Nutrition Interventions for Children with Special Health Care Needs

Chapter 22 - Ketogenic Diet for Seizure Disorders
Assessment Intervention Evaluation/Outcome
Caregivers plan, prepare, and
measure meals with 100%
accuracy as demonstrated in class
and follow-up visits. Ketosis is
stable as demonstrated by stable
betahydroxybutyrate. Weight gain
consistent with defined parameters.
Determine education needs Ketogenic Diet education—caregivers come with different levels
of understanding and preparation regarding the diet. Education
program should include:
• History of the diet
• Theoretical basis
• Expectations of the diet
• Possible complications
• Expectations of the program
• Resources needed
• Ketone testing
• How to handle illness
• Importance of compliance
• Monitoring requirements
• Nutritional guidelines—energy, protein, carbohydrate, fat, fluids,
vitamins, and minerals
• Meal planning—eating consistently, using a gram scale, careful
measuring, recipe suggestions, and meal preparation
Give caregivers as much written information as possible in an
organized format for home reference. Education on an outpatient
basis may be achieved with a one-day class. The outpatient approach
allows an education environment that is lower in stress and free from
interruptions common with hospital admissions.
Ideally, a child will remain on the diet for 2 years or for one year
after becoming seizure-free. This is individualized based on the
child’s needs as determined by the KD Epileptologist. The diet is then
weaned over a one-year time period, with decreasing ratio every
3-6 months. If seizures increase, the diet can be reversed. Not all
children have total seizure control, or become medication-free.
258 Nutrition Interventions for Children With Special Health Care Needs
Seizure control remains during and
after weaning from the diet.
Assess appropriate time and
regimen for weaning the diet
*For reference data and guidelines for taking accurate measurements, see Chapter 2.
†Ideal weight is the weight that would place the child at the 50th percentile for weight for height (or length).
‡See Freeman JM. The Epilepsy Diet Treatment: An Introduction to the Ketogenic Diet, 2nd Edition, p.39 for more information.