or fold over.

October 2014 Note: This is one of my first attempts to make a cookie recipe for my child on the ketogenic diet. It was better than I expected, but certainly not the same as a non-keto cookie. Coconut meal, in particular, has a very different texture than flour and some people don’t like it. Because this blog is also something of a record of our lessons learned and progress, I choose to keep it here even though it was not a perfect replica of a non-keto peanut butter cookie. You could also try the linked recipe, which was the original inspiration. The recipes developed more recently have been much more successful, so I recommend going to the 2013 or 2014 recipes that have been tried and true. 

One word on Netiquette: Remember that when you are commenting on a blog, you are communicating with a real person and you should be respectful and aware of the impact of your words. Several comments on this post were not approved because they were rude or disrespectful. In all communications, be kind and thoughtful; write and speak in a way that you would like to be addressed. I’m a mom, not a professional cook. I’m doing my best.

Mmmm, cookies. What else is there to say?

I guess I should say that these also contain 4.5 g of coconut oil, the prime MCT oil. Nora gets 5 g of coconut oil, 3 times per day. What a nice way to get it.

The cookies also have 1 gram of fiber each. Coconut meal has very low net carbs because of all of the fiber.

I have tried a few peanut butter cookie recipes. My recipes have improved by modifying the recipes from this great low-carb baker blog. She has many amazing recipes, some of which will not work for Nora because they still have too many carbs, but if you are doing low-carb or gluten-free baking, I would highly recommend her recipes.

http://tmstrevival.wordpress.com/ [link updated on 11/26/2013]

Peanut Butter Coconut Cookies

Nutrition Information for Peanut Butter Coconut Cookies from caloriecount.com

½ cup Adams Natural Peanut Butter
¼ cup butter
2 eggs
2/3 cup coconut oil
1/2 tsp pure vanilla extract
½ tsp baking soda
¼ tsp sea salt
1/2 c Coconut Flour (Bob’s Red Mill)

Cream together PB, butter, eggs, coconut oil and vanilla.
Mix with flour, baking soda and salt.
Form balls of 1 tablespoon and press with fork on to baking sheet (makes 32 cookies).
Bake 11 minutes at 350.

Nora says "yum!" to baked eggs.

Nora has enjoyed baked eggs on 2 occasions, which qualifies for a recipe post.

I’ve seen lots of baked eggs recipes–and they don’t even need to be modified for Nora! I make 3 portions at a time for the boys too (I can’t eat eggs, so I’m the one with the alternative meal on these nights). Next time I will crack 2 eggs into Ted’s cup for a larger portion. You could also throw in a bit of veggies, salmon, or vary the cheese option to your taste, although within the acceptable ranges for someone on the keto diet. Also be aware of the egg size that you are using. The nutrition facts here assume a large egg.

Nutrition analysis for baked eggs from caloriecount.com

Baked Eggs
1 egg
1 Tbsp heavy cream
7 g grated cheddar cheese
pinch of thyme

Lightly grease a small ovenproof ceramic dish or ramekin with butter. Pour in 1/2 Tbsp of cream, sprinkle in 1/2 of the cheddar cheese and a dash of thyme. Crack the egg into the dish, and top with the remaining 1/2 T heavy cream, cheese, and sprinkle again with thyme and salt or pepper to taste.

While preparing the egg cups, boil a teapot of water and preheat the oven to 375º F. In a large heatproof pan (I use my glass cake pan), put in the egg cups and place in the oven. Then pour the water from the teapot into the large pan, surrounding the egg cups (I don’t like to risk sloshing or dropping a heavy pan full of hot water). Bake for 10-14 minutes, depending on how firm you like your egg yolks. When finished, I take the ramekins out with a big tongs first and cool a bit, then take the pan of hot water out of the oven later. Safety first!

For dinner, Nora had her baked egg, an 1/8 of her high-protein, high-fiber tortilla with 2 tsp of double cream cheese mixed with 1 tsp of ground flax and a sprinkle of cinnamon, and 21 g of red pepper.

The Brekkens have now found another veggie option. Ted’s words. We will not get any more excited than that, because it is still kale.

But it is kale that we are now happy to eat. Yesterday when I was weighing a piece of kale for Nora, Ted later admitted that he thought (but did not say):  “8 grams of kale, 10 grams of yuck.” I do take the blame for ruining kale, because I probably never cooked it right. After he tasted this recipe, he admitted that this is an acceptable way to make kale. And both kids liked it too! We could eat 1 bunch of kale at one meal with this recipe.

Kale isn’t a superstar for Nora’s diet, but it is full of wonderful veggie goodness so it’s nice to fit it in. It is very similar to the seaweed snacks that she likes, and made at home.

Find the recipe here, to give a well-deserved nod to the original post: http://www.weeatreal.com/2009/11/roasted-kale-chips.html

To measure it for Nora, I weighed 1 piece of raw kale (which came in at 6 g) and used the nutrition breakdown for that, which was 0.5 carbs (0.1 fiber), 0.2 protein, 0 fat (although the olive oil adds a bit of fat). Because it is baked in this recipe, it becomes like thin paper and the only thing that it loses is water, so the nutrition information from the raw kale should be the same as the baked kale. Please correct me if that is a mistaken assumption.

We work so hard on getting the right balance of food into Nora in a palate- and socially-pleasing way, but we don’t always succeed. There are so many details to consider, and sometimes things are still just not right.

On Valentine’s Day, our family was invited to celebrate the 7th birthday of our great friend, Mackenzie. I knew in advance that they would be serving pizza and cheesecake, so I planned to bring everything I needed for Nora to eat pizza too. I also made some mini-pumpkin cheesecakes, which are ever so yummy.

However, the planning did not start with just the dinner and dessert foods, it started that morning when I made Nora’s breakfast and lunch. I was careful to not give her too many carbs in the morning, considering that the pizza and cheesecake would be a fairly carby dinner. When it came time to pack for the party, I realized she had already blown through her protein requirements for the day–she had been really hungry that afternoon and I deftly avoided carbs! So no meat on the pizza, and I actually had to cut the pizza portion in half to take out some protein. For every extra gram of protein, I had to find 3 grams of fat to feed her, and that just wasn’t going to happen. In addition, the keto-diet is also calorie controlled, as too many calories can interfere with ketosis. Things got complicated, but I kept 1 mini-cheesecake in the plan at all costs.

There was no fuss about the dinner, but the cake was a different story. Michael is a fabulous cook, so his cheesecake is divine and it was topped with mounds of blueberries. Nora couldn’t take the sight of it, even with her yummy mini-pumpkin cheesecake before her. She is only 3, and sees that she is getting something that is qualitatively different from everyone else. She cried, she whined, she pleaded for a taste of the “real” cake. She would not taste her own cheesecake. I carried her around and told her that I know it’s hard and talked to her about why she is on a special diet. She calmed down, but it’s just so hard to see others eating something so beautiful that you can’t have.

Mama learned a lesson from this. I need to get more details. I could have given her a few blueberries on top of her cheesecake, had I known in advance and planned for it. By the time she got her cheesecake, she had eaten all of her carbs for the day. I had nothing left to give her. I had actually considered making her cheesecake in a pan and cutting wedges instead of doing a mini-cupcake, but I was afraid that the sliver she would get would look even more pathetic than a mini-cupcake. But the blueberries could have fixed it.

Maybe. Or maybe not. Nora also cried when Mackenzie opened presents, because she wanted to get presents too, especially cool dress-up girl sticker books. Nora is 3, and it comes with the territory.

When she finally tried a bite of her cheesecake, she declared it “yummy!” and ate the whole thing. But I have to remember that the emotional impact of the food is in the appearance, and that just as important as the taste and nutritional profile.

“Yummy” Mini-Pumpkin Cheesecakes (without tears)

Mini-Pumpkin Cheesecake Muffins. Nutritional analysis from www.caloriecount.com

6 oz Plain cream cheese
2 Tbsp Traditional Plain Greek Yogurt
2 Tbsp English Double Devon Cream
1/4 cup pumpkin puree
1/4 tsp cinnamon
1/8 tsp nutmeg
1 egg (room temperature)
1/2 tsp pure vanilla extract

Preheat oven 300F.

Beat cream cheese with mixer until smooth.
Add yogurt and double cream, beat until combined. Scrap down bowl.
With mixer running add cinnamon & nutmeg.
Add egg and vanilla. Mix till smooth. Scrap down bowl again making sure mixture has no lumps.
Last add pumpkin puree and mix until combined.

Divide evenly into 24 lined mini-muffin cups. Bake for about 15 minutes. When done, crack open oven door and let cheesecake cool in oven.