An Introduction to the Ketogenic Diet

The current form of the classical Ketogenic Diet (KD) was first successfully used to manage hard to treat (intractable) epilepsy by Wilder in the 1920s but its use declined with the development of the anti-epileptic drug, phenytoin, in 1938.  Its use has now increased dramatically, initially at the John Hopkins Institute and now worldwide, primarily when anti-epileptic drugs have failed or there are unacceptable side effects from their use.

The classical Ketogenic Diet is a high fat, adequate protein and low carbohydrate diet.  Most commonly, the classical diet provides a 4:1 ratio of 4 grams of fat to every 1 gram of non-fat (protein and carbohydrate) energy, although the ratio can be modified to individual tolerances.  Other forms of the Ketogenic Diet are also administered for example, the medium chain triglyceride (MCT) diet developed by Huttenlocher.  The classical version of the diet remains by far the most widely used, with good evidence supporting its efficiency.

The classical Ketogenic Diet can be achieved using foods with a high fat content e.g. double cream and has the following characteristics;

• 4:1 ratio of fat to protein and carbohydrate
• Prescribed to provide 75% or more of the child’s usual energy requirements depending on individual needs
• May be low in fluid, depending on a centre’s practice, although this practice is declining.
• Provides adequate protein to meet growth requirements e.g. >1gram/kg body weight for a 1-5 year old child
• Carbohydrate content is very low – i.e. only sufficient to prevent low blood sugars/ symptomatic hypoglycaemia (lower than normal level of glucose (sugar) in the blood)

The Ketogenic Diet causes the metabolic equivalent of fasting.  The very high long chain triglyceride (LCT) fat content of the Ketogenic Diet means that the body has to derive energy from fat rather than from carbohydrate.  Energy is derived from fat by b oxidation (the process by which fatty acids are broken down) producing ketone bodies (three water-soluble compounds that are produced as by-products when fatty acids are broken down for energy in the liver and kidney) such as b hydroxybutyrate (BHB).  These ketone bodies are used as a metabolic fuel by the body including the brain for energy giving rise to plasma ketosisis (a stage in metabolism occurring when the liver converts fat into fatty acids and ketone bodies which can be used by the body for energy).  The Ketogenic Diet’s mechanism of action is unknown.  Various theories exist such as: the change in brain energy metabolism resulting in the production of ketone bodies which may be anti-convulsant (a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures); change in neuronal cells which may reduce neuronal excitability and hence be anti-epileptic or a change in brain acidosis (increased acidity)

How do you rate this information out of 5?:

Recent Reviews for this information

Health Care Information Disclaimer

The content provided by shs-nutrition is for information purposes only and is in no way intended to be a substitute for medical consultation with your doctor, dietitian or healthcare professional. The information, opinions, and recommendations presented in these pages are not intended to replace the care of your own doctor, dietitian or healthcare professional. Before you make any changes in the management of your diet / treatment or any other persons diet /treatment you should always consult your doctor, dietitian or healthcare professional. Although we carefully review our content, shs-nutrition cannot guarantee or take responsibility for the medical accuracy of documents we publish, nor can shs-nutrition assume any liability for the content of any web site linked to our site. © 2008 SHS International. All rights reserved.