What is Ketogenic Therapy?

An Introduction to Ketogenic Therapy

The history of the ketogenic diet begins in biblical times, when fasting was used to cure what were known as "fits". Later, in the early 1900's abstaining from food for several days was found to result in cessation of seizing activity. However, while fasting did have temporary benefits, it could not be used to treat seizures indefinitely. Since then, many researchers have studied the effects of fasting on seizures, but the development of the Ketogenic Diet can be credited to Dr. R.M. Wilder at the Mayo Clinic in Minnesota. His idea for the diet stemmed from the knowledge that during starvation, the body undergoes a state of ketosis. Ketosis is the result of fat being burned in the presence of little carbohydrate. Examples of ketones are beta-hydroxybutyric acid, acetone, and acetoacetic acid. Therefore in 1921, Dr. Wilder proposed a diet that was high in fat and low in carbohydrate to produce ketosis in the body that could be maintained on a long term basis1.

Ketogenic Therapy: An In-Depth Look

Although this therapy has been in existence for a long time, its popularity has both waxed and waned and the mechanism of how ketone bodies function to reduce epileptic activity is still unknown. Currently, the way in which the therapy is administered is by prescribing a diet to a patient to be followed as rigidly as one would follow a prescription for a drug. The diet prescription is made up of several components including an allotment of adequate calories, protein, and nutrients for each individual. Supplementation is commonly employed to meet nutrient needs. The strength of the diet prescription (what would be comprable to a dosage amount in medication) is gauged by the ratio of fat in grams to grams of proteins summed with grams of carbohydrates. So, a prescribed ratio of 4:1 is indicative of 4 grams of fat for every 1 gram of protein plus carbohydrates.

This diet is akin to approximately 80 to 90 percent of energy from fats compared to an approximate average of 34 percent in a typical diet. The mechanism of ketogenic therapy is theorized to be a result of long term metabolic changes as well as central nervous system adaptation and efficacy typically takes time to be achieved. Its efficacy is, however, cited as indisputable2.


Freeman , J. M., & Kelly, M. T., & Freeman, J. B. (1994). The Epilepsy Diet Treatment. New York, NY: Demos Publications.

Choragiewicz T, Zarnowska I, Gasior M, Zarnowski T. Anticonvulsant and neuroprotective effects of the ketogenic diet. Przegl Lek. 2010;67(3):205-12.

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Dr. Peggy R. Borum
University of Florida
FSHN Department
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