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The Ketogenic Algorithmic Challenge: Rethinking Ratio Use in Clinical Practice and Research

Presented at the 9th Global Symposium on Ketogenic Therapies, September 2025.

This poster explores three connected questions arising from clinical practice and doctoral research.

1. What is the Ketogenic Algorithmic Challenge?

Understanding ketogenic ratios involves more than knowing what calculations to perform. It requires examining why we use them, how protein-to-carbohydrate relationships influence the result, and how to balance a patient's prescribed ratio while maintaining practical, acceptable meals.

2. How have ketogenic ratios evolved?

The poster examines the history of ketogenic ratio use, the distinction between ratios as labels and therapeutic targets, and how clinical approaches are evolving beyond traditional epilepsy treatment.

3. Do we need more consistent labelling?

A flexible, standardised approach to describing ketogenic diets could improve communication, comparison and interpretation across clinical practice and research, without prescribing a single treatment methodology.

In our clinical practice, this approach helps communicate ratios, macronutrients and portions clearly, supporting treatment initiation, adjustment, problem-solving and collaboration with neurologists.

Practitioners interested in these ideas are welcome to get in touch through our contact page.