Full question:My son has been on the Ketogenic Diet for 10 months, he is at a 1.75:1 ratio and his BHB levels measure between 6 and 7. We have seen a 75-80% decrease in his seizure activity. His first month on the diet he went seizure free, but we haven't seen that again. My question is: Does "tweaking" the diet always coincide with trying to maintain ketosis? If a child is already making adequate ketones, is it worth trying dietary changes to gain better seizure control? Thank You.
Reply: it is possible that adjustments to the diet could promote further seizure-control even after 10 months on the diet (which may or may not be related to degree of ketosis). I've found an effective method of improving seizure control is to limit food choices to mostly whole foods (foods that are not processed). Some of the kids I've worked with have achieved better seizure control when they elminate foods with sugar-alcohols and artifical sweeteners such as low-carb bars, cookies, and diet sodas. Also, the current ratio that your son is on is considered quite liberal, possibly a 2:1 would provide better control but it also means less carbohydrate and a little more fat. These are the first adjustments that I'd attempt - you should give them each at lesat 2 weeks to see if there's a difference.