What is a ketogenic diet?

A ketogenic diet is a special food plan. Some children with epilepsy have found it reduces their seizures.

It is a very specialist diet that means you eat lots of fat, things like:

  • butter
  • oil
  • margarine
  • cream
  • mayonnaise

You can also eat protein, which is found in:

  • meat
  • fish
  • cheese

But you must limit the number of carbohydrates you eat. This means very little:

  • potato
  • pasta
  • rice
  • bread
  • fruit

The ketogenic diet is usually offered to children over the age of two if all the tablets they have taken to control their epilepsy have not worked.

Vanessa Hopkins, a dietitian (someone who understands what food we should eat) at Birmingham Children’s Hospital recommends two types of ketogenic diet:

  • the classical diet, which is very strict
  • the modified ketogenic diet, which is a little more flexible and easier to follow.

Most youngsters are put on the modified diet, which means they can eat as much fat as they want, and – unlike the classical diet – eat unlimited protein. But they can only eat a very small amount of carbohydrate.

The small amount of carbohydrate is mainly from vegetables and small amounts of fruit. Potatoes, rice, bread and pasta are not often eaten as children find portions too small.

No one really knows why the ketogenic diet works. It is believed that when the body breaks down fat it produces something called ketones.  This “ketosis”, as it is known, helps to stop the seizures.

It has a 50 per cent success rate, which means that half of the children who go on the food plan see a huge reduction in the number of epileptic fits they suffer.

Before you are allowed to go on the ketogenic diet, Dr Sunny Philip, a neurologist, someone who is a brain expert, looks at your medical history.

He will examine how many fits you are having, how serious they are, and how many times you have to go to hospital to be treated before deciding if you should try it.

Dr Philip will discuss the options very carefully with your parents and with Vanessa before giving you the go ahead to change your diet.

If he thinks you should try it, you cannot start the diet straight away. You have to go on a waiting list – which may take a couple of months – before being able to see the dietitian who will explain what you can and cannot eat, as well as give your parents some simple recipes to try, such as chicken with creamy herb sauce and vegetables.

They will also go on a short training course to ensure they understand how to plan meals and do blood tests to check if your body is reacting well to the diet.

You may also see Bernie Concannon, the epilepsy nurse, who is also able to assess whether or not you could follow the diet. She also holds a nurse clinic with Vanessa to review progress after one month on diet. Bernie may also go out to your school to speak to teachers/school nurses about diet if they have questions.

You will be asked to try the diet for three months to see if your symptoms improve and if Dr Philip believes your seizures are reducing sufficiently, he will let you continue with it.

Although your diet will be restricted, more recipes are being added to a database all the time, which means that you can vary what you eat. You will still be able enjoy your own version of a pizza, enjoy a special home-made ice cream and low-sugar jelly.

Many parents worry about the high fat content of the diet, but because the fat is being used to produce energy in your body  there is no risk of high cholesterol or a bad heart.

It is difficult to get used to at first, but most youngsters stick with it when they see the benefits.

You are normally put on the diet for two years. After that you may be able to go back to a normal diet.

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