Dietary Approaches

Maintaining a special diet can be a part of epilepsy care. Physicians will often recommend a diet as a supplement to  epilepsy medication or epilepsy surgery. In some cases, a specific diet may be the only epilepsy treatment.

Ketogenic Diet

The ketogenic diet is typically used to treat children with epilepsy and uncontrolled seizures. It is a high fat, low carbohydrate and low protein diet. The diet is commonly recommended for children who don’t respond to seizure medication, and is particularly suggested for children with Lennox-Gastaut syndrome.

The diet has shown to be effective for all ages, but it isn’t typically recommended for adults because the restricted food choices makes it difficult to follow. Studies have shown that reduces or prevents seizures in children whose epilepsy cannot be controlled by medication. More than half of all children who follow the diet have a 50 percent reduction in seizures. 10 to 15 percent of children can become entirely free of seizures.

How It Works

The body normally uses carbohydrates as its source of energy, but with the ketogenic diet the body burns fat for energy instead. This restrictive diet is carefully monitored by a dietician to ensure each person is getting proper nutrition. When followed closely, the diet can be effective in controlling most types of seizures. Following the diet builds up ketones in the body, which are thought to protect against seizures. Learn more by visiting

In the ketogenic diet, a person eats three to four grams of fat for every one gram of carbohydrate and protein. The ratio of fat to carbohydrates and proteins varies based on age. Most children follow a 4:1 ratio, while infants and adolescents follow a 3:1 ratio. Children who require a higher amount of protein may also be recommended to follow a 3:1 ratio.

Because carbohydrates and proteins need to be restricted, careful meal preparation is required. Guidance is provided by a dietician. Common sources of fat include butter, mayonnaise, heavy creams and oils.

Children on the ketogenic diet continue to take seizure medication, although some are able to reduce their dosage or medication. It’s very important to avoid restricted foods, because the diet can lose its effectiveness if the wrong foods are eaten. Ketogenic diets can’t provide the nutrition benefits of a normal diet, so vitamin and mineral supplements must be taken. These include:

  • Vitamin D
  • Calcium
  • Iron
  • Folic Acid

Medical Monitoring

When first beginning the ketogenic diet, children are monitored by their doctor every one to three months. Blood and urine tests are run to screen for medical problems. Height and weight are measured to ensure normal growth isn’t being impacted by the diet. A dietician may adjust the diet as the child gets older.

If the seizures have been controlled for at least two years, the doctor may recommend stopping the diet. If this is the case, the individual will be gradually taken off, as stopping the diet suddenly can cause seizures to worsen. In cases where the ketogenic diet has led to significant seizure control, it may be beneficial to stay on the diet for many years.

Modified Atkins Diet

Some people who followed the ketogenic diet over a number of years stopped weighing and measuring foods, but noticed that seizures continued to be controlled. This led to the modified Atkins diet. This diet is less restrictive but is otherwise similar to the ketogenic diet. It allows more protein and carbohydrates and doesn’t limit calories or fluids. High fat foods such as bacon, eggs, mayonnaise, butter, oils and hamburger are encouraged. Specific fruits, vegetables, nuts and cheese are also permitted.

The modified Atkins diet is still being studied, but shows promise in controlling seizures for adults who have not responded to anti-seizure medication. Approximately half of those who follow the modified Atkins diet have a 50 percent reduction in seizures after six months. People considering this diet should still consult with a dietician and neurologist.