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What is the Ketogenic Diet?

 

The ketogenic diet is a carefully calculated, medically managed diet, designed to mimic a fasting state over a long period of time. It is available as a treatment option for children with difficult-to-control epilepsy and some neuro-metabolic disorders. 

 

The idea of using diet to help manage seizures is not new.  In fact, Physicians in Ancient Greece treated epilepsy by altering the patient’s diet.

 

In keeping with this ancient approach to treating epilepsy, the Ketogenic Diet was originally developed in the 1920’s to manage difficult-to-control seizures.[1]  There were hardly any effective medications at the time, and the diet was developed to “simulate the apparent anticonvulsant effects of fasting”.[2]  While it remained a popular treatment during the 1920’s to 1940’s, it fell out of favour during the 1950’s with the development of anti-epileptic drugs (AEDs).

 

When on the Ketogenic Diet, a simulated ‘fasting state’ is achieved by switching the body to burn fats rather than carbohydrates. When there is very little dietary carbohydrate, the liver converts fat into fatty acids and ketone bodies. The ketone bodies then pass into the brain, replacing glucose as the primary energy source. This elevated level of ketone bodies in the blood is referred to as ketosis.

 

The body burns fat when:

  • The consumption of carbohydrates (e.g. sugars, pasta, and bread) is limited
  • The consumption of foods high in fat (such as butter, cream, and oil) is increased
  • There is adequate consumption of protein to aid body growth and repair

 

It is important that the ratio of fats to carbohydrates and proteins be medically determined and carefully managed to ensure optimal outcomes and limit untoward side-effects and potentially serious nutritional deficiencies.  Typically a Paediatric Dietician, a Paediatric Neurologist, and an experienced Nurse are involved in the management of patients who are placed on the Ketogenic Diet.



[1] Wilder RM. The effect of ketonemia on the course of epilepsy. Mayo Clin Bull. 1921;2:307, cited in Freeman et al. The Efficacy of the Ketogenic Diet. Pediatrics. 1998;102:6.

 

[2] Freeman, Vining, Pillas, Casey, & Kelly. The Efficacy of the Ketogenic Diet-1998: A prospective Evaluation of Intervention in 150 Children. Pediatrics, 1998; p. 1362.

 

 

 

 

 

 

The information provided on this page was created on the 10th October 2014. It has been written by members of the PENNSW Website Editorial Committee in consultation with:

  • Dr Michael Cardamone, Paediatric Neurologist, Sydney Children's Hospital Randwick (PhD, University of  Melbourne; MBBS University of Sydney, FRACP)
  • Helen Kepreotes, Paediatric Dietitian, Sydney Children's Hospital Randwick (BSc Master Nutrition & Dietetics, APD)