The table is brimming with food at the Farooq household in the Petaling Jaya suburb of Kuala Lumpur, Malaysia. There is creamy spinach, broccoli, cauliflower rice, beef and chicken for Sunday lunch – and seated around the table are Norah Mohammed Khir, her mother Chan Yoke Yen, husband Mohammed Farooq and son Azran Farooq. The dishes Khir is serving are part of the ketogenic diet that all three generations have been following for several years to improve or reverse their individual medical issues, including diabetes , high blood pressure, anxiety attacks, mood swings and Alzheimer’s disease . The point of the keto diet is to reduce the intake of carbs drastically and replace it with fats which put the body into a metabolic state of ketosis, allowing it to burn fat for energy instead of carbs. On the keto diet, only 20 to 50 grams (0.7 to 1.8 ounces) of net carbs per day are allowed. Typical keto foods are meat, fish, cheese, full fat yogurt, healthy fats such as avocado oil and coconut oil, non-starchy vegetables, berries – but no fruit. Khir was diagnosed with type two diabetes in 2003 and was prescribed medication. Her blood sugar levels continued to creep up, and she developed “type one-and-a-half diabetes”, also called Latent Autoimmune Diabetes in Adults (Lada). “I tried to follow doctor’s orders like eating whole grain, fruit and vegetables, but whenever I had carbs, my blood sugar went very high and I would get the shakes and become tired and lethargic,” says Khir, a mathematics teacher. Her doctor told her that she was “expecting too much” and prescribed her more medicine. In 2016, she met another doctor at choir rehearsal who suggested that she cut the carbs and go keto. Keto for beginners: how it works, what you can and cannot eat Khir was sceptical at first, wondering how she, as a Malaysian, could live without rice, potatoes and delicious roti bread. “I decided to let my family help me decide whether keto would work out by cooking them a meal of roast duck with guacamole and non-starchy vegetables like aubergine, Brussels sprouts and okra,” she recalls. Since that meal, the Farooqs have embraced the keto lifestyle. According to Julie Mokhtar, a Kuala Lumpur-based certified ketogenic living coach, the keto diet can indeed be helpful in addressing conditions that are brought on by insulin resistance and/or chronic inflammation . “Insulin resistance is the onset of many health conditions we are facing today, including type two diabetes and polycystic ovary syndrome (PCOS),” says Mokhtar, adding that the limited carbohydrate intake on keto breaks the endless cycle of high-carb consumption and excessive insulin response. Before going keto, Khir’s now 27-year-old son weighed 98kg (216lbs). He suffered from ulcerative colitis, or inflammation of the colon, and was diagnosed with Asperger’s syndrome, an autism spectrum disorder. The result was regular anxiety attacks, anger fits, absence seizures and mood swings. “Azran would worry excessively about things and blow them up in his mind,” says Khir. But since going keto, her son is more mellow and has fewer mood swings. On top of the mental health benefits from the high-fat, low-carb diet, her son has lost 20kg and is also off his medication for colitis. Although it sometimes flares up if he eats the occasional gluten-rich treat, it will improve significantly when eating keto or fasting. He lost 20kg in two years: PE teacher’s keto diet tips “Since the keto diet promotes a whole-foods-based approach and limits intake of foods like sugar and industrialised vegetable oils which are known to be inflammatory, a significant improvement can be seen here,” says Mokhtar. Khir’s 61-year-old husband, the managing director of a business consulting firm, had his doubts when he started the keto diet. But being overweight with a family history of cardiovascular problems and having struggled with high blood pressure most of his adult life, he was more than ready to give it a try. “I used to believe that there was very little I could do about my poor health and that as a consequence of growing old, I would acquire more and more chronic diseases – how wrong was I,” he says. Farooq’s blood pressure has gone down significantly since going keto and as an added bonus, he has lost nearly 30kg. “I am grateful to Norah for bringing this concept into our lives, for me and especially for the huge impact on Azran’s health and well-being,” he says. Farooq quickly learned from his wife that there is much more to keto than just meat, cheese and avocado. Some of his favourite dishes are creamy salmon soup, spinach pie, braised aubergine and blueberry muffins. Although he frequently faces temptation and finds it difficult to refuse carbs at family and friends’ homes because social norms require people to be polite, Farooq knows how to whizz back into ketosis: by fasting. ‘It isn’t a diet, it’s a lifestyle’: the benefits of intermittent fasting “I often eat only one meal a day [OMAD – often combined with the keto diet] or I fast for at least 16 hours a day, and I can say that today I am the healthiest I have ever been in my entire life,” he says. According to Mokhtar, initial scepticism about going keto is normal and it is the high-fat part of the keto diet that gets the most eyebrow raises. “Unfortunately, we’ve been led to believe that fat is unhealthy and fattening when in fact … it’s especially important for hormonal health, with fat, protein and cholesterol forming the building blocks of hormones,” she says. Khir’s now 84-year-old mother, who suffers from Alzheimer’s disease, moved in with the family in 2018, and became paranoid and tried to run away. While Alzheimer’s disease is not curable, Khir believes that she has been able to slow her mother’s decline by having her follow the keto diet. “My mother will typically eat eggs, chicken and stock with added whey protein and she enjoys the keto cakes – like the chayote ‘apple’ pie – my son makes her,” says Khir, who believes that the high-protein diet has helped her mother maintain some muscle mass as well. Although some see the keto diet as being notoriously hard to stick to, the Farooq family do not feel deprived of anything and they believe that following a diet that is composed of “real foods” is a joy rather than a sacrifice. Dad tests keto diet, then puts epileptic son on it – seizures stop “The key to making our keto life a success is to look at what we can eat rather than what we can’t – and the list is very long,” says Khir, who plans to make roast duck, steamed fish, mixed vegetables and a keto dessert for the upcoming Lunar New Year. Five years into their lifestyle, what started out as a family project for the Farooqs has led to weight loss, a higher quality of life and lasting health improvements. As for Khir, she now takes only metformin, a medicine to treat type two diabetes, and low-dose insulin. Her interest in keto inspired her to enrol in a nutrition course with the Noakes Foundation in South Africa. “Thanks to my training and my own experience, I can now counsel people on reversing diabetes and obesity,” she says. Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .