Ketogenic Diet (Keto Diet) for Epilepsy

What is the ketogenic diet for seizures and epilepsy?

The ketogenic diet for epilepsy is a meal plan — generally high in fats and low in carbohydrates — designed to manage seizures. Your provider might recommend dietary treatment if you aren’t getting the results you hope for from antiseizure medications alone.

Keto diet for epilepsy types

There are different types or variations of the ketogenic diet for epilepsy, including:

• Classic ketogenic diet (CKD). High in fat, low in carbohydrates, moderate in proteins. It’s very structured and requires strict meal planning.
• Modified Atkins diet (MAD). High in fat, low in carbohydrates, flexible in proteins. It’s less restrictive than CKD, but you still need to monitor how many carbohydrates you eat.
• Low glycemic index diet. Moderate in fat and proteins. It encourages you to eat carbohydrates that absorb slowly (low glycemic index).

Who should go on the keto diet for epilepsy?

The keto diet is an option when seizures aren’t managed with antiseizure medications alone. Healthcare providers typically recommend the keto diet to treat epilepsy for children of all ages, including infants. Adults with seizure conditions or epilepsy can also participate in the keto diet. But it’s usually not preferred. This is because it has limited food choices that make the diet hard to follow.

What happens in your body when you follow a keto diet for epilepsy?

The ketogenic diet resets how your body uses food. Usually, carbohydrates from the foods you eat (like sugars and starches) provide most of your energy. The keto diet lowers the amount of carbs you eat and teaches your body to burn fat for energy instead. Burning fat leads to the formation of excess ketones in your body known as ketosis. Ketosis a metabolic state that occurs when your body burns fat for energy instead of glucose.

How does a ketogenic diet reduce seizures?

Healthcare providers are still researching exactly how the keto diet affects epilepsy. But there are a lot of theories.

When a seizure happens, neurons (nerve cells) in your brain fire signals uncontrollably. It takes a lot of energy to do this. Studies suggest that changes to your metabolism may affect how much energy is available for your neurons to activate a seizure under the keto diet.

Studies are also ongoing to learn how changes to your metabolism and gut microbiome may influence certain bacteria species. These may help neurotransmitters (chemical messengers) in your brain to regulate seizures.

How do I start the keto diet for epilepsy?

If you’re interested in starting the ketogenic diet, talk with your healthcare provider. They’ll offer a physical exam to learn more about your general health. This is to make sure the keto diet is safe for you to try.

Your provider may ask you to keep track of your seizure activity in a seizure diary. If necessary, they may also order imaging, urine and blood tests.

If your provider approves that you can start the keto diet, they may recommend meal planning resources, like meeting with a dietitian, since the keto diet can be very restrictive.

Some children may need to be admitted to the hospital when they start the keto diet. This is to make sure their blood sugar levels and hydration are where they should be.

How successful is the ketogenic diet for epilepsy?

The keto diet has proven effective over time to help epilepsy. Research shows that the keto diet (including the CKD, MAD and low glycemic index types) may reduce how many seizures you have by more than half after three months. Some people report that they’re seizure-free on this meal plan.

Results may vary from person to person. It’s important to work closely with your healthcare provider so they can make sure this is the right treatment option for you.

What are the risks of the ketogenic diet?

Despite its success in managing seizures, the keto diet isn’t risk-free. Most tolerate the diet well with minimal side effects. Common side effects may include:

• Abdominal pain
• Constipation
• Dehydration
• Diarrhea
• Lethargy
• Low blood sugar levels
• Vomiting
• Weight loss

Risks that may occur with long-term use include:

• Low bone density and bone fractures
• High cholesterol
• Kidney stones
• Metabolic acidosis
• Slower growth than typical (children)

How long will it take for me to feel better?

Research shows that you may start seeing results within the first 3 to 4 months. Providers recommend this trial period to see the meal plan’s effectiveness. During this time, it’s important to follow your provider’s instructions and continue taking any prescribed medications as directed unless your provider tells you otherwise.

You’ll need to follow up with your provider at least once every three months. Your provider will monitor you for side effects and keep track of your seizure activity.

How long should I continue the keto diet for epilepsy?

Your healthcare provider may stop you or your child’s keto diet after a few years if it helps you manage epilepsy well. They may also discontinue this meal plan if it isn’t providing the right results. Ask your provider for more information about how long you should be on the keto diet for epilepsy.

When should I call my healthcare provider?

You should call your healthcare provider if:

• Seizures worsen or continue without change while on the keto diet
• You or your child has an allergic reaction to any of the foods in the diet
• You have trouble sticking to the meal plan
• You experience any uncomfortable side effects