Efficacy of the ketogenic diet as a treatment option for epilepsy: meta-analysis

J Child Neurol. 2006 Mar;21(3):193-8. doi: 10.2310/7010.2006.00044.


The evidence base for the efficacy of the ketogenic diet was assessed among pediatric epileptic patients by application of a rigorous statistical meta-analysis. Nineteen studies from 392 abstracts met the inclusion criteria. The sample size was 1084 patients (mean age at initiation 5.78 +/- 3.43 years). The pooled odds ratio, using a random effects model, of treatment success (> 50% seizure reduction) among patients staying on the diet relative to those discontinuing the diet was 2.25 (95% confidence interval = 1.69-2.98). The reasons for diet discontinuation included < 50% seizure reduction (47.0%), diet restrictiveness (16.4%), and incurrent illness or diet side effects (13.2%). The results indicate that children with generalized seizures and patients who respond with > 50% seizure reduction within 3 months tend to remain on the diet longer. Although no class I or II studies have been published regarding the efficacy of the ketogenic diet, this meta-analysis shows that current observational studies reporting on the therapeutic effect of the ketogenic diet contain valuable statistical data. Future observational studies should aim for long-term follow-up, patient dropout analysis, and improved seizure type characterization.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Diet / methods*
  • Diet, Carbohydrate-Restricted / methods
  • Diet, Protein-Restricted / methods
  • Epilepsy / diet therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Ketosis / etiology
  • Ketosis / metabolism*
  • Male
  • Odds Ratio
  • Patient Dropouts
  • Time Factors
  • Treatment Outcome