“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
I never set out to lose a certain amount of weight when I started, I just wanted to be healthy for myself and my kids. In the beginning it was tough, I was used to eating a whole large pizza with ranch for dinner, or 3 grilled cheese sandwiches dipped in barbecue sauce. Veggies were eschewed unless they were a topping on my cheeseburger. I remember my first week I packed a salad with chicken and bacon and blue cheese dressing, and that was pretty good. Then I made some brats and sauerkraut and mustard with a side of broccoli. Hey this isn't so bad. I got in to the habit of picking a protein and a veggie and mix and matching for variety. Chicken, pork chops, brats, steak, and broccoli, Brussels sprouts, asparagus, green beans were my staples. I didn't weigh or count macros, I just avoided the bad carbs and focused on the good.
Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
Live It! This phase is a lifelong approach to diet and health. In this phase, you learn more about food choices, portion sizes, menu planning, physical activity, exercise and sticking to healthy habits. You may continue to see a steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week until you reach your goal weight. This phase can also help you maintain your goal weight permanently.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy. It is approved by national clinical guidelines in Scotland, England, and Wales and reimbursed by nearly all US insurance companies. Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet. About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults. A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.
So now that I'm here everyone likes to ask me when I'm going to stop, and I say what do you mean? Why would I stop doing something that makes me feel so wonderful everyday, gives me energy and focus and go back to the way of eating that got me into this predicament to begin with. If I never lose another pound I will still be happy for the rest of my life a Keto practitioner.
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether. Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions. This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.
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