A ketogenic diet is a special high-fat, low-carbohydrate, adequate-protein diet that mimics starvation. A ketogenic diet can help control epilepsy in some children, especially those that do not respond well to medication. Ketogenic diets also are used as a primary treatment for pyruvate dehydrogenase deficiency and GLUT-1 deficiency.
About the Ketogenic Diet for Children
In a ketogenic diet, your child’s body switches from using carbohydrates as its main energy source to using fat. This condition is called ketosis.
Although it is still unclear why it works, ketogenic diets can help 50-60 percent of epilepsy patients reduce the frequency of their seizures by about half. A small number of patients see their seizures almost entirely disappear when using a ketogenic diet.
We recommend this treatment only for children who have not responded well to at least two medications. Ketogenic diets seem to work best for children with certain types of seizure disorders, such as Lennox-Gastaut syndrome. You and your child will also work alongside our pediatric dietitian team to maintain a healthy diet.
Types of Ketogenic Diets
Although there are several types of ketogenic diets, at UVA we generally prescribe the classic ketogenic diet (CKD) or modified Atkins diet (MAD). Your child’s neurologist and dietitian can help choose which diet works best for your child, and you’ll work closely with the dietitian to balance your child’s nutritional needs based on age and activity level.
Classic Ketogenic Diet
The CKD is perhaps the most well-known anti-seizure diet, because it has been the most thoroughly studied.
- Generally provides 3-4 grams of fat for every 1 gram of carbohydrate and protein combined
- Requires that all food must be carefully prepared and weighed on a gram-based scale using specific recipes provided by your child's dietitian
- Requires patients to stay at the hospital when starting the diet so we can monitor for any side effects and provide education on following the diet
Modified Atkins Diet
Like the CKD, the MAD is also a low-carbohydrate, high-fat diet; however, the MAD allows for more protein and carbohydrate intake and requires less fat.
- Was created to offer a less restrictive treatment option than the CKD
- Restricts daily carbohydrate intake to 10-20 grams while emphasizing high-fat foods
- Can be started at home along with the guidance of a dietitian and neurologist
Life on the Ketogenic Diet
Your child’s neurologist and dietitian will discuss your child's medical history, perform an exam and review any imaging or other lab studies to help determine the correct diagnosis and treatment. We will also provide you with detailed education about the ketogenic diet for children.
Depending on which diet your child is prescribed, you may need to use a gram-based scale to measure foods to make sure the carbohydrate-to-fat ratio is correct. Some foods, such as fruits and vegetables, may only be allowed in small amounts. Other foods, such as bread, juice and desserts, may not be allowed at all. Your child's vitamin, mineral and electrolyte levels are regularly checked, and your child will receive vitamin and mineral supplements to prevent any deficiencies.
How the Ketogenic Diet Works
Diana Gulotta, a registered dietitian with UVA Neurology’s Ketogenic Diet Therapy Program, explains how a ketogenic diet works and why it helps stop seizures.