Magazine article The Exceptional Parent

The Ketogenic Diet

Magazine article The Exceptional Parent

The Ketogenic Diet

Article excerpt

sometimes in conjunction with anticonvulsive medications (medications to control seizures). Although there are a few theories, nobody really knows why the diet reduces or stops seizures in certain children.

The ketogenic diet consists of foods that cause the body to produce ketones, primarily a byproduct of fat metabolism. A person on a well-balanced diet consisting of carbohydrates, protein and fats will derive energy primarily from the metabolism of glucose--metabolism being the process whereby food is converted to energy. In contrast, a person on a ketogenic diet derives energy from "burning" fat, rather than glucose.

A ketogenic diet consists of foods such as heavy cream, butter, other fats and only a limited amount of protein. Essentially no carbohydrates (sugar and starch) are allowed. Protein and calorie intake must be set at levels that meet requirements for growth. Vitamin supplements must also be used appropriately.

The ketogenic diet may sound much easier to do than it really is. It should never be attempted without very close medical and dietary supervision. Typically, the diet is started in a hospital setting after several days of severe caloric restriction. This initial restriction of food intake causes the body to begin "burning" fat for energy, starting the production of ketones. During this initial hospitalization, a dietitian works with the family and child to set guidelines for the types and amounts of food the child may have. Once started, and barring any major complications, it is essential that the patient follow the diet strictly. "Cheating"--whether accidental or intentional--may result in increasing or restarting seizures.

According to studies done at Johns Hopkins Pediatric Epilepsy Center, the optimal age for the diet is between one and eight years. Younger children are more prone to hypoglycemia (low blood sugar) when on the diet and older children who are oral feeders (as opposed to tube feeders) are more resistant to following the ketogenic diet, primarily because of its limited taste appeal.

The ketogenic diet should be considered another therapeutic option, just as the option to use or change anticonvulsant medications. This diet should not be the first choice among options for seizure control, but it is a viable treatment for children with many types of seizures that are not well controlled with anticonvulsants or where anticonvulsants cause significant side effects.

Just as with drugs, the ketogenic diet has potential side effects including hunger, thirst (because of the decrease in fluids taken in as part of the diet), constipation (because of the small volume of food and high concentration of fat in the diet), hypoglycemia, kidney stones (because of too little liquid), hypocalcemia (low blood calcium), hyperuricemia (excessive uric acid in the blood) and acidosis (a build-up of acid in the blood). …

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