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Epilepsy

A ketogenic diet is sometimes used to treat epilepsy in children who have seizures that are not helped by medicines. As a treatment for epilepsy in children, ketogenic eating plans have been well studied and used for many years. This type of diet is usually started in the hospital and carefully monitored by a healthcare team. It is usually tried for several months to see if it will lessen seizures.

Other conditions

Ketogenic eating plans have also been studied to help treat other conditions, including:

• Cancer
  
  
•  Type 2 diabetes
•  Alzheimer's disease
  
•  Parkinson's disease
  
• Autism
  
  
•  Multiple sclerosis

More studies need to be done to see how well this eating plan works for these and other conditions and what the long-term side effects might be.

What are the side effects of a ketogenic eating plan?

Side effects of a ketogenic diet may include:

•  Vitamin deficiencies
  
•  Loss of body fluids (dehydration)
  
•  Bad breath
  
• Nausea
  
  
• Hunger
  
  
•  Difficulty passing stool (constipation)
  
•  Problems with menstrual periods
  
•  Inflammation of the pancreas
  
•  Kidney stones or gall bladder stones
  
•  Bone fractures
  
•  High cholesterol

What are tips for following this plan?

Reading food labels

•  Look for foods that have a low glycemic index (GI) label.
  
•  Read food ingredient lists to check for any hidden or added sugar.
  
•  Check food labels for the number of grams of carbohydrates and protein. This ensures that you are eating the right amounts of these nutrients. This is important.

Cooking

•  Carefully measure or weigh foods.
  
•  Make desserts using ketogenic or low GI recipes.
  
•  Avoid cooking with sauces that contain added sugar, such as barbecue sauce or ketchup.

Meal planning

•  Aim for a daily meal and snack time schedule that you can follow consistently.
  
•  Every meal will include high-fat items such as avocado, cream, butter, or mayonnaise.

General information

•  Buy a gram scale to weigh foods. This is necessary to follow this diet correctly and accurately. Your dietitian will teach you how to use one for this diet.
  
•  Ask your healthcare provider what steps you can take to avoid side effects of this eating plan, such as constipation or kidney stones.
  
•  Take vitamin and mineral supplements only as told by a healthcare provider or dietitian.
  
•  Work with your dietitian and healthcare provider to handle the key challenges of this diet and to help you stay on track.

What foods should I eat?

Fruits

Fresh pineapple, peaches, and apples. Other fresh and frozen fruits in small amounts.

Vegetables

Lettuce. Beets. Bok choy. Eggplant. Tomatoes. Turnips. Cucumbers. Peppers. Radishes. Cauliflower. Zucchini. Fennel. Swiss chard.

Grains

Whole wheat bread. Bran cereal. Brown rice. Whole wheat pasta. Low GI cereals.

Meats and other proteins

Meat, poultry, and fish. Eggs. Egg substitutes. Nuts, seeds, lentils, and split peas in small amounts. Bacon.

Dairy

Cheese in moderate amounts.

Beverages

Plain water. Sugar-free, caffeine-free beverages. Mineral water or club soda. Caffeine-free, carbohydrate-free herbal tea.

Fats and oils

Avocado. Cream. Sour cream. Cream cheese. Butter. Plant-based oils, such as olive, canola, and sunflower. Margarine. Mayonnaise.

Sweets and desserts

Any homemade sweets or desserts made using ketogenic diet recipes.

The items listed above may not be a complete list of recommended foods and beverages. Contact a dietitian for more information.

What foods should I avoid?

Fruits

Fruit juice. Fruits packed in syrups. Dried or candied fruits.

Vegetables

Corn. Potatoes. Peas.

Grains

All bread, dry cereals, and cooked cereals with added sugar. Baked goods. Crackers and pretzels.

Meats and other proteins

Meat, poultry, or fish prepared with flour or breading. Nut butters with added sugar. Beans.

Dairy

Milk. Yogurt.

Fats and oils

Salad dressings with added sugar. Gravies.

Beverages

Sugar-sweetened teas, coffee drinks, or soft drinks. Juice. Sports drinks.

Sweets and desserts

All sweets and desserts, unless the dessert is homemade using ketogenic diet recipes.

The items listed above may not be a complete list of foods and beverages to avoid. Contact a dietitian for more information.

Summary

•  A ketogenic eating plan is a diet that is very low in carbohydrates, moderately low in protein, and very high in fat.
  
•  Aim for a daily meal and snack time schedule that you can follow consistently.
  
•  Buy a gram scale to weigh foods. This is necessary to follow this diet correctly and accurately. Your dietitian will teach you how to use one for this diet.
  
•  Work closely with your healthcare provider and a dietitian while you are following a ketogenic eating plan.
  

This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your healthcare provider.

References:

Al-Khalifa A., Mathew T.C., Al-Zaid N.S., Mathew E., Dashti H.M.: Therapeutic role of low-carbohydrate ketogenic diet in diabetes. Nutrition 2009; 25: pp. 1177-1185.

Bough K.J., Rho J.M.: Anticonvulsant mechanisms of the ketogenic diet. Epilepsia 2007; 48: pp. 43-58.

Kossoff E., Wang H.: Dietary therapies for epilepsy. Biomed J 2013; 36: pp. 2-8.

Rho J.M.: How does the ketogenic diet induce anti-seizure effects?. Neurosci Lett 2017; 637: pp. 4-10.

The Charlie Foundation for Ketogenic Therapies. What is a ketogenic diet? https://www.charliefoundation.org/explore-ketogenic-diet/explore-1/introducing-the-diet . Accessed 7 Feb, 2021