Nutrition Interventions for Children with Special Health Care Needs

Chapter 22 - Ketogenic Diet for Seizure Disorders
Table 22-1: Ketogenic Diet for Seizure Disorders
Assessment Intervention Evaluation/Outcome
Anthropometric*
Child’s growth continues
appropriately. Weight maintenance
for the first full year on the diet
(maintenance defined as staying
within weight channel)
Adjust recommendations for energy intake, based on growth, activity
level. Goal is to allow for child to continue to grow according to
current weight/height channels
• To ensure accurate calories, obtain three-day food record.
Evaluate average daily calorie intake.
• Caloric adjustments are made slowly, and not combined with a
ratio adjustment.
Weight loss can result in
hyperketosis and vomiting.
Consistent energy intake is
important.
Measure and plot on appropriate growth
chart:
• Height or length for age
• Weight for age
• Weight for height (or length) or
BMI
• Head circumference (under 3
years)
Identify ideal body weight (IBW).†
Weight gain can result in a loss of
ketosis, resulting in loss of seizure
control.
Compare all current measurements
to reference data for age and to
previous measurements.
Measure weight weekly (at home).
Weight should be reported to RD.
250 Nutrition Interventions for Children With Special Health Care Needs
Biochemical
MD to order the following serum lab
tests (pre-diet and monthly for the first
months). MD will determine schedule
depending on how stability of the child.
Mild elevations of cholesterol and
triglycerides are acceptable. After
initial increase in cholesterol and
triglycerides (during first 6 months),
levels will stabilize or return to
baseline.
Modification of fat sources may be needed if increased levels do not
decline or stabilize. Adding fish oil is an effective therapy to decrease
serum triglycerides. Converting some of the fat from heavy whipping
cream and butter to olive oil or canola oil is also helpful.
Total cholesterol
Triglycerides