Neurology

Eating for epilepsy: True or false?

If you or a loved one has epilepsy, you may have heard that a ketogenic diet can help with seizures. This special type of diet is very low in carbohydrates and very high in fat. Eating this way causes the brain to start relying on fat as its main fuel source instead of carbs. This change, called ketosis, has long been known to produce fewer seizures in many people with epilepsy. But is it right for you?

True or false: A ketogenic diet is a cure for epilepsy.

False. A ketogenic diet may help control epilepsy, but it's not a cure. Often, the diet helps a person have significantly fewer seizures. People who follow a ketogenic diet still need to take anti-seizure medicine. And their seizures could get worse if they go back to a normal diet all at once.

True or false: A ketogenic diet is the same as other low-carb diets.

False. A ketogenic diet is very strict and relies on precise rations. There are modified versions, but these are still different from mainstream diets. In order to achieve ketosis, you need to eat very low amounts of carbohydrates. Protein and fat need to be precisely calculated. It's important to account for all sources of carbs—even some medicines and toothpastes.

True or false: For a ketogenic diet to be safe and effective, you'll need a dietitian to help you plan your meals.

True. You need to maintain the right balance of fat, carbohydrates and protein in order to stay in ketosis. This can make it tougher to get enough of some nutrients—like calcium, vitamin D, iron and folic acid. The diet has serious risks, and it requires a dietitian's help.

True or false: A ketogenic diet only works for children.

False. A ketogenic diet isn't usually recommended for adults with epilepsy. But that's generally because the restricted food choices can make it hard to stick with. When followed correctly, studies show that the diet seems to work just as well in adults as in children. Talk with your doctor if you're interested in giving it a try.

True or false: A ketogenic diet can cause serious, even dangerous, side effects.

True. The side effects can be serious. They include weight gain, kidney stones, high cholesterol, dehydration, constipation, slowed growth and bone fractures, as well as a potentially deadly condition called acidosis—when the body produces too much acid. Work closely with your healthcare team to get the most benefit from the diet—and reduce the risks.

A ketogenic diet is generally used when medicines aren't working well on their own. It can be very effective—but consider starting the diet only with the help of your doctor.

Learn more about seizures

Sources: American Academy of Neurology; Epilepsy Foundation