Ketogenic diet as a treatment for seizures

June 14, 2013 Jenny Schoenfeld, ARNP

The ketogenic diet is a high-fat, low-carbohydrate diet that has proven to be effective in the treatment of seizures. In fact, the ketogenic diet is one of the oldest and most effective treatments available for patients with seizures regardless of age, from infancy through adulthood. The ketogenic diet must only be started under direct medical supervision.

Here are some frequently asked questions about the ketogenic diet:

What is the ketogenic diet?
The ketogenic diet is a special high-fat diet that often includes heavy cream, butter and vegetable oils to provide the necessary fat. The diet eliminates carbohydrate rich foods such as bread, rice, cereals, pasta, cookies, and cakes.

How effective is the diet at controlling or eliminating seizures?
Studies that have followed children on the diet for long periods reveal that at least 2/3 of all children on the diet have a significant reduction in seizures by over half. 1/3 of children on the diet will have a greater than 90% reduction in seizures, with half of these children becoming seizure free.

How is the diet prepared?
A calorie level is determined by a dietitian for each child based on the individual’s age and activity level. The dietitian creates meal plans that provide the required amount of fat, protein and carbohydrate for each meal. Each meal plan indicates the exact gram weight of each food, which must be weighed on a gram scale. A typical meal includes a small amount of fruit or vegetable, a protein rich food, and a source of fat, such as heavy cream and butter or vegetable oil.

Will seizure medications be reduced after my child goes on the diet?
If the child’s seizures improve on the ketogenic diet, then seizures medication can be reduced slowly overtime. Some children are able to have all of their seizure medications completely discontinued on the diet. 

How long is the diet used for?
If the diet is helpful in reducing or eliminating seizures, then it is often continued for about 2 years. If the diet is not helpful, it will be stopped within a few months.

Will my child gain too much weight with this high fat diet?
The ketogenic diet is calculated at a specific calorie level that is unique for each child. Each child’s growth is followed very closely to determine if a change in calories is needed to ensure normal growth. 

Will the diet cause high cholesterol?
Most children do not develop high cholesterol levels while on the diet. Cholesterol levels will be checked prior to starting the diet, and on follow-up visits in order to closely monitor for changes.

Are there other diets that can help reduce seizures?
The Modified Atkins Diet is a similar low-carbohydrate, high-fat diet that is less restrictive than the traditional ketogenic diet. The Modified Atkins Diet has also shown to help decrease seizures.

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For more information about dietary treatments for epilepsy, call the Swedish Pediatric Neuroscience Center at 206-215-1440.  For additional information on the ketogenic diet, click here.

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