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The ketogenic diet — again.

The ketogenic diet originated in the early 1920s when it was found that children with seizure disorders (also called epilepsy) improved considerably when their diet consisted mostly of fats and almost no carbohydrates. The kids also drove their parents nuts because of their intense craving for carbohydrates.

The Atkins low-carbohydrate diet is not as severe and it often works to help you to lose weight. Any diet that sharply limits refined grains and sugar is likely to result in weight loss. The downside is that Atkins dieters have a hard time limiting their carbs so drastically that they manage to go into ketosis – deriving most of their energy from fat in their diet and their own body fat. In addition to offensive breath odor, those who do adhere to the diet are often constipated and irritable – the latter effect making their family members unhappy.

The present-day ketogenic diet consists of only 2-5 percent carbohydrates and 70-90 percent fats. The rest is protein. It should not be confused with the Paleo Diet, which eliminates all cereal grains and dairy products but includes plenty of fruits and vegetables. The Paleo Diet provides plenty of plant-based vitamins and antioxidants but the ketogenic diet does not. A poorly-designed ketogenic diet can lead to complications such as fatigue, kidney stones and gout. A rare event in children who have been placed on the diet for seizures is cardiac arrest.

How about a compromise: the Mediterranean Diet that we described in the last blog. It has plenty of fat in the form of healthy olive oil but almost no saturated fat. More than half of its calories come from fruits and vegetables; dairy is in the form of cheese but only a little, mostly as a garnish; protein comes from fish and poultry – and an occasional meatball or two with a little pasta. This diet is documented to be heart-healthy, especially if you include a glass of red wine every day! No bad breath, no constipation and everybody is happy!

Lifestyle

      It’s not a problem for most people but the subject comes up from time to time among my audiences and it’s one that I dealt with regularly during 35 years of pediatric practice: ear wax.

Some people have almost no ear wax; some persons have an abundance of it and it can be a problem. A physician whose view of the eardrum is obscured by wax can’t be sure if a child has an ear infection. We learn early in our training how to scoop it out but it’s not always easy. When it completely fills the ear canal it may impair hearing.

Your genes determine how much wax you form and what kind. It can be sticky and gooey or hard and crumbly, the latter being typical among Asians.

What NOT to do: never use Q-tips, bobby pins or anything else to blindly sweep the stuff out. I have seen punctured eardrums and dislocated ossicles (the tiny bones of the middle ear that are necessary to transmit sound) in persons who thought that a cotton swab can do no harm.

Over-the-counter drops to dissolve ear wax are a waste of money. There is a simple, inexpensive solution that I have never seen to fail: hydrogen peroxide. Simply place two drops in each ear canal once a day after showering or at bedtime. Let it drain out. About one week of daily treatment will break up the wax that will fall out while you sleep. I have had a couple of patients whose wax build-up was so long-standing that it took a full three weeks of daily hydrogen peroxide drops to eliminate all of it.

I hate to take business away from my physician colleagues but it’s not necessary to make regular trips to the doctor to flush it out. Your ears don’t need an enema – a few pennies worth of hydrogen peroxide (make sure it’s fresh) will do the job while you sleep.