May 28, 2024
ketocal, other-than-epilepsy

Is Ketocal safe for everyone on a keto diet?

Is Ketocal safe for anyone on the keto diet?

Not really. Most doctors prescribe the product for children suffering from diseases such as epilepsy and diabetes. There has been some success in using it for treating Alzheimer’s Disease. However, manufacturers of the product say that recent advances in the formula mean adults can occasionally use it. But they should still consult with a physician first.

The ketogenic diet is typically viewed by neurologists and parents as solely containing heavy cream, mayo, and margarine. With perhaps some kinds of heavier neutral edible oil. Or a heavy dipping sauce if the child tolerates it well. They are true for the majority of the children undergoing this therapy. These meals make up a significant amount of the child’s normal intake in order to build a solid food diet in which 90% of the calories are fat.

However, both newborns and kids with gastrostomy tubes can very readily be given the ketogenic diet in a liquid-only formulation. While many ketogenic diet professionals have been using these formulations for years with favorable outcomes. This may come as a surprise to some parents. If the child will accept a Keto BLT salad, they can try that as well.

What do these equations mean?

The ketogenic diet can be formulated in a variety of ways. Utilizing Nutricia KetoCalTM, which comes in a powdered mix with a 3:1 or 4:1 ratio, is maybe the simplest option. A dietician calculates the calories, and then water is added. The 3:1 KetoCal is unflavored, while the 4:1 KetoCal has a faint vanilla flavor. These milk-based formulas are full of nutrients, and contain corn syrup solids.

Ketogenic Diet

“Modular” ketogenic diets can benefit kids utilizing Ross Carbohydrate FreeTM (Abbott Nutrition), MicrolipidTM (Nestle Nutrition), and PolycoseTM for kids. Whose distinct components (such as fat, carbohydrate, and protein) are wanted or who has lactose intolerance (Abbott Nutrition).

KetoniaTM is a drug that has been investigated and is currently being used in South Korea specifically to treat infantile spasms.

It is now possible to buy Ketonia IITM, a redesigned formulation that does not contain MCT oil.

Several companies have also created a powdered medium chain triglyceride powder (forty grams) that is intended to give adults with Alzheimer’s disease oral ketones.

It is called AxonaTM, is clinically available, and contains both milk and soy protein.

How well do they function in a keto environment?

Intriguingly, two small trials suggest that ketogenic diet formulas may be more effective than a solid food ketogenic diet in treating children with epilepsy. Our team at Johns Hopkins chose to study and noted sixty-one kids on an all-liquid keto diet (27 percent of all kids initiated on the ketogenic diet at Johns Hopkins over a 6-year period). The study is public in Epilepsia in 2004. Surprisingly, 59% of these kids experienced a reduction in their seizure frequency of >90%. Which is approximately double the typical response for kids who are generally getting the ketogenic diet. Similar findings were published in Pediatric Neurology by Dr. Hosain and his Cornell University Medical Center colleagues in New York a year later.

After a year on a ketogenic diet consisting entirely of formula, six (or 50%) of the 12 children experienced a >90% reduction in seizure frequency.

Why do kids on a ketogenic diet consisting just of liquids fare so well?

The solution is obscure. With ketosis guaranteed and cheating virtually impossible, faultless compliance may have contributed to the success in part. The cause of the increased seizure control. However, is probably more complex than that and may have to do with the fatty acid makeup of these formulas or other elements. 

Any further benefits of ketocal?

There are some other possible advantages of liquid ketogenic diets, aside from improvements for seizure control and compliance. There is no requirement for supplementary multivitamin and calcium supplements because KetoCalTM is nutritionally balanced. On solid food ketogenic diets, thoughtful people add extra supplements of selenium, carnitine, and zinc. Additionally, we have heard anecdotally that the liquid versions cause less constipation. And last, kids on all-liquid ketogenic diets seem to have considerably lower rates of having high total cholesterol.

According to one study, if a child was solely receiving ketogenic diet formula, there was a 1/3 chance that their total cholesterol would rise above 200 mg/dL. Solely 17% of kids who only consumed ketogenic formulas had high total cholesterol when following the ketogenic diet.

Why is it the case that way? It becomes abundantly evident when you contrast the cholesterol readings of formula and a regular solid-food ketogenic diet.

Average keto cholesterol

Average cholesterol and fat levels on three different ketogenic diets in a single day (4:1 ratio and 1000 calories).

Reproduced with permission from Nizamuddin et al.

Modular formula* Solid food diet** Nutricia KetoCalTM Cholesterol (milligrams)


0*** 0***

overall fat (grams)

104 100 100

Unhealthy Fat (grams)

63 20 23

Saturated fat percentage of daily calories from fat




Poultry, tuna, hen fruit, oil, heavy cream, and plants are in this example of a 1000-calorie diet. ** MicrolipidTM (Nestle Nutrition), Ross Carbohydrate FreeTM (Abbott Nutrition), and PolycoseTM (Abbott Nutrition) are used in combination to create a 4:1 ratio. 

*** Both products contain 0.01 mg of cholesterol. 

Future of ketogenic food products

These formulae may have further uses in the future, despite being primarily utilized in 2009 for babies and kids with intractable epilepsy who have gastrostomy tubes. And are on the ketogenic diet.

Many keto institutions and ketocal

Many institutions are now conducting a study to see if the modified retro Atkins diet. Combined with additional KetoCalTM shakes (10 ounces per day) for the first month is more likely to lead to seizure control than the modified Atkins diet alone. This study uses the ketogenic diet in addition to solid foods rather than as the sole source of nutrition. In research and clinics, people other-than-epilepsy use ketogenic shakes (such as AxonaTM and KetoCalTM). Including ALS and Alzheimer’s disease. The August 2008 issue of KetoNews included information on the benefits of the ketogenic diet. For conditions other than epilepsy.

The bottom line is that if you are an adult on the keto diet, you should not use Ketocal unless you have an underlying condition. Diagnosed by a physician.