Your Ketogenic Diet Pathway
How The Keto Dietitian can support you or your child
Referrals
We will need a referral from your consultant before we can begin the education, planning and support for ketogenic diet therapy with you. We only support patients to undertake medical ketogenic diet therapy with the support of their medical team. Following referral, we will continue to liaise with your local medical team, to ensure seamless continuity.
Medical KD Therapy Clinic
Our clinic supports children and adults to undertake medical ketogenic diet therapy for epilepsy, metabolic disorders and migraines.
We offer all variations of medical ketogenic diet therapy
A medical ketogenic diet is very low in carbohydrate, high in fat and has a moderate protein intake. Ketogenic diet therapy encompasses five main types of KD: classical KD, MCT KD, modified Atkins diet, modified KD and low glycaemic index treatment. Often referred to as medical ketogenic diets, these diets have been shown to be effective for treating a wide range of clinical conditions. In our keto clinic we offer these diets to treat children and adults with drug resistant epilepsy, migraines and metabolic disorders, including Glut 1 Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency Syndrome.
Carbohydrate intake can be as low as 10g per day depending on the individuals age, weight and circumstances together with very high fat intakes. As you can imagine this degree of dietary restriction can increase the risk of unwanted side effects, so it is important that you or your child have regular blood and urine tests and are monitored and supported by your consultant and dietitian.
We offer all variations of medical ketogenic diet therapy and calculate an individualised ketogenic diet prescription for each patient. Our clinics are fully remote and use a secure telehealth video calling platform to undertake virtual clinic appointments. Zoom or telephone can be used if preferred.
Your Ketogenic Diet Pathway
Your dietitian will meet with you to undertake a pre-KD assessment. Following this, if you and your team are in agreement, preparation for a 3-month trial of KD therapy will commence. Together we will explore your expectations of KD therapy and set achievable goals. If the trial period proves successful, further treatment will continue for up to 2 years. Some patients may require a longer duration of treatment and if so, support and monitoring will continue. To ensure consistency and quality of care, we strongly recommend that you remain under the care of The Keto Dietitian for the duration of treatment. We will liaise with your local managing medical team regularly throughout your treatment.
1. Pre-ketogenic diet assessment
A short online module will be shared to help to you to prepare for your consultation with your dietitian. The module covers a range of topics listed below which helps to address some of the myths, fears and misconceptions of undertaking ketogenic diet therapy.
-
introduction to the different types of ketogenic diets
-
how the diet might work
-
the evidence supporting its use for various conditions
-
the benefits and positive outcomes of ketogenic diet therapy
- the potential side effects of ketogenic diet therapy.
In your pre-assessment consultation, your dietitian will undertake a detailed assessment and discuss your goals and the practicalities of KD therapy. This is also an opportunity to ask questions and address any uncertainties or worries you might have about KD therapy.
Once your pre-KD bloods have been reviewed and a referral received from your local team, we will then support you through the treatment pathway discussed below.
2. Preparation for a 3 month trial of ketogenic diet
You will spend considerable time with your dietitian preparing for the 3-month trial period, receiving training and education to confidently implement and manage the KD. This preparation phase typically takes between 2-4 weeks but it is individualised as needed.
You will be enrolled in our self-paced online Preparation for Ketogenic Diet Programme and meet regularly with your dietitian. The programme contains 8 modules of video content, activities and useful resources including starter keto recipes and shopping lists that you can complete in your own time.
- Welcome, expectations and a typical day on keto diet
- Expectations of KD and The Evolving Keto Mindset
- Resources and support on your keto journey
- Preparing your kitchen for keto and understanding food groups (fat, protein and carbohydrates)
- Keto-friendly changes and low carbohydrate swaps
- Specialist ketogenic products and supplements
- Testing ketones and managing abnormal results
- Next steps
We know life is very busy so you can chip away at the sessions as you have time. Completing this programme will give you the information and insight you need to prepare and manage a ketogenic diet for you or your child. You will feel empowered and ready to start your keto journey with support from your dietitian along the way!
Parents report feeling nervous when their child is starting a KD. However, they feel it gets easier with time as their confidence builds with the support of their dietitian, other parents and charities like Matthew’s Friends.
Your dietitian will liaise with your local team to request any keto prescription products or lower carbohydrate medications and provide reports for school, respite centres or employers as needed. You will have regular contact with your dietitian to monitor progress and make necessary adjustments to optimise the outcomes of KD therapy.
Typically, a 3-month trial of KD is undertaken to assess the effectiveness of KD therapy, however if needed this can be extended. If your dietitian, you and your team are in agreement that the KD is helping to achieve positive outcomes, then treatment can continue for up to two years or longer if indicated. If little positive impact has been achieved, then your dietitian will support you to wean from KD.
3. Ongoing treatment with ketogenic diet
You will attend a clinic consultation at 6, 12, 18 and 24 months as a minimum. During these consultations, we will review your progress with KD and the results of blood tests. Blood tests must be arranged locally by your medical team and made available to the Keto Dietitian for review. In addition, you will have regular contact with your dietitian between appointments via email, telephone or video call to review progress, answer any queries and fine-tune your KD for optimal benefit.
4. Weaning from ketogenic diet
You will attend a clinic consultation at 6, 12, 18 and 24 months as a minimum. During these consultations, we will review your progress with KD and the results of blood tests. Blood tests must be arranged locally by your medical team and made available to the Keto Dietitian for review. In addition, you will have regular contact with your dietitian between appointments via email, telephone or video call to review progress, answer any queries and fine-tune your KD for optimal benefit.
Medical Ketogenic Diet Therapy Clinic
Our medical ketogenic clinic supports children and adults to undertake medical ketogenic diet therapy for epilepsy, metabolic disorders and migraines.
Why can I not self refer myself or my child for medical ketogenic diet therapy?
A medical ketogenic diet involves drastic dietary changes in a bid to achieve seizure control and other positive outcomes on quality of life, behaviour and cognition. Following a medical ketogenic diet increases the risk of side effects and nutritional deficiencies, so this diet must be undertaken with medical and dietetic supervision. Blood and urine tests are required 3-6 monthly to help monitor for adverse effects. A dietitian is required to fine-tune the KD prescription individually for each patient to achieve the best possible outcomes.
