The ketogenic (or keto) diet — a high-fat, low-carbohydrate diet — is not just another fad diet. It is an evidence-based dietary therapy that can help patients with epilepsy by reducing seizures. After three months on the keto diet, research indicates that 87% of patients with epilepsy report an improved quality of life.

“It’s really remarkable seeing how patients can succeed with the keto diet and regain a sense of control over their lives,” says Yara Mikhaeil-Demo, MD, at Northwestern Medicine Comprehensive Epilepsy Center.

Health Benefits of a Keto Diet for Patients With Epilepsy

Since it was first introduced in the 1920s, the keto diet has become an evidence-based dietary therapy for specific conditions like epilepsy. First tested among pediatric patients, it is now prescribed to adult patients with epilepsy, alongside medication or surgical treatment. These patients report:

How It Works

On the keto diet, patients are encouraged to reduce consumption of foods high in carbohydrates, such as grains, legumes and sugars. The goal is to replace carbohydrate intake with fat to induce ketosis: a metabolic state whereby ketone bodies (chemicals produced in the liver from fatty acids) provide fuel for the body.

The reason why this diet produces health benefits for patients with epilepsy is still unknown. However, experts believe that when the brain gets nourishment from ketone bodies instead of glucose, the body has a higher capacity to convert food into energy. Ketone bodies are also believed to increase the production of gamma-aminobutyric acid (GABA), which is a neurotransmitter in the brain. This could help keep seizures from occurring.

Risks of a Keto Diet

There are pros and cons to the keto diet, including potential risks and side effects. The most well-known side effect is often referred to as the keto flu, which can occur during the body's initial withdrawal from carbs and include such flu-like symptoms as fatigue, headache, dizziness, nausea and vomiting. The keto flu typically subsides in a few days.

Risks associated with the keto diet concern heart health, kidney stones and high cholesterol levels. To minimize such risks, consult your physician before starting a keto diet. Each patient with epilepsy shifting to a keto diet should be carefully monitored by an epilepsy specialist and registered dietitian.

How to Sustain a Keto Diet

There are a few types of keto diets for different lifestyles. Michelle Creek, MS, RDN, LDN, CNSC, a clinical dietitian at Northwestern Memorial Hospital, explains that patients begin the Northwestern Medicine Keto Program with an educational class about the keto diet to build an understanding of its benefits. Then, they meet individually with clinical staff to establish a customized plan that meets specific goals and helps them achieve success.

Effective keto regimens can be modified to help patients stick to the diet. Although it may be tempting to cook repetitive meals or purchase processed items marketed as keto, it is vital for long-term health to include a variety of whole foods in your diet.

Remember, It’s a Mindset

“The most important thing about this diet is mindset,” advises Dr. Mikhaeil-Demo. “Think about all of the positives it can create in your life and realize that it can be a very versatile diet if you want it to be.” Start the diet with optimism, log progress and commit to at least three months for optimal results.