Ketogenic Diet

What is the ketogenic diet?

The ketogenic diet is a very strict diet used to help control some types of seizures. It is high in fat, adequate in protein and low in carbohydrates.

Your child’s doctor will manage the diet. The diet:

  • Contains three to four times more fat than carbohydrate and protein
  • Makes the body burn fat for energy instead of glucose (sugar)
  • Strictly limits calories

When is the ketogenic diet used?

The diet is most often used in infants, children and teens with any type of seizure that is hard to control with medicine or in which medicines have not worked.

How does the diet work?

Doctors do not know exactly how the diet helps control seizures. We do know these things:

  • The body’s main fuel is glucose. The body burns glucose to make energy and maintain a normal blood sugar level. The body only stores a 23-hour supply of glucose.
  • After this, the glucose stored in the body is gone, and the body begins to burn fat for fuel. The body does not burn fat completely, but it breaks it down into ketones. Ketones in the brain may help to control seizures.

What does my child eat?

The ketogenic diet will provide adequate protein but only allow a few carbohydrates. About 90 percent of your child’s calories will come from fat.

  • Common foods on the diet include whipping cream, real butter, avocado and coconut oil
  • Your child will only be able to eat a few fruits and vegetables
  • Your child will not be able to eat any carbohydrate rich foods, including:
    • Pasta
    • Bread
    • Rice
    • Potatoes
    • Crackers
    • Cookies
    • Candy
    • Soda
    • Juice

Other things to know include:

  • Your child may need calcium, vitamin and mineral sugar-free supplements, since the diet does not provide complete nutrition.
  • All medicines must be sugar-free
  • Personal care products, such as toothpaste, must be sugar-free

What are the possible side effects with this diet?

Some possible side effects include:

  • Constipation
  • Kidney stones
  • Hypoglycemia (low blood sugar)
  • Excess ketones
  • Sleepiness

Talk with your child's doctor if you have any questions or if any of these are a problem for your child.

How long will my child need the ketogenic diet?

This diet may help reduce the number or length of your child’s seizures. It must be supervised by his doctor and care team.

To begin the diet, your child may have to stay in the hospital for about three days. Once the diet begins, it is recommended to try the diet for three months. If the diet helps to decrease seizures, your child will usually stay on it for about two or more years.

  • During this time, your child will need regular lab tests and visits to his doctor.
  • Coming off (weaning) seizure medicines varies from child to child. It is not always possible.

If the diet is not helpful, your child will wean off the diet over time – not all at once.

  • Talk with your child’s neurologist before stopping or changing the diet.
  • Fat content in the diet is slowly decreased, and carbohydrate intake is slowly increased.
  • Your child will slowly return to a normal eating pattern.
  • If seizures return during the weaning process, your child may need to go back to the previous

How do I know if the diet is right for my child?

Your child's physician will determine if this diet is right for your child. 

How do I get started? 

To start the ketogenic diet, you should talk with your child's neurologist and see if it is an option for your child. You will need a referral from your child's neurologist in order to be seen in the ketogenic diet clinic.

After your child is seen in the ketogenic diet clinic, it will be decided if hospital administration is needed. If your child is admitted to the hospital, the following will occur:

The ketogenic diet team will:

  • Decide on your child’s calorie needs based on his height, weight and activity level.
  • Take a diet history along with a list of foods your child prefers.

 Your child’s doctor and the nursing staff will: 

  • Monitor your child.
  • Create special meals help to get your child used to a high-fat diet and allow ketones to build.

Before your child can go home: 

  • He must eat three full meals without vomiting and have stable blood glucose and urine ketone levels.
  • Your child’s nutritionist will teach you about weighing foods, planning meals, and dealing with problems that may come up with the diet at home. She can also help you review your child’s diet and set new limits as needed.

Helpful Resources

Medical professional resources

Learn more about our neurosciences medical professional resources and referral forms

Patient family resources

You can get more information from your child's neurologist or care team. You can also find more information about the diet at: 

For more information on our ketogenic diet clinic, please call 404-785-KIDS (5437).