Ketogenic Diet
Ketogenic Diet Program at Winchester Medical Center 
Winchester Medical Center has designed a Ketogenic Diet Program as part of the Virginia Comprehensive Epilepsy Program to help those struggling with difficult-to-control seizures. 
What is the Ketogenic Diet? 
The Ketogenic Diet is a high-fat, adequate protein, very-low-carbohydrate diet offered for children from infancy to teenage years. In the traditional Ketogenic Diet, meals are calculated in ratios such as 4:1, 3:1, or 2:1. A 4:1 ratio means that there is 4 times as much fat as there is protein and carbohydrate combined. All food is weighed on a gram scale using recipes that are created specifically for your child. 

How does the diet work? 
No one knows for sure how the diet works. Our body normally burns glucose from carbohydrate for energy. On the ketogenic diet, fat breakdown produces ketones which replace glucose for energy. This creates metabolic changes in the brain and this may be associated with the anti-seizure affect. Since the 1920’s, studies consistently show that 50-75% of children with seizures of all types are helped by the diet. If the diet is effective, it is generally followed for 2-3 years. If the diet is not helpful, it will be stopped within a few months. 
What to expect 
You will meet with the ketogenic neurologist and dietitian to discuss your plan of care. If it is decided that the ketogenic diet is recommended for your child, an appointment will be scheduled with the dietitian for a thorough nutrition assessment and to provide education on the diet and what to expect during the planned 4-day hospital stay at Winchester Medical Center. 

During the admission, your child will be monitored closely as they are transitioning to the ketogenic diet. You will receive instruction on diet management and how to properly use the gram scale for measuring food. You will also be preparing meals in the kitchen with guidance from your dietitian following the recipes specifically designed for your child. After discharge from the hospital, you will continue to meet with the Ketogenic Diet team several times per year while continuing to follow with your primary neurologist. 

Modified Atkins Diet (MAD) and Low Glycemic Index Treatment (LGIT) 
We also offer the MAD and LGIT for adolescents and adults that may benefit from a more liberalized diet. Similar to the ketogenic diet, these are also high in fat and low in carbohydrate. The MAD contains 10-20gm of carbohydrate per day with a very high fat content. In the LGIT, the carbohydrate amount is limited to 40-60gm per day while only eating foods with a low glycemic index. These diets are started after meeting with the dietitian. Hospital admission is not needed. Follow-up will be planned several times per year to meet with the ketogenic diet team. 
For more information on the Ketogenic Diet Program at Winchester Medical Center, please contact Laila Hammer, RD, at 540-536-7698.