Ketogenic Diet

When a child’s epilepsy and seizures do not respond to medicines, consuming a ketogenic diet may help reduce the frequency of seizures. A ketogenic diet is a diet high in fats, supplies adequate protein and is very low in carbohydrates. The ketogenic diet requires precise measurement of foods and is only used under medical supervision.

Eating a high fat, low carbohydrate diet changes the way energy is used in the body. The liver turns the fat into fatty acids and ketone bodies, which are used as energy instead of carbohydrates. A higher level of ketone bodies in the blood can help with seizure control.

Types of seizures that respond well to a ketogenic diet include:

Uncontrolled seizures (seizures that do not respond to medicines)
Generalized seizures (these affect the whole brain or a large part of it and can affect consciousness)
Tonic seizures (the body and limbs stiffen during the seizure)
Absence seizures (sudden, short episodes of blanking out)
Infantile spasms (a form of generalized seizure that occurs in infancy)
Other seizure types and epilepsy syndromes may also respond to ketogenic dietary therapy. View the International Ketogenic Diet Study Group consensus report for a more comprehensive list of seizure types and epilepsy conditions that may benefit from treatment

More than half of all children who go on the ketogenic diet see a 50 percent reduction in the number of seizures. Between 10 and 15 percent of children become seizure-free.

Before starting a ketogenic diet, each family will meet with the ketogenic dietitian for adequate education, including your child’s feeding plan, recipe ideas, sick day guidelines, as well as other ketogenic diet related information.

The ketogenic diet is typically started at home in an outpatient setting after extensive education with the ketogenic dietitian(s). This approach allows families to begin gradually, introducing the diet step by step while helping minimize potential side effects.

A ketogenic diet can be challenging, as it requires strict compliance and patience. It can take up to three months to see improvement, although some patients report improvement beforehand.

Up to one month to learn how to weigh or prepare meals
One month to fine-tune the diet
One month to get used to the new way of eating

With any particular diet, close monitoring is required. Your child’s ketogenic diet will be individualized to his/her preferences, as well as appropriate nutrient needs.

The ketogenic therapy team at Riley Children’s Health will work closely with you and your child to help you follow this nutritional plan. Once the ketogenic diet is fine-tuned to your child's specific needs, he or she will meet with the ketogenic therapy team once every three to six months for monitoring and to make any needed adjustments.

What to Expect

If your child’s epilepsy does not respond to other treatments, his or her neurologist may refer you to the ketogenic therapy team. You and your child will meet with a neurologist and dietitians who will explain how the ketogenic diet works.

You can expect the following before your child starts a ketogenic diet:

You and your child will meet with the ketogenic therapy team to discuss your child’s medical and seizure history and to go over the ketogenic diet process.
The neurologist will order certain tests and lab work to ensure the ketogenic diet will be effective. These tests include blood tests and a urinalysis to ensure your child is healthy.

You can expect the following when your child begins a ketogenic diet:

Weekly check-ins with ketogenic dietitian
Lab monitoring and weight checks
Additional support including virtual support groups and holiday newsletters

You can expect the following in the months after your child begins a ketogenic diet:

Your child will attend regular follow-up visits with the ketogenic therapy team every three to six months.
The doctor will order labs in preparation for each follow-up visit to continue to monitor your child’s health.
Because the ketogenic diet does not supply all the nutrients growing children need, the doctor will prescribe/recommend certain vitamins, minerals and other necessary supplements.

Key Points to Remember

The ketogenic diet is used to reduce the seizure rate in children (and adults) whose seizures do not respond to medicines.
The ketogenic diet is a high fat, adequate-protein, very low carbohydrate diet.
More than half of children who use the ketogenic diet see a 50 percent reduction in their seizure rate; 10-15% become seizure-free.
There are different ways to follow a ketogenic diet, including Classic Ketogenic Diet, Modified Ketogenic Diet, Modified Atkins Diet, as well as Low-Glycemic Index Treatment (LGIT). Your child’s dietitian will help you navigate what is best for your child.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.