Ketogenic Diet

The ketogenic diet is a very strict diet that helps stop or control seizures for some children with epilepsy. Everything — exactly what and how much a child can eat — must be closely watched and regulated. Even something as small as a few cookie crumbs or drops of toothpaste can stop the diet from working. The diet should be treated like serious medicine and must be closely supervised.

Because it is so difficult to follow, most doctors don't recommend trying the diet until a child has tried at least two epilepsy medications without success. It requires a team effort, with the family, doctors, a dietician and, when old enough, the child working together.

The diet forces a child's body to burn fat instead of glucose for energy. It does this by keeping calories low and using mainly foods that are high in fat. Doctors don't know why, but this helps to prevent seizures in some children. About one-third of children on the diet stop having seizures completely and another one-third show some improvement.

To start the diet, a child must fast — not eat anything — for 24 hours. This is usually done with supervision in a hospital. Then, the child must eat only what's allowed on the diet, with everything closely measured and weighed.

Children usually need to take some medicine with the diet, but often less than before. Eventually, some children can stop taking medicine completely. After about two years of doing well on the diet, doctors will usually suggest slowly allowing the child to try some regular foods and seeing if the seizures return.

While on the diet, children must be closely watched by doctors and their families to make sure they are getting enough nutrition and not having any side effects such as dehydration and constipation. If your child is in school, you should talk to the teacher and school nurse about the importance of making sure your child sticks to the diet. Find a sample letter you can send to the school in the article "Back to School on the Ketogenic Diet" in


Holidays can be difficult for children on the diet, as food is such a big part of many celebrations. Find ecipes for some treats that are allowed and easy to make at home in 


Read more about the ketogenic diet. 

Reviewed By: 
Joseph I. Sirven MD
Patty Obsorne Shafer RN, MN
Wednesday, March 19, 2014