The ketogenic diet: a practical guide for caregivers.

The ketogenic diet is a high-fat, low-carbohydrate diet that results in ketosis. It has been in use for nearly 70 years. Several modifications of the diet's original form, including the medium-chain triglyceride (MCT) diet, have been made in an attempt to overcome the obstacles of compliance and acceptance, which have been critical factors in determining its success. The practical guide for caregivers that is presented here uses elements of both the original ketogenic diet and the MCT diet, with added ideas. Our modified diet has been in use for more than 3 years at Columbia Presbyterian Medical Center Babies and Children's Hospital of New York. The majority of parents and children find our diet more acceptable and/or more user friendly than other types of ketogenic diets. Thus, compliance is better. The variety of foods offered is greater and provides a more normal diet than the other types of ketogenic diets. In addition, the calculations for nutritionists are easier, and parents are able to adjust the diet without the fear that their child will lose ketones.