Epilepsy and diets

There are a number of diets linked to the treatment of epilepsy. Children and adults with uncontrolled seizures may be helped by epilepsy dietary therapy, however, there is no way to predict beforehand whether they will be successful. The following provides a short overview of these diets, which should only be initiated under the supervision of a dietitian and with the approval of treating doctors and specialists.

 For more information, please find a more detailed fact sheet at the bottom of this page.

The Ketogenic Diet is a special high-fat diet that is used for difficult-to-treat seizures. Heavy cream, butter and vegetable oils provide the necessary fat. It is low in carbohydrates thus eliminating sugar and other carbohydrate-rich foods such as bread, rice, pasta and cereals. The main source of carbohydrate is from small serves of measured fruits and vegetables.

Variations in this type of diet have developed over time. A distinction should be made between “The Classical Ketogenic Diet” and the “Modified Ketogenic Diet” (MKD).

The ketogenic diet for epilepsy is now referred to as the “Classical” Ketogenic Diet. This differentiates the ratio-controlled diet from popular mainstream diets which may be referred to as ‘ketogenic’.

The “Classical” Ketogenic Diet is an exact diet where every meal must provide just the right amount of fat, protein and carbohydrates. The diet is calculated in terms of ratios such as 4:1, 3:1 and 2:1. In a 4:1 ratio, there is 4 times as much fat as there is protein and carbohydrate combined.  The dietitian devises meal plans that complete the required fat, protein and carbohydrate for each meal.

Recipes indicate the exact grams of each food ingredient that must be accurately weighed on a gram scale. 

This is less restrictive than the Classical Ketogenic Diet. It allows all protein-rich foods such as meat, chicken, eggs and fish to be eaten to appetite and fats are encouraged. Food does not need to be weighed and recipes do not need to be precise.

Carbohydrate foods are counted and spread throughout meals with the aim to keep within the daily gram limit set by the dietitian.

The MKD is often used for adolescents and adults as it allows more flexibility in mealtime choices compared with the Classical Ketogenic Diet.

For more information please read the “Diets and Epilepsy” fact sheet below. This provides more detailed information about the function, health, effectiveness and impact of these types of diets for people with epilepsy. It also includes referral information to consider.

Acknowledgement:  Adapted with input from dietitians from Mater Health Services and the Ketogenic Diet Service at the Queensland Children’s Hospital.