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Ketogenic dietary therapies for epilepsy and beyond

deCampo, Danielle M.; Kossoff, Eric H.

Current Opinion in Clinical Nutrition & Metabolic Care: July 2019 - Volume 22 - Issue 4 - p 264–268
doi: 10.1097/MCO.0000000000000565
GENES AND CELL METABOLISM: Edited by George Grimble and James Ryall

Purpose of review The ketogenic diet, a high-fat, low-carbohydrate therapy, has become an established treatment for pediatric epilepsy since 1921. There has recently been an increase in important studies on the ketogenic diet, and this review will highlight the most recent in order to provide a synthesis of where this field stands today.

Recent findings Clinical studies continue to support the use of ketogenic diets in epilepsy, with more recent trials supporting its use in adults. Clinical recommendations published in 2018 based on a decade of practice and research, guide implementation and management of the ketogenic diet in epilepsy. One of the most rapidly growing ‘indications’ includes the role of ketogenic diets in status epilepticus. An exciting new potential mechanism for how the ketogenic diet exerts its antiseizure effects is through changing the composition of the gut microbiome. Lastly, ketogenic diets are being applied to a range of neurological conditions from autism to Alzheimer's disease.

Summary The ketogenic diet is a versatile therapy, with growing clinical evidence and guidelines, widely used for the treatment of epilepsy. New indications include status epilepticus and neurological conditions other than epilepsy.

Departments of Neurology and Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland, USA

Correspondence to Eric H. Kossoff, MD, 200 N. Wolfe Street Rubenstein Building, Suite 2158 Baltimore, MD 21287, USA. Tel: +1 410 955 4529; e-mail:

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