The Ketogenic Diet is a special diet high in fat, low in carbohydrates and moderate in protein, carefully controlled. The word “ketogenic” means that a chemical substance, called ketones, is produced in the body (keto = ketones, genesis = production).
The ideal Ketogenic Diet called the “long chain triglyceride diet,” provides 3 to 4 grams of fat per gram of carbohydrate and protein. The “ratio” in the Ketogenic Diet is the ratio of fat for each gram of carbohydrate and protein combined. The type of fat source foods of the Ketogenic Diet is butter, cream or cream, mayonnaise, and oils.
Although both carbohydrates and proteins in the diet are restricted, it is essential to provide enough amounts of protein. It is also imperative to prepare the Ketogenic Diet carefully supervised by a Nutritionist, who monitored the nutrition of the children.
Usually, the body uses carbohydrates (sugar, bread or pasta) as its fuel, but in the Ketogenic Diet fat becomes the primary fuel. Ketones are one of the potential mechanisms of action of the diet. There are different theories such as the stabilization of glucose, adenosine, polyunsaturated fatty acids and more.
It is prescribed for children with seizures that are refractory to treatment, that is, they do not respond to several different anticonvulsant medications. They have been used first in some situations. However, it is particularly prescribed for children with Lennox-Gastaut syndrome. It is also suitable for certain types of seizures or epileptic syndromes, being useful for: myoclonic epilepsy of childhood (Dravet syndrome), asthmatic myoclonic epilepsy (Doose syndrome), infantile spasms (West syndrome), mitochondrial defects, tuberous sclerosis or tuberous sclerosis complex (TSC), Rett syndrome. And for the GLUT 1 deficiency syndrome (GLUT1 DS) and pyruvate dehydrogenase deficiency (PDH).
Typically this diet is begun in the hospital. The child habitually begins with a fast or small amount of the food (except for water) and under strict medical supervision for 24 hours. The main reason to enter them in most centers is to monitor any increase in seizures with diet, treat hypoglycemia or acidosis (which may occur at the onset of CD), monitor and improve tolerance, ensure that all medications are free of carbohydrates, and educate the family to maintain the diet at home.
Approximately half of the children who start the diet have at least a 50% reduction in the number of seizures and other children (10-15%) are free of seizures. However, not all children have greater control of the crisis, and some have other benefits such as being more alert, aware and with a better response.
Urine test strips are used to monitor the production of ketones in the urine, produced by the diet. Also, every three months or so, other laboratory tests are performed to monitor electrolytes, kidney function, liver function, carnitine, selenium, and others.
The person who starts the ketogenic diet may feel lazy for a few days after starting the diet. Other side effects that may occur include kidney stones, high serum cholesterol levels, vomiting, constipation, poor growth or weight gain, bone fractures, and more.
Because the ketogenic diet does not produce all the vitamins and minerals found in a balanced diet, the Nutritionist will suggest vitamin and mineral supplements such as calcium and vitamin D, selenium, iron and folic acid. Many Centers treat children with citrates (e.g., Polycitra-K) to prevent kidney stones. Additionally, many of these Centers use L-carnitine.