The John Radcliffe diet
This is a variation of the MCT diet, but is easier to manage practically. The calculation is based on the daily energy intake required for the child, with 30% energy being provided from MCT and 30% from other fat which may be of vegetable or animal origin.
Calculation of daily amounts
Energy intake for the day should be apportioned as follows:
30:30: 11:19: 10 - MCT oil: double cream: fat from foods: carbohydrate: protein
Construction of the diet
Skimmed milk is used as the medium for incorporating MCT oil or Liquigen into the diet and an allowance for this is made before calculating the rest of the diet
The amount of double cream required is calculated; 10ml double cream can be exchanged for 5g other fat (e.g. butter).
Fat used in cooking is not included in the calculations provided the energy intake is not excessive.
Protein foods are counted using 6g protein exchanges (see Table 3); 6g fat is assigned to each 30g meat (1 protein exchange).
Carbohydrate foods are counted using a 10g exchange system (Table 3), avoiding high sugar foods or those with a significant protein content.
If the total number of protein and/or carbohydrate exchanges are not consumed this is acceptable, provided the estimated protein requirement is met and weight loss does not occur.
A combined protein and carbohydrate exchange can be calculated for foods that are not on the exchange list, allowing greater flexibility.
Table 5 Example calculation of John Radcliffe diet,
based on a desired intake of 1500kcal
|25g skimmed milk powder||0..3||9.1||13.2|
|100ml double cream||48.0||1.5||2.0|
|4 protein exchanges||24.0||24.0||0.0|
|5 carbohydrate exchanges||Trace||Trace||50.0|
|MCT oil||= 450kcal||= 50ml MCT oil|
|MCT oil||= 50ml x 8.3 (1g MCT =8.3kcal)||= 450kcal||= 30%|
|Fat from double cream||= 48.0 9 x 9 (1g fat = 9kcal)||= 433.8||= 29%|
|Saturated fat||= 24.3g x 9(1g fat =9kcal)||= 218.7kcal||= 14.5%|
|Protein||= 34.6g x 4 (1g protein =4kcal)||138.4kcal||=9.2%|
|Carbohydrate||= 65.2 9 x 4 (1g CHO = 4 kcal)||= 260..8/151.7kcal||= 17.3%|
|Total daily intake in 24 hours from calculation|
|4 protein exchanges|
|5 carbohydrate exchanges|
|25g skimmed milk powder plus water to 250ml|
|100ml double cream|
|50ml double cream and|
|25g other fat (e.g. butter, margarine)|
continue to The Great
Ormond Street Diet
return to UK ketogenic diet protocols
return to MCT oil