This information is for children and young people with epilepsy. Parents or carers might also find this information helpful.
On this page we talk about what the ketogenic diet is, how it works for young people with epilepsy, and the possible side effects.
Use this page as a general guide. Talk to a health professional for more help.
The ketogenic diet, sometimes called keto, is a special way of eating. It involves having lots of high fat foods and very small amounts of carbohydrates (carbs). The aim of the diet is to have fat as the main source of energy for the body.
Following a keto diet can help reduce seizures in some children and young people with epilepsy. It can also help people improve their general health and lose weight.
If the keto diet is right for you, it will be carefully planned and explained by a doctor and dietitian (an expert in eating healthy).
Normally, your body uses carbs, such as bread or potato, as its main source of energy. But when you cut out carbs, or have a very small amount, your body doesn’t have enough carbs to burn for energy. So it uses fat instead. When your body uses fat in this way it produces something called ketones. This is called being in ketosis.
How long it takes your body to go into ketosis varies from person-to-person. For most people it usually takes a few days, but it can depend on other things. For example, how quickly your body takes to turn food into energy (your metabolism). And how strictly you’re following the keto diet.
You can check if you’re in ketosis by checking the level of ketones in your body. Your doctor may suggest doing regular blood or urine tests to check if your body is in ketosis.
The ketogenic diet can work well at reducing the number of seizures you have. Children who closely follow a keto diet can reduce their seizures by half.
This is because being in ketosis changes how your brain works – your brain metabolism. Ketones help to give your brain a more steady source of energy and keep nerve cells (neurons) in your brain calm. These things can help to reduce seizures.
If you’re starting a keto diet, you should carry on taking your anti-seizure medications (meds) as normal. If the keto diet works well and your seizures start reducing, your doctor may suggest slowly reducing your meds. Remember, never stop taking your meds without talking to your doctor first. They will help you reduce them gradually and safely.
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The keto diet isn’t normally an option for everyone with epilepsy. More research is needed to fully understand how well it works at reducing seizures in people with all types of epilepsy. We also don’t know for sure how long people with epilepsy can stay on a keto diet safely.
But the keto diet does work well in people with epilepsy that doesn’t respond to anti-seizure meds (drug-resistant epilepsy). The keto diet may also work well for people with certain types of epilepsy, including Dravet syndrome and Lennox–Gastaut syndrome. People who have infantile spasms may also benefit from trying a keto diet.
If your doctor has suggested you try a keto diet to help manage your seizures, they will talk to you about what it involves. They will talk to you about what you can eat and what foods you should avoid.
If you’re starting a keto diet, you’ll need to eat lots of high fat foods. High fat foods include:
If you’re on a keto diet, it’s important that you don’t choose ‘low-fat’ options. This is because foods labelled as ‘low-fat’ sometimes have sugar in them instead of fat. Sugar is a carbohydrate and you should avoid it on the keto diet.
You can eat some vegetables and fruits if you’re on a keto diet. But you should only eat these foods in small amounts. This is because they contain natural sugar which you should avoid on a keto diet. If you’re not sure, talk to your dietitian.
Other foods you should avoid if you’re on a keto diet include:
For more information and support if you’re on a keto diet, talk to someone from your medical team. They will be able to help and support you. The charity, Matthew’s Friends, also has lots of helpful information on their website. They have keto recipes and a meal planner.
For some children and young people, being on a keto diet can start reducing seizures in a few weeks. For others, it may take longer.
It can take a while to get used to a new way of eating, especially if it’s very different to the way you ate before. Try staying on the keto diet for at least three months. This will give you the best chance of seeing an improvement in your seizures.
It can be hard sticking to a special diet. Especially if you have to avoid many of the foods that you normally enjoy.
It can also be very hard sticking to a diet if you’re around family or friends who aren’t eating the same as you. If you go to a restaurant, or it’s a special occasion, you might be tempted to break your diet.
For the keto diet to work properly you need your body to go into ketosis – when your body uses your fat to burn energy. This only happens when you’re strictly following the diet. Not following the keto diet carefully, may mean that your body comes out of ketosis. If this happens, the keto diet may not work well, and you may start having more seizures again. It’s okay to have slip ups every now and again. But it’s important to try again and keep going. It may take a few days to get your body into ketosis again.
If you’re on a keto diet, but you’re struggling to stick to it, talk to your doctor. They will be able to help and support you.
People who go on a keto diet don’t usually have any serious side effects. If you do have side effects, they’re likely to start in the first few days of being on the diet. This is because your body is getting used to a different way of eating. Side effects of the keto diet may include:
You may hear some of these symptoms being called ‘keto flu’. Symptoms are usually mild and don’t last very long. But, if you’re having side effects that are hard to deal with or not getting better after a few weeks, talk to someone from your medical team.
There are different versions of the keto diet, including the classic keto diet and the modified keto diet. They are kind of the same, but the amount of fats and carbs you can eat is a little different. Which version of the diet your doctor suggests for you, may depend on things like your age, height and weight.
If you’re on a modified keto diet, you may be able to have more protein than on the classic keto diet. This type of diet can be helpful if you find being on a very strict diet hard to stick to.
If the keto diet is right for you, your medical team will make a plan with you. They will explain how it works. You may see a consultant (specialist doctor) and a dietitian regularly, who will support you with your diet.
A dietitian is someone who knows a lot about food. They help people choose the right foods to stay healthy or feel better when they are ill. A dietitian will help make the keto diet just for you. For example, working out how much fat you should eat. Ask them if you have any questions or worries. They are there to help you.
You may need to have regular blood or urine tests. And your medical team may recommend some vitamins and minerals for you to take.
A charity that supports children and their families with ketogenic diets. They provide information, training, research and grants.
Information about epilepsy and different tests and scans.
Up-to-date guidelines for children and young people with epilepsy.
A charity that supports children and their families with drug-resistant epilepsy, including information about the keto diet.
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8. Ketogenic diet for epilepsy (children). Chelsea and Westminster Hospital NHS Foundation Trust. Accessed March 10, 2026. https://www.chelwest.nhs.uk/services/childrens-services/childrens-medicine/ketogenic-diet-for-epilepsy-children
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Last updated December 2023.
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