A blinded, crossover study of the efficacy of the ketogenic diet

Epilepsia. 2009 Feb;50(2):322-5. doi: 10.1111/j.1528-1167.2008.01740.x. Epub 2008 Aug 19.


Despite over 80 years of use, the ketogenic diet (KD) has never been tested in a blinded manner. Twenty children with intractable Lennox-Gastaut syndrome (LGS) were fasted 36 h and then randomized to receive the classic KD in conjunction with a solution containing either 60 g/day of glucose or saccharin. Parents and physicians were blinded to both the solution composition and level of ketosis. A crossover to the KD with the alternate solution occurred following the sixth day and a repeat fast. A 24-h electroencephalography (EEG) was obtained at baseline and after each arm. After administration of the solution, there was moderate evidence of a reduction in parent-reported seizures between the glucose and saccharin arms, with a median difference of 1.5 seizures per day (p = 0.07). There was no reduction in the number of EEG-identified events, with a median reduction of 7 events per day (p = 0.33). Ketosis was not completely eliminated in the glucose-added arm.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • 3-Hydroxybutyric Acid / urine
  • Child
  • Child, Preschool
  • Cross-Over Studies
  • Diet, Ketogenic*
  • Double-Blind Method
  • Electroencephalography
  • Epilepsies, Myoclonic / diet therapy*
  • Epilepsies, Myoclonic / urine
  • Epilepsy, Generalized / diet therapy*
  • Epilepsy, Generalized / urine
  • Female
  • Glucose Solution, Hypertonic / administration & dosage
  • Humans
  • Infant
  • Ketones / urine
  • Male
  • Saccharin / administration & dosage
  • Syndrome


  • Glucose Solution, Hypertonic
  • Ketones
  • Saccharin
  • 3-Hydroxybutyric Acid