Background

Treatment of epilepsy was generally ineffective in the early 1900's. In the 1920s, it was found that fasting could reduce the number of seizures but it was not clear why. Fortunately, anti-seizure medications were developed that helped the majority of people with epilepsy. As a result, dietary treatments lost popularity as a main treatment option for epilepsy.

The ketogenic diet is a high fat, low carbohydrate diet.. The classic diet is made up of 3 parts fat and 1 part carbohydrate and protein. There are variations of the diet, like one that uses medium chain triglycerides as a primary source of fat. You and your child's doctor and dietitian will make adjustments to your child's diet as needed.

How it Works

The diet mimics some effects of fasting on the body. Glucose (sugar) is the easiest source of energy for the body. Most of the glucose comes from carbohydrates that we eat. Once the glucose is burned off, the body uses fat as a source of energy. The use of fat creates a by-product called ketones. For reasons not completely understood, the ketones may reduce or eliminate seizures. Your body will also use body fat for fuel when you fast but fasting is clearly not a long term option.

Degree of Difficulty

Any dietary change is difficult. The range of food in this diet is somewhat limited, some find it easier than others to complete the process. To get the most benefit, it is important to follow the diet as closely as possible.

The transition to this diet will be monitored by a doctor. Your child will also be tested on a regular basis to look for side effects and maintain body function. If your child is not seeing a benefit your doctor may stop the diet and try alternative treatments.

Let's Eat!

What kinds of foods will your child be able to eat? Focus on what can be eaten, rather that what cannot be eaten. Keep in mind that the ketogenic diet is fat-based, so fatty foods rule the menu. You can be as creative as you want as long as you are mindful of what your child can eat. Here is a list of possible menu items:

• Eggs
• Meats (bacon, steak, hamburger)
• Full-fat dairy low in carbohydrates
• Full-fat condiments (mayonnaise, oil, butter)
• Vegetables low in carbohydrates
• Limited servings of fruit

Common Side Effects

• Constipation
• Irritibility
• Sleepiness
• Dehydration (make sure your child has adequate fluid intake)

Unusual, Rare, or Serious Side Effects

• Delayed growth due to nutritional deficiency
• Kidney stones
• Inflammation of the pancreas

Heart Disease

Heart disease as an adult is the biggest potentially harmful side effect of eating a high-fat diet. Cholesterol and triglycerides are fats in the blood. High levels can increase the risk of future heart disease. Although the diet leads to significant elevations of fatty substances in the blood, the diet has not been proven to be unsafe. For many, the benefit of reducing or eliminating seizures outweigh the potential of a possible harm developing later in life.