Researchers studied whether a special high-fat, low-carb diet called the ketogenic diet could help children with epilepsy reduce or stop taking seizure medications. They looked at 151 children who responded well to this diet over a 15-year period. About one in four children were able to stop taking at least one of their seizure medicines after six months on the diet. The study found that younger children and those taking fewer medicines at the start had the best chances of reducing their medications. This suggests the ketogenic diet might be a helpful tool for some children with epilepsy to eventually need fewer or different medicines.

The Quick Take

  • What they studied: Can eating a special high-fat, low-carb diet help children with seizures stop taking some of their seizure-preventing medicines?
  • Who participated: 151 children (ages 0-18) with epilepsy who were treated at a children’s hospital in the Netherlands between 2008 and 2023. All of these children had responded well to the ketogenic diet and stayed on it for at least six months.
  • Key finding: About 27 out of every 100 children (27%) who responded to the ketogenic diet were able to stop taking at least one seizure medicine within six months. On average, children reduced their number of medicines from 2.6 to 2.4 medicines.
  • What it means for you: If your child has epilepsy and their doctor is considering the ketogenic diet, this research suggests it might help reduce the number of medicines they need to take. However, this only worked for about one-fourth of children studied, and it works best for younger children taking fewer medicines. Always talk with your child’s doctor before making any changes to their medicines.

The Research Details

This study looked back at medical records from children treated at a hospital in the Netherlands over 15 years. The researchers reviewed information about 151 children with epilepsy who had done well on the ketogenic diet (a special diet high in fats and very low in carbohydrates) and stayed on it for at least six months. They collected information about each child’s age, how many seizure medicines they were taking, and whether they were able to reduce or stop any medicines after starting the diet.

The researchers used statistical methods to figure out which factors helped predict whether a child could successfully stop taking medicines. They looked at things like the child’s age when they started the diet and how many medicines they were taking at the beginning. This type of study is called a retrospective study because the researchers looked back at information that was already collected, rather than following new patients forward in time.

This research approach is important because it shows real-world results from actual patients treated over many years. By looking at which children succeeded in reducing medicines and which ones didn’t, doctors can better understand who might benefit most from trying the ketogenic diet. The study helps identify patterns that could guide doctors in deciding which children to recommend for this treatment and when to try reducing medicines.

This study has some strengths and some limitations to keep in mind. The strength is that it includes a large group of children (151) followed over a long time period (15 years), which gives a good picture of real-world results. However, because researchers looked back at existing medical records rather than planning a study in advance, there could be missing information or differences in how doctors recorded things. The study only included children who responded well to the diet, so we don’t know as much about children for whom the diet didn’t work. Additionally, the study was done at one hospital, so results might be different in other places or populations.

What the Results Show

The main finding was that 27% of children (about 1 in 4) who responded well to the ketogenic diet were able to stop taking at least one seizure medicine within six months of starting the diet. This is a meaningful result because it shows that for some children, the diet can reduce their need for medicines.

When looking at all the children together, the average number of seizure medicines they took decreased slightly from 2.6 medicines at the start to 2.4 medicines after six months. While this might seem like a small change, it’s important because taking fewer medicines means fewer side effects and a simpler daily routine for children and families.

The researchers found two important factors that predicted success: younger age and taking fewer medicines at the start. Children who were younger when they started the diet were more likely to be able to reduce their medicines. Similarly, children who were already taking fewer medicines had better chances of stopping at least one medicine. For example, a child starting the diet at age 5 had better odds of reducing medicines than a child starting at age 15.

The study also showed that the number of medicines decreased from an average of 2.6 to 2.4, meaning some children reduced their medicine load even if they didn’t completely stop any single medicine. This partial reduction is still helpful because it can reduce side effects. The research supports trying to reduce medicines within 3-6 months of starting the ketogenic diet for children who are good candidates, rather than waiting longer.

This research adds to growing evidence that the ketogenic diet can be helpful for children with epilepsy. Previous studies have shown that the diet can reduce seizures, but this study specifically focuses on whether it helps reduce medicine use. The findings align with what doctors have observed in practice—that some children do better on the diet and need fewer medicines—and now provides numbers to show how often this happens (about 1 in 4 responders).

Several limitations should be considered when thinking about these results. First, this study only looked at children who responded well to the ketogenic diet and stayed on it for six months. We don’t know how many children tried the diet but stopped because it didn’t work or was too difficult. This means the 27% success rate applies only to children whose seizures improved with the diet, not to all children with epilepsy who try it. Second, the study was done at one hospital in the Netherlands, so results might be different in other countries or settings. Third, because researchers looked back at medical records, some information might be missing or recorded differently by different doctors. Finally, the study didn’t follow children for longer than six months, so we don’t know if children who reduced medicines stayed off them long-term or if they needed to go back on them later.

The Bottom Line

Based on this research, the ketogenic diet appears to be a reasonable option to discuss with your child’s epilepsy doctor if your child’s seizures are not well-controlled with medicines alone. The evidence suggests that if your child responds well to the diet, there’s about a 1 in 4 chance they could reduce or stop at least one medicine within six months. This is most likely to work if your child is younger and already taking fewer medicines. Doctors should consider trying to reduce medicines within 3-6 months for children who are good candidates. However, any changes to seizure medicines must be made carefully under a doctor’s supervision, as stopping medicines too quickly can be dangerous.

This research is most relevant for families with children who have epilepsy that is difficult to control with medicines alone. It’s especially important for parents of younger children (under age 10) who are taking multiple seizure medicines. Children whose seizures have improved on the ketogenic diet should definitely discuss medicine reduction with their doctor. However, this research doesn’t apply to children whose seizures are already well-controlled with just one or two medicines, as they may not need to change anything. Adults with epilepsy should talk to their own doctors, as this study only looked at children.

If your child starts the ketogenic diet, doctors suggest waiting 3-6 months to see if it’s working before trying to reduce medicines. If the diet is going to help reduce seizures, you’ll usually see improvement within the first few months. If your child’s seizures do improve and the doctor decides to reduce medicines, this process should happen slowly and carefully, typically over weeks to months, not all at once. It’s important to be patient and work closely with your child’s epilepsy team throughout this process.

Want to Apply This Research?

  • Track your child’s seizure frequency weekly (number of seizures per week) and document any changes in seizure medicines, including dose reductions or withdrawals. Also note diet adherence by recording percentage of meals that follow the ketogenic diet plan.
  • If your child’s doctor approves, work with a dietitian to implement the ketogenic diet properly. Use the app to log meals, track seizure patterns, and monitor any side effects. Share weekly reports with your child’s epilepsy team to support discussions about medicine adjustments.
  • Set up monthly check-ins within the app to review seizure trends and medicine changes. Create alerts to remind you of doctor appointments and medicine review dates. Track energy levels, mood, and any side effects alongside seizure counts to give your doctor a complete picture of how the diet is working.

This research describes one study about the ketogenic diet and seizure medicines in children. While the findings are promising, they apply only to children whose seizures improved on the diet. The ketogenic diet is a medical treatment that requires supervision by a doctor and dietitian. Never change, reduce, or stop seizure medicines without explicit guidance from your child’s neurologist or epilepsy specialist, as this can be dangerous and cause serious seizures. This information is educational only and should not replace professional medical advice. Always consult with your child’s healthcare team before making any changes to their epilepsy treatment plan.