What Is a Ketogenic Diet?

If medicine doesn't control seizures in epilepsy, sometimes doctors prescribe a ketogenic (or keto) diet. A ketogenic diet is a strict high-fat, low-carbohydrate diet that can reduce, and sometimes stop, seizures.

It's called "ketogenic" because it makes ketones in the body. Ketones are made when the body uses fat for energy. By replacing carbs with fat in the diet, the body burns more fat and makes more ketones.

The ketogenic diet is prescribed by a doctor. Kids on the diet need to be followed closely by a dietitian to make sure they follow the diet and get the nutrients they need. The diet starts with fasting during an overnight hospital stay.

Who Needs a Ketogenic Diet?

Children with seizures that are not well-controlled by medicines (called intractable epilepsy) and severe epilepsy syndromes (such as infantile spasms or Lennox-Gastaut syndrome) might benefit from a ketogenic diet.

Studies show that the ketogenic diet also may help treat other conditions, such as diabetes, obesity, and even cancer.

How Does a Ketogenic Diet Work?

Although the ketogenic diet for epilepsy has been around since 1920, doctors aren't exactly sure how the higher ketone levels works. Some seizure types seem to respond better than others to the ketogenic diet.

In babies, the keto diet is given in formula. Young children may be fed by a tube that is place in the stomach by a surgeon. This helps the child stay on the diet.

How Long Do Kids Need a Ketogenic Diet?

You should know if a ketogenic diet works for your child within a few months. If it does, your doctor may recommend weaning your child off the diet after 2 years of seizure control. The weaning process is done over several months to avoid triggering seizures.

Some people stay on a ketogenic diet for years.

Are There Any Risks?

The ketogenic diet is a safe treatment for epilepsy in children. There are some possible side effects with long-term use, though, including:

• constipation
• kidney stones
• dehydration
• high cholesterol
• slowed growth
• weak bones

How Can Parents Help?

The ketogenic diet isn't a quick, easy fix. It can be very hard to stay on such a strict diet. To help your child:

• Keep foods they can't eat out of sight and not in easy reach.
• Get support from your doctor and dietitian.
• Be sure the whole family understands the diet and helps your child follow it.

Following the ketogenic diet requires regular follow-up with your doctor and dietitian. Be sure to go to all visits.

For many families, the hard work pays off with better seizure control and less medicine use.