The amount of dietary carbohydrate needed for optimal health in humans is unknown. In the few older studies of populations that consume low-carbohydrate and high-fat and high-protein diets for their lifetime (the Masai, Greenland natives, Inuits, and indigenous people of the South American Pampas), there were no apparent effects on health or longevity (67,68). The new dietary reference intake (DRI) for carbohydrates is set at 130 g/d for adults and children (69). This amount was based on the average minimum amount of glucose utilized by the brain. The average American eats two to three times this amount of carbohydrate daily.
The typical KD consists of 80-90% calories from fat, protein prescribed at recommended daily allowance (RDA, if possible), and the remaining calories as carbohydrates. The total carbohydrate content per day in the KD is often under 10 g (much more restrictive than the popular Atkins diet, which tries to keep the carbohydrate content under 40 g) (70). The KD treatment period is typically limited to 3 yr (2-yr treatment, 1-yr wean), but some patients have been treated for significantly longer periods (up to 10-20 yr). The long-term effects of the KD on children's overall health have not been studied well and will need further investigation (see Chapter 9, this volume).
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