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Dear Dietitian – Ketogenic Diet for Epilepsy

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PICT Leanne McCrate Dear Dietitian
Leanne McCrate, RD, LD, CNSC

Dear Dietitian,

My four-year-old son, Alex, has suffered from epilepsy since shortly after birth. He is on medication, but still has as many as five seizures a week. I have been thinking about putting him on a ketogenic diet, as I have heard from other parents that it will reduce the number of seizures. Other parents have said the diet is very hard to stick to, and it didn’t work for their child. What do you think?


Dear Sharon,

A ketogenic diet is a high fat, moderate protein, and very low carbohydrate diet used to treat epilepsy. Its success rate is well-documented with some studies reporting that patients had 50% fewer seizures than before.  The diet is used in conjunction with anti-epileptic drugs, and in many cases after being on the ketogenic diet, patients were able to decrease medication.

The focus of this diet is that your body goes into ketosis, where it uses ketones as an energy source. Under normal circumstances, your body uses glucose for energy. When there is a lack of carbohydrate in the diet, your body breaks down fat, although inefficiently, and ketones are produced in the process.  The mechanism by which ketosis reduces seizures is not well -understood. Your doctor will provide the tools necessary to monitor ketosis at home.

This diet is not without challenges.  It may not be as palatable since it is very low in carbohydrate, and a child may simply refuse to eat it. A child who is mobile may “sneak” a sugary drink or cookie. The good news is today there are many sugar-free alternatives your child can enjoy, you will find many kid-friendly ketogenic recipes on the internet.

 I strongly recommend that you make an appointment with a Registered Dietitian at a Children’s Hospital (if possible), as she or he will have the expertise needed to educate you on the ketogenic diet and incorporate it into your child’s life. 

Sincerely, Dear Dietitian

Leanne McCrate, RD, LD, CNSC, is an award-winning dietitian with over fifteen years of experience. Have a question?  Email Leanne at