Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group

Eric H. Kossoff, Beth A. Zupec-Kania, Per E. Amark, Karen R. Ballaban-Gil, A. G. Christina Bergqvist, Robyn Blackford, Jeffrey R. Buchhalter, Roberto H. Caraballo, J. Helen Cross, Maria G. Dahlin, Elizabeth J. Donner, Joerg Klepper, Rana S. Jehle, Heung Dong Kim, Y. M. Christiana Liu, Judy Nation, Douglas R. Nordli, Heidi H. Pfeifer, Jong M. Rho, Carl E. StafstromElizabeth A. Thiele, Zahava Turner, Elaine C. Wirrell, James W. Wheless, Pierangelo Veggiotti, Eileen P.G. Vining, Anne Anderson, Bruce Cohen, Mary Currey, Diane Donley, Leon Dure, Bhuwan Garg, Michael Goldstein, Brian Grabert, David Griesemer, Edward Kovnar, Roger Larson, Agustin Legido, Leslie Anne Morrison, Colette Parker, J. Ben Renfroe, Juergen Schreck, Shlomo Shinnar, Russell Snyder, Carmela Tardo, G. Dean Timmons, Gregory Yim

Research output: Contribution to journalReview article


The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.

Original languageEnglish (US)
Pages (from-to)304-317
Number of pages14
Issue number2
StatePublished - Feb 1 2009



  • Children
  • Consensus
  • Diet
  • Epilepsy
  • Ketogenic

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Kossoff, E. H., Zupec-Kania, B. A., Amark, P. E., Ballaban-Gil, K. R., Christina Bergqvist, A. G., Blackford, R., Buchhalter, J. R., Caraballo, R. H., Helen Cross, J., Dahlin, M. G., Donner, E. J., Klepper, J., Jehle, R. S., Kim, H. D., Christiana Liu, Y. M., Nation, J., Nordli, D. R., Pfeifer, H. H., Rho, J. M., ... Yim, G. (2009). Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group. Epilepsia, 50(2), 304-317. https://doi.org/10.1111/j.1528-1167.2008.01765.x