A ketogenic diet is a special high fat, low-carbohydrate diet used to treat certain types of epilepsy. Sometimes called the epilepsy diet, a ketogenic diet provides the recommended dietary allowance for protein, and causes the body to continually produce ketones. Ketone production causes a state called ketosis, which decreases seizures in some children.
Children who are candidates for the diet can eat normally, use feeding tubes, or use a combination of both methods to take in nutrition. The diet requires a carefully controlled start (induction), strict adherence to the diet, and regular follow-up care by trained professionals.
Who Benefits From a Ketogenic Diet?
Children whose seizures don’t respond to antiepileptic medicines are candidates for the ketogenic diet. The diet is often most helpful for children who have atonic, tonic, myoclonic and generalized seizures.
Children who have seizures that are related to specific syndromes—such as those listed below—often respond well to the diet.
- Glucose transporter type 1 deficiency syndrome.
- Pyruvate dehydrogenase deficiency.
- Myoclonic epilepsies:
- Myoclonic-astatic epilepsy (Doose syndrome).
- Severe myoclonic epilepsy of infancy (Dravet syndrome).
- Tuberous sclerosis complex.
- Rett syndrome.
- Infantile spasm.
- Certain mitochondrial disorders:
- Phosphofructokinase deficiency.
- Glycogenosis type V.
- Mitochondrial respiratory chain complex disorders.
- Landau-Kleffner syndrome.
- Subacute sclerosing panencephalitis.
Other types of conditions can improve on the diet as well.
What to Expect with a Ketogenic Diet
Starting a Ketogenic Diet
Your child will begin the ketogenic diet at the hospital, where blood sugar levels, vital signs and ketones can be closely monitored. We also perform routine baseline tests, such as:
- Renal ultrasound.
- Electrocardiogram.
- Other exams as needed.
We use a ratio to describe the ketogenic diet’s macronutrient (fat, carbohydrate and protein) requirements. For most children, the ratio falls between 3:1 and 4:1. The ratio shows that on a ketogenic diet meal plan, your child should take in three to four times as many calories from fat as from protein and carbohydrates.
Life on a Ketogenic Diet
After your child starts the diet, follow-up visits typically happen every three months.
In addition to following the diet’s nutrition requirements and eating approved ketogenic diet foods, you or your child must monitor the ingredients in medicines and nonprescription products (such as vitamins and dietary supplements). Other factors that can affect the diet include:
- Intravenous fluids that contain dextroses.
- Tooth swabs, syrups or suspensions.
- Toothpaste, deodorant, sunscreen and other topical lotions.
At Gillette, we take all these items into consideration along with carbohydrates when planning your child’s diet.
Ketogenic Diet Side Effects
Side effects of the ketogenic diet can include:
- Constipation.
- Low blood sugar (also known as hypoglycemia).
- Poor or delayed growth.
- Renal stones.
To avoid some side effects, children on the ketogenic diet must take vitamin and mineral supplements as prescribed by their care team.
Going off a Ketogenic Diet
Children usually go off the ketogenic diet after two or three years of successful seizure control. The process happens gradually over six months. In rare cases, children must continue the diet or follow a modified version to maintain seizure control for more than two or three years.
How a Ketogenic Diet Helps
For many children, the ketogenic diet makes seizures less common, or stops them altogether. However, the diet only helps if followed very strictly and regulated by a health care professional.
Integrated Care
If your child experiences seizures, our highly trained experts can help you manage a ketogenic diet as a treatment for severe epilepsy. Our team has extensive experience identifying patients who might benefit from the diet. Gillette is a regional leader in pediatric neurology and neurosurgery, and our team includes specialists in pediatrics, nutrition and nursing.
Your child might receive care from specialists in the following disciplines:
- Neurology.
- Nursing.
- Nutrition and feeding.
- Specialty pediatrics.
Whether your child uses a ketogenic diet or other treatments for seizures, we provide support and education in a family-centered environment. You’ll work closely with our internationally recognized experts to develop a customized treatment plan to fit your child’s needs.
What Is a Low Glycemic Index Diet?
A low glycemic index diet (GI diet) is a low-carbohydrate diet used to treat children who have epilepsy. The treatment was developed in 2002 as a less strict alternative to the ketogenic diet.
A low glycemic diet measures a food item by how much it raises a child’s blood glucose level. That measurement is called its glycemic index. The GI diet favors foods that have only a small effect on blood glucose levels. Such low glycemic index foods include meats, cheeses, and vegetables.
Children who follow a GI diet may safely eat certain carbohydrates that have a low glycemic index. However, they should pair carbohydrates with fats and proteins. For example, eating a piece of whole-wheat toast (high in carbohydrates) along with peanut butter (high in fat and protein) can further lower the glycemic index of the snack.
Who Benefits From a Low Glycemic Index Diet?
Children who have limited success with antiepileptic drugs might be candidates for the GI diet. Additionally, kids who have safely reduced their seizures on the ketogenic diet for two to three years might be able to move to the less strict low glycemic index diet.
What to Expect With a Low Glycemic Index Diet
Before beginning a GI diet, it’s important for your child to have a thorough physical evaluation to determine if they’re a good fit for the diet.
If your child starts following a low glycemic diet, follow-up visits usually happen every six to 12 months to check nutritional balance and seizure control.
How a Low Glycemic Index Diet Helps
Kids who maintain good seizure control on a GI diet will have more flexibility than those following the ketogenic diet. Benefits of the low glycemic diet include:
- Flexibility: The GI diet allows a wider variety of foods than the ketogenic diet. Portion sizes can be approximated, as opposed to carefully weighed and measured.
- Convenience: Families can easily work the diet into their mealtime routines.
- Lifelong value: The diet works well for lifelong nutrition.
Integrated Care
At Gillette Children’s Specialty Healthcare, your family works with pediatric neurologists and pediatric dietitians to fully understand the diet’s requirements.
If your child experiences seizures, our internationally recognized experts can help you manage the GI diet as a treatment for epilepsy. Gillette is a regional leader in pediatric neurology and neurosurgery, and our team includes specialists in pediatrics, nutrition and nursing. Our low glycemic index diet experts will safely start your child on the diet, and monitor its effects over time.
