What is the ketogenic diet for epilepsy?

The Ketogenic Diet is a high-fat, moderate protein, low-carbohydrate way of eating. By restricting carbs and sugar the body goes into a state of ketosis, which is where the body burns fats/ketones instead of glucose/carbs/sugar. When there are very little carbohydrates in one’s diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source, it is this elevated level of ketone bodies in the blood, which is known as ketosis.

Video courtesy of Outside Magazine

The Birth of Keto: A Less Restrictive Treatment for Epilepsy

The following timeline showcases the slow but steady growth in keto popularity and uses.
consult dietitian

Although originally used as a treatment for seizures and exploring neurology, our predecessors knew the health benefits of a ketogenic diet. Today, keto research is mounting and we are continuously uncovering new, positive side effects and ways in which the keto diet can benefit health and well-being.

Regardless of your reason for interest in the classic ketogenic diet, always consult with your physician or dietitian or nutritionist before beginning a new dietary regimen.

Candidate for Ketogenic Diet

Doctors usually recommend the ketogenic diet for those people whose seizures have not responded to several different types of medicines or before going down the surgery route.

How many carbs can I eat?

This really depends on your particular needs. Every person’s carb requirements are different. The strictest recommendation is 20 grams or less especially at the start of a keto diet.

20 g carbohydrates
measure height weight

Before Starting the Ketogenic Diet

Referrals for the diet are made by your neurologist. Before starting the diet, you will need to see the ketogenic team and have the following:

  • Blood and urine tests to ensure the diet is safe to start
  • Weight and height measurements
  • A medication review
  • A review of your seizure types and how often seizures are happening
  • A review of current diet

If the team are happy for your child to start, an appointment will be arranged with the dietitian who will discuss the individual diet plan with you. The nurse will teach you how to do a finger prick blood test to check your blood ketone and blood glucose levels and will discuss what to do if you are unwell.

When You Start the Ketogenic Diet

Once you start the ketogenic diet, the dietitian will be in touch with you regularly by phone or email to discuss how the diet is going, as well as to monitor your weight and blood ketone levels. They may advise changes to the diet during this time.

The ketogenic team will follow you up after three months of starting the diet to check whether the diet is still the most appropriate treatment option.

The ketogenic team will ask you to keep a ketone and seizure diary to help best manage and adjust your diet.

It is important to follow the diet as the dietitian has advised, and to weigh and measure foods carefully. If you have any problems following recipes, or have concerns about side effects, you should discuss these with your dietitian before making any changes.

The diet may be weaned after approximately two years to evaluate the benefits of the diet and whether or not to continue with the diet.

Video courtesy of freestylediabetes.co.uk

What Is Required at Home?

Basic equipment for home includes:

Types of Ketogenic Diet

There are different types of ketogenic diets which are used. The ketogenic team will advise on the diet most suitable for you. The dietitian will calculate the diet to ensure that it is safe and nutritionally adequate. For certain types of the diet, some special products may be needed which are available on prescription.

Classical ketogenic diet (CKD)

  • Fat in the diet provides – around 90 per cent of calories and mostly comes from foods naturally high in fat, like double cream, butter, oil and avocado.
  • Carbohydrates are very limited.
  • Diet is lower in protein than a normal diet, but provides enough for growth.
  • All foods are weighed for everything eaten on the diet.
ketogenic diet meal

Medium chain triglyceride (MCT) diet

  • More generous intake of protein and carbohydrate.
  • Diet contains some fat which occurs naturally in food, as well as supplements of MCT fat.
  • Prescribed supplements will include: MCT oil and Liquigen.

  • All foods are weighed for everything eaten on the diet.

Modified ketogenic diet (MKD)

  • High in fat with limited carbohydrate and unlimited protein.
  • Carbohydrates are weighed and fat is provided in household measures (e.g. 1tbsp double cream).
  • Protein foods do not need to be weighed.

What Food Can You Eat on the Ketogenic Diet?

Meats and meat substitutes

  • beef
  • deli meats
  • game
  • lamb
  • organ meats
  • pork
  • poultry
  • sausages
  • tempeh
  • tofu, extra firm

meat ketogenic
seafood ketogenic

Keto-friendly fish and seafood

  • fish of all types
  • anchovies
  • crab
  • lobster
  • shrimp
  • squid
  • tuna


  • boiled, hard or soft
  • fried
  • in quiches or frittatas
  • omelets
  • poached
  • scrambled

eggs ketogenic
vegetables ketogenic

Keto vegetables

  • cauliflower
  • avocado
  • broccoli
  • cabbage
  • brussels sprouts

  • zucchini
  • spinach
  • asparagus
  • kale
  • green beans

Keto fruits and berries

  • blackberries
  • coconut
  • lemons
  • raspberries
  • strawberries
  • limes
fruits ketogenic
nuts ketogenic

Keto nuts and seeds

  • almonds
  • Brazil nuts
  • hazelnuts
  • macadamia nuts
  • peanuts
  • pecans
  • pine nuts
  • walnuts


  • unsweetened almond milk
  • coconut milk
  • macadamia nut milk
  • flax milk
  • soy milk
  • cashew milk
  • pea/protein milk
milk ketogenic
double cream ketogenic


  • double thick cream

What Should I Avoid on the Keto Diet?

Avoid high-carb foods, such as:

  • bread, rice, pasta, noodles
  • grains & cereals
  • traditional desserts, pastries, sweets & baked goods
  • high-carb fruits
  • juices & sodas
  • anything with added sugar
non keto foods
liquor dry wine ketogenic

Can I Drink Alcohol on Keto?

Yes. High-carb drinks are a no-no (such as cocktails, sweet wines, and most beers, for example), but as long as you stick to pure liquor or dry wines, you can definitely enjoy a glass or two.

Many people notice they get drunk much quicker on keto, so keep that in mind, and go slow. Moreover, alcohol has calories and your body needs to burn it before everything else, so make sure to track it, if your goal is weight loss.

What is Ketosis?

Ketosis is a metabolic state where your body starts using fats for fuel instead of carbohydrates. To reach ketosis, you must first reduce your carbohydrate intake to limit your body’s supply of glucose.

Are There Any Side Effects of the Ketogenic Diet?

Everyone experiences varying side effects, as with any other epilepsy treatment. Common side effects of this dietary therapy include:

  • Headaches
  • Brain fog
  • Dizziness
  • Fatigue
  • Nausea
  • Constipation
  • Difficulty sleeping
  • Sugar cravings
  • Diarrhea
  • Vomitting
  • Upset Stomach

dizziness side effect
keto meal prep

Cons About Being on the Ketogenic Diet

  • Very strict
  • Cumbersome
  • Time consuming
  • Precise food weighing required

Other Benefits

A modified keto diet may provide benefits beyond epilepsy management.

  • Alertness
  • Concentration
  • Psychological function
  • The quality of life
concentration alertness

Special Considerations for Families:

The ketogenic diet meal planning and preparation take time

This can fit into your family schedule, but it takes practice and gets easier as you adapt to the new routine. All food or formula needs to be weighed daily and each meal must be eaten in its entirety.

The diet is very restrictive, especially for a young child

It controls the type of food and the quantity of food. Some children may feel isolated at school, because they cannot eat “normal” food. Many are just unable or unwilling to follow it, but most find it a far better alternative than frequent seizures.

It can be adapted to all ethnic diets―as well as for people who are allergic to dairy products

(although this can further limit already narrow food choices). The dietitian will be a great resource for you along the way and can help calculate the diet with foods your like.

There is a chance that, no matter how closely the diet is followed, it might not work for some children or adults
Diet must be followed closely by a doctor and Dietitian as it is not something to try on your own

Celebrities Who Have Tried the Ketogenic Diet

More Information on the Ketogenic Diet Contact

Ketogenic Diet Recipes

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Few people are actually willing to step up and talk about Epilepsy. We need to make the world aware of the impact Epilepsy has on so many and find a cure. Without a cure, there are far too many people who will never have relief from seizures.