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Information on epilepsy: ketogenic diet |
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Up
to 70% of people with epilepsy could have their seizures controlled with
anti-epileptic drugs. For some children who continue to have seizures, the
ketogenic diet, alongside anti-epileptic medication, may help to reduce
the number or severity of seizures they have. For others it may completely
stop their seizures.
What is the ketogenic diet?The ketogenic diet is a high fat, low carbohydrate, low protein diet that has been used since the 1920s for the treatment of epilepsy. The word ketogenic means that chemicals called ketones are made in the body (keto = ketone, genic = producing). How does the ketogenic diet work?Usually the body uses glucose from carbohydrates for its energy source. Glucose is a type of sugar. Carbohydrates are found in foods like sugar, bread or pasta . In the ketogenic diet the body's energy source comes from using fats instead of glucose. Ketones are made when the body uses fat as its source of energy. This is called 'ketosis'. For some people with epilepsy, when their body makes ketones it helps prevent seizures from happening. During the diet the level of ketones that your child makes needs to be carefully measured to see if their body is getting energy from the fat they are eating. Who is the ketogenic diet suitable for?The ketogenic diet is only believed to help improve seizure control in children. It may not work for every child and it is not possible to predict who the diet will help. The diet is complex and can be difficult to follow so it is only considered when medication has been tried but isn't working. The diet must only be followed with the support of an experienced paediatrician (children's doctor) and dietician (food specialist). It can be adapted to all ethnic diets and is suitable for children who are allergic to dairy products. However when dairy foods are left out it can be more difficult to follow the ketogenic diet as it limits the food choice. What age range is the ketogenic diet suitable for?Usually the diet is suitable for children between 12 months and 16 years old. Although it can be used for younger babies in some specialist centres that offer more detailed monitoring. Does the ketogenic diet work?The diet has been shown to significantly reduce the number of seizures in some children who have epilepsy that is difficult to control. Not all children have better seizure control with the diet. However some may have other benefits, like a better day-to-day well being. Some children benefit from the ketogenic diet within a week while others show a slower response. Usually the diet is tried for three months to see how well it works. What sort of food is eaten on the ketogenic diet?There are two different types of the diet - the classical diet and the medium chain triglyceride (MCT) diet. The types of foods eaten are slightly different on the diets. At the moment it is not clear if one diet is more effective than the other. Classical
diet MCT
diet Is this a healthy way for my child to eat?To make sure the diet is nutritional, an experienced paediatric dietician (children's food specialist) works out exactly how much of which foods your child can eat each day. Because it is a strict programme the diet can be difficult to get used to and follow. To help with this, parents have individual recipes for their child. They are also given support on how to plan meals and guided on which foods should be avoided. How is my child's health monitored?You will be given a diary to record the number and type of seizures your child has while on the diet. The foods people eat can sometimes affect the way they feel or act. So you may be asked to note any changes in your child's mood, alertness and overall behaviour. Regular follow-ups with the dietician and paediatrician will monitor your child's growth, health, their epilepsy and if there is any need for a change in their medication. The diet does not provide all the vitamins and minerals found in a balanced diet, so the dietician may recommend vitamin and mineral supplements. If the diet is followed carefully, children do not usually become overweight or have an increased risk of heart disease. How is the diet monitored?One way to check if the fat eaten is being changed into energy is to measure the level of ketones in your child's urine. This is done using a urine analysis stick, which your child would wee on (similar to using a home pregnancy testing kit). Another way is using a blood ketone monitoring system, where a small pin prick on the finger is needed (similar to monitoring diabetes). You can decide with your child's doctor which to use. Are there any side effects?Reports from Great Ormond Street Hospital suggest there are generally few side effects from the ketogenic diet. The most common side effects seem to happen when first starting the diet . These can include feeling sick, having less energy and being constipated. The effects may get less with time and can sometimes be avoided with careful monitoring. How can my child start the diet?There are a very limited number of centres in the UK that offer the ketogenic diet. Parents who would like to look into the possibility of their child starting the diet can discuss this with their GP or paediatrician. The ketogenic diet is a very specialised way of treating epilepsy. Following the diet should only be done with the care, supervision and guidance of trained medical specialists. Further informationGreat
Ormond Street Hospital (GOSH) Matthew's
Friends (opens new window) - a charity giving support and information
about the ketogenic diet.
© The National Society for Epilepsy
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What age range is the diet suitable for? What sort of food is eaten on the diet? Is this a healthy way for my child to eat? How is my child's health monitored? How can my child start the diet?
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