Common Questions About the Ketogenic Diet for Pediatric Epilepsy

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The Lurie Children's Keto Dietitian Team includes (from left): Robyn Blackford, RDN, LDN; Wesley Lowman, RDN, LDN; Nikki Haggerty, MS, RD, LDN; and Chu-Yi Huang, MS, RD, LDN

The Pediatric Epilepsy Center at Ann & Robert H. Lurie Children's Hospital of Chicago has been prescribing and implementing the ketogenic for more than 20 years, growing from just a handful of patients, to over 350 patients currently on ketogenic therapies. This makes Lurie Children’s Ketogenic Diet Program one of the largest in the world.

All of the physicians, nurses, dietitians and staff within the Pediatric Epilepsy Center are well-versed in ketogenic diet therapies, providing a comprehensive, multi-disciplinary, targeted approach to its use.

Learn more about this diet and how it is helps some patients with epilepsy by reading the Q&A below with the Epilepsy Center at Lurie Children’s own registered and licensed dietitian/nutritionists. They include: Robyn Blackford, RDN, LDN; Wesley Lowman, RDN, LDN; Nikki Haggerty, MS, RD, LDN; and Chu-Yi Huang, MS, RD, LDN.

What is the ketogenic diet?

The medical ketogenic diet is a diet that is high in fat and low in carbohydrate and sugar. Following this diet will put the body into a state of ketosis where it’s burning fat for energy instead of carbs. It is used for those that have intractable epilepsy, which means that seizure medications have not been helpful for them in their course of treatment.

The ketogenic diet mimics a state of fasting which seems to have an anti-seizure effect on the brain. There are several health benefits of inducing ketosis, but unfortunately, the exact mechanism of action for seizure control is still unknown.

What are some specific foods that are part of the ketogenic diet and can help control seizures?

The ketogenic diet for seizure control works based on the ratio of fat to carbs and protein in the diet, more so than which particular foods are consumed, the ratio of the food is what's important. With that being said, high fat foods that can be beneficial include: avocado, coconut oil, fatty fish such as tuna and salmon, butter, and olive oil. Low carb foods that are beneficial include green, leafy vegetables and other high fiber, high water content fruits and veggies. Starches, grains and sweets are best to avoid due to the concentration of carbs that they contain, which work against the high fat to carb/protein ratio.

How effective is the ketogenic in managing seizures?

The ketogenic diet continues to be beneficial in 2/3 of patients who try it. As the diet has become more tailored and more expert clinicians are in the field, we've seen the benefit ratio improve to around 75% of patients in some studies.

How do Lurie Children’s dietitians help families maintain the ketogenic diet?

The dietitians at Lurie Children’s offer ongoing guidance and support to families whose children are on a Ketogenic Diet. They work with families during the initial discussion, initiation and maintenance of the diet. They prepare custom meal plans and adapt them as the child grows, to meet their ever-changing needs, from infancy to adulthood.

What are the risks and benefits of the ketogenic diet for children with epilepsy?

Potential benefits include seizure control, increased alertness and attention, use of less medications, improved sleep patterns, and mood stabilization.

Some of the common side effects include constipation, metabolic acidosis, and carnitine deficiency. Most side effects are reversible and should be monitored by a healthcare professional who is an expert in ketogenic diet therapy. An epilepsy provider and dietitian team are essential to the safe and effective use of the ketogenic diet.

Is the ketogenic diet healthy and safe for people without seizures or epilepsy syndromes?

The version of the Ketogenic Diet that is used as a treatment for epilepsy may look very different from other versions of the diet for other uses. Any medical diet should be implemented under the supervision and care of an experienced medical team, with the expertise of a Registered Dietitian.

Learn more about the Ketogenic Diet Program

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