Epilepsy | Ketogenic and Modified Atkins Diet

This diet gets its name from the fact that people who follow it produce a high level of “ketones” in the body. Ketones are organic compounds that form when the body uses fat for its source of energy. They are not dangerous.

The ketogenic diet is very restrictive, and requires careful measuring to ensure that the child receives a precise balance of carbohydrate, protein, and fat grams with each meal. To begin the diet, children are admitted to Cincinnati Children’s for a three- to four-day inpatient stay. During this time, our team introduces the diet and monitors the child closely to see how their child’s body responds to the restrictive diet and make adjustments as needed.

Your family will have one-on-one education with the dietitian to make sure you and your child feel comfortable with all aspects of the diet prior to discharge. Children come to the clinic for follow-up appointments at the one-month mark, and then every three months after that.

A modified Atkins diet is less restrictive than the ketogenic diet. It does not require a hospital stay, but instead requires an outpatient visit with the dietitian. This diet does involve some blood tests prior to starting, as well as frequent monitoring and follow-up appointments.

Will a specialized diet reduce my child’s seizures?

Unfortunately, it is not possible to predict whether a specialized diet will help reduce your child’s seizures.

The ketogenic diet often is effective for children with certain types of conditions that are associated with seizures, such as GLUT1 deficiency syndrome and pyruvate dehydrogenase deficiency. However, the diet also helps some children with other types of epilepsy. The child’s age or epilepsy type does not seem to affect whether the diet will be effective. Our care team will talk to you about whether a ketogenic diet might be a good option for your child.

Which diet should I consider?

Following either diet can be a big adjustment for families, so it is important for you to learn all you can before making the commitment. You will meet with the dietitian and discuss your child’s nutrition history and preferences prior to starting the diet. The dietitian will work with you to decide which diet will be the best fit for your child.

Can a ketogenic diet harm my child?

No, but the diets do require close monitoring with the dietitian and medical team. Ketogenic and modified Atkins diets can cause minor issues, such as constipation and kidney stones, but these are avoidable.

Is a ketogenic diet forever?

In most cases, children remain on the diet for two to three years, if it is effective. Eventually, we may recommend introducing regular food into your child’s diet to see if the seizures recur. If the diet is not effective within a few months, it will be stopped.

How long until we see results?

Often, a period of fine-tuning is needed to determine whether a ketogenic or modified Atkins diet will be effective in helping a child achieve seizure control. After three to six months, our team will evaluate how well the diet is working. If your child is experiencing an improvement in his or her seizure frequency, we may reduce his or her anti-seizure medication at this time.