Ketogenic Diet

The ketogenic diet is a very strict diet used to help control some types of seizures. It is high in fat, adequate in protein and low in carbohydrates.

Your child’s doctor will help manage the diet, which:

• Contains three to four times more fat than carbohydrates and proteins.
• Makes the body burn fat for energy instead of glucose (sugar).
• Strictly limits calories.

What is my child able to eat on the ketogenic diet?

The ketogenic diet will provide adequate protein but will only allow a few carbohydrates. About 90% of your child’s calories will come from fat.

• Common foods on the diet include whipping cream, real butter, avocado and coconut oil.
• Your child will only be able to eat a few fruits and vegetables.
• Your child will not be able to eat any carbohydrate-rich foods, including:
  • Pasta
  • Bread
  • Rice
  • Potatoes
  • Crackers
  • Cookies
  • Candy
  • Soda
  • Juice

Other things to know include:

• Your child may need sugar-free calcium, vitamin and mineral supplements since the diet does not provide complete nutrition.
• All medications must be sugar-free.
• Personal care products, such as toothpaste, must be sugar-free.

Doctors do not know exactly how the diet helps control seizures, but we do know these things:

• The body’s main fuel is glucose. The body burns glucose to make energy and maintain a normal blood sugar level. The body only stores a 23-hour supply of glucose.
• After this, the glucose stored in the body is gone, and the body begins to burn fat for fuel. The body does not burn fat completely, but it breaks it down into ketones. Ketones in the brain may help control seizures.

When is the ketogenic diet used?

The diet is most often used in infants, children and teens with any type of seizure that is hard to control with medication or when medicines have not worked.

What are the possible side effects with this diet?

Some possible side effects include:

• Constipation
• Kidney stones
• Hypoglycemia (low blood sugar)
• Excess ketones
• Sleepiness

Talk with your child’s doctor if you have any questions or if any of these are a problem for your child.

How long will my child need to remain on the ketogenic diet?

This diet may help reduce the number or length of your child’s seizures. It must be supervised by his doctor and care team.

To begin the diet, your child may have to stay in the hospital for about three days. Once the diet begins, it is recommended to try it for three months. If the diet helps decrease seizures, your child will usually stay on it for about two or more years.

• During this time, your child will need regular lab tests and visits to his doctor.
• Coming off (weaning) seizure medications vary from child to child. It is not always possible.

If the diet is not helpful, your child will wean off the diet over time—not all at once.

• Talk with your child’s neurologist before stopping or changing the diet.
• Fat content in the ketogenic diet is slowly decreased, and carbohydrate intake is slowly increased.
• Your child will slowly return to a normal eating pattern.

To start a ketogenic diet, you should talk with your child’s neurologist and see if it is an option for your child. You will need a referral from your child’s neurologist in order to be seen in the Ketogenic Diet Clinic at Children’s Healthcare of Atlanta.

After your child is seen in the clinic, we will decide whether hospital admission is needed. If your child is admitted to the hospital, the following will occur:

The ketogenic diet team will:

• Decide on your child’s calorie needs based on his height, weight and activity level.
• Take a diet history, along with a list of foods your child prefers.

Your child’s doctor and the nursing staff will:

• Monitor your child.
• Create special meals to help get your child used to a high-fat diet and allow ketones to build.

Before your child can go home:

• He must eat three full meals without vomiting and have stable blood glucose and urine ketone levels.
• Your child’s nutritionist will teach you about weighing foods, planning meals and dealing with problems that may come up with the diet at home. The nutritionist can also help you review your child’s diet and set new limits as needed.

Having a child diagnosed with a neurological condition can be an emotional and overwhelming experience. At Children’s, our No. 1 priority is supporting you and your family. Whether treating a toddler with epilepsy or helping a teen through seizure disorders, we make it our mission to provide the best care—and the best experience—for every child. Family is a big part of your child’s well-being. Not only are you a vital member of your child’s healthcare team; you are a source of security and comfort.