The Development of a Modified Ketogenic Diet Program

Abstract

Developing and implementing the modified ketogenic diet (MKD), an alternative to the traditional ketogenic diet (KD), proved to be a clinical and family-centered care success for the outpatient and ultimately the inpatient program at Connecticut Children's Medical Center. Initially introduced as an option in the outpatient program, the need for the MKD treatment was soon identified in the inpatient setting as well. To ensure consistent and appropriate care for the children receiving the MKD, an inpatient clinical pathway was developed and adopted as standard of care. This included the development of a standard MKD menu for the hospital. Use of the name modified ketogenic diet versus modified Atkins diet® was adopted to differentiate it from the KD and avoid possible confusion regarding the diet for weight management. An observational study of Connecticut Children's MKD outcomes demonstrates effectiveness similar to the KD diet. Out of 36 patients completing the MKD, 56% experienced ≤50% to 100% seizure reduction. Of this 56%, 17% were seizure free, and 39% had 350% to 90% seizure reduction. Connecticut Children's outcomes support the MKD as a viable nutrition option for pediatric patients with refractory epilepsy. Two case studies are presented to provide support and additional treatment modalities for use in clinical practice for registered dietitians initiating the MKD. © 2012 The Author(s).