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Ketogenic Diet

Medically reviewed by Last updated on Dec 2, 2022.

What is a ketogenic diet?

The ketogenic diet may help decrease your seizures if they do not respond to epilepsy medicine. The ketogenic diet is high in fat and low in carbohydrates. It causes your body to produce ketones (chemicals) that can help decrease seizures. You may need to follow this diet for at least 3 months to find out if it helps to decrease your seizures.

What are the different types of ketogenic diets?

There are 4 different types of ketogenic diets. Your healthcare provider or dietitian can help choose the best ketogenic diet for you. He or she will also help you plan meals. Your provider or dietitian will need to monitor your health very closely while you follow a ketogenic diet.

  • The modified Atkins diet limits carbohydrates to 10 to 20 grams each day. Protein, fats, fluids, and total calories are not limited.
  • The low glycemic index (GI) diet limits carbohydrates to 40 to 60 grams each day. Protein, fat, and total calories are not limited. The carbohydrates you eat must have a low GI. GI is the rate at which a food raises your blood sugar. Low GI foods raise your blood sugar at a slower rate than high GI foods. The carbohydrates you eat must have a GI of 50 or less. Examples include whole-wheat pasta and breads, brown rice, lentils, split peas, and sunflower seeds. Fruits you can eat include fresh pineapple, peaches, and apples. Vegetables you can eat include eggplant, tomatoes, beets, turnips, and lettuce.
  • The classic ketogenic diet allows about 3 to 4 grams of fat for each gram of carbohydrate and protein you eat. This means that carbohydrates and protein are limited, and high amounts of fat are allowed. Heavy cream, butter, and vegetable oils provide this fat. Sweets, such as candy, cookies, and desserts, are not allowed. Foods must be weighed and measured carefully.
  • A medium-chain triglyceride diet includes a high amount of a type of fat called medium-chain triglycerides (MCT). MCT can produce more ketones than long-chain triglycerides (LCT). With this diet, the fats you eat are made up mostly of MCT and only a small amount of LCT. You can have more protein and carbohydrate on this diet than on the classic ketogenic diet.

What side effects may occur with a ketogenic diet?

You may have low blood sugar, dehydration, weight loss, and fatigue. You may also have nausea, vomiting, constipation, diarrhea, and abdominal pain. Over time, your blood cholesterol levels may increase. You may develop kidney stones if you take certain seizure medicines.

What do I need to know about medicines if I follow a ketogenic diet?

  • Continue to take your seizure medicines as directed. Your healthcare provider will decide if and when the dose of your seizure medicine can be decreased.
  • Talk to your healthcare provider before you take any new medicines. You may only be able take medicines that contain little or no carbohydrates.
  • Take your vitamins and mineral supplements as directed. A ketogenic diet may cause deficiencies (low levels) of certain vitamins and minerals. Your healthcare provider may recommend that you take supplements to prevent deficiencies.

What else do I need to know if I follow a ketogenic diet?

  • Follow your ketogenic diet as directed. Any changes made to your diet can affect your seizure control.
  • Check your ketones as directed. Your healthcare provider may recommend that you regularly check ketones in your blood or urine. Ask how often you should check ketones. This information is used to adjust your diet as needed.
  • Keep a seizure diary. Write down the dates of your seizures, where you were, and what you were doing.
  • Follow up with your healthcare provider as directed. You may need to see your healthcare provider every 3 months, or more often. During your visits, your provider will review your health, ketones, and seizure history. Your provider will use this information to adjust your diet if needed.

When should I contact my healthcare provider?

  • You have more seizures after you start this diet.
  • You have side effects that are making it hard for you to follow this diet.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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