A ketogenic diet isn’t recommended for children unless it’s prescribed and supervised by a medical team. Its main established use in children is as a treatment for epilepsy that doesn’t respond to medicines: the NHS lists a specialist ketogenic diet among the treatments that can reduce seizures. Outside that setting, keto is risky for growing children, because it restricts foods they need for growth, energy and bone health, can affect growth and cause constipation, kidney stones and high cholesterol, and can set up an unhealthy relationship with food. If you’re concerned about your child’s weight or health, a balanced diet with plenty of vegetables, fruit, whole grains, protein and dairy, plus regular activity, is the safe approach.
Keto for epilepsy: a medical treatment
Ketogenic diets have been used to treat childhood epilepsy since the 1920s. A Cochrane review of 13 studies, most in children, found that ketogenic diets increased the chances of seizure freedom and of reducing seizures compared with usual care, although the certainty of the evidence was low.
When it’s used medically, the diet is very carefully managed:
- It’s prescribed by a specialist epilepsy team, usually after medicines haven’t worked.
- A specialist dietitian plans every meal, often weighing food precisely.
- Children are monitored closely, with regular checks of growth, blood tests, urine and ketone levels.
- Supplements are given, usually including a multivitamin, calcium, vitamin D and sometimes citrate to reduce the risk of kidney stones.
- The diet is reviewed regularly and usually stopped after a set period if it isn’t helping.
This is very different from adults following keto for weight loss, and families should never start a ketogenic diet for epilepsy without their child’s medical team.
Why keto isn’t suitable for most children
Children need carbohydrates and a varied diet
Growing children need energy and a wide range of nutrients. Keto restricts fruit, whole grains, beans, starchy vegetables and many dairy foods, which are major sources of fiber, vitamins, minerals and energy. Our guide to nutrient deficiencies on keto explains what can run low.
Growth and bones
Very restrictive diets can affect growth and bone health in children. That’s why children on medical ketogenic diets have their height, weight and bone health checked regularly.
Kidney stones
In a meta-analysis of keto diet studies, about 5.8% of children developed kidney stones. Our guide to keto and kidney stones explains why.
Constipation, tiredness and other side effects
Constipation is common because of low fiber. Some children also feel tired, irritable or unwell, especially in the early weeks. Cholesterol levels can rise.
Relationship with food
Strict food rules in childhood can lead to anxiety around eating, secrecy, and a higher risk of disordered eating later. Children do best when food is relaxed, varied and shared as a family.
What about children who are overweight?
If you’re worried about your child’s weight, keto isn’t the answer. Instead:
- Talk to your GP or health visitor, who can check your child’s growth and offer support.
- Focus on the whole family’s habits, rather than putting one child on a diet.
- Offer regular meals and healthy snacks, with plenty of vegetables, fruit, whole grains and protein.
- Cut down on sugary drinks, sweets and ultra-processed snacks. Our guide on how much sugar per day gives limits by age.
- Encourage activity that your child enjoys.
- Avoid talking about weight or “good” and “bad” foods; talk about energy, strength and enjoying food instead.
Our guides to family meals and getting kids to eat vegetables have practical tips.
What if parents follow keto?
Many parents follow keto themselves while their children eat a normal, balanced diet. That can work well if you:
- Cook shared meals built on protein and vegetables, and add starchy foods such as rice, pasta, potatoes or bread for your children.
- Keep fruit and whole grains available for children, and don’t describe them as “bad.”
- Avoid making children feel guilty about the foods they eat.
- Model a relaxed attitude to food and eating together.
Our keto dinner ideas include family-friendly meals that can be adapted for children.
Teenagers and keto
Teenagers sometimes try keto for weight loss or sports performance. It’s not recommended without medical supervision. Teenagers have high nutritional needs for growth, and restrictive dieting at this age is linked with a higher risk of eating disorders. If a teenager wants to change their diet, encourage them to focus on balanced meals and talk to a doctor or registered dietitian. Our guide to healthy eating for teenagers explains what they need. If you notice signs of disordered eating, such as skipping meals, extreme food rules, secrecy around food or rapid weight loss, talk to your GP. If you or your teenager need someone to talk to now, findahelpline.com lists free helplines in many countries.
Common questions
Can keto help children with autism or ADHD?
There isn’t good evidence to recommend ketogenic diets for autism or ADHD. Any special diet for a child with a medical or developmental condition should only be tried with the support of their medical team and a registered dietitian.
Can children do low-carb diets?
Cutting back on sugary drinks, sweets and refined snacks is healthy for children, but cutting out whole food groups isn’t. Children need whole grains, fruit and starchy foods as part of a balanced diet.
Is the ketogenic diet safe for children with epilepsy?
It can be a safe and effective treatment when prescribed and closely monitored by a specialist team, but it has side effects and isn’t suitable for every child.
My child eats very little carbohydrate already. Is that a problem?
If your child is a fussy eater who avoids starchy foods, talk to your GP or health visitor. They can check growth and offer support.
Safety note: Keto isn’t suitable for everyone. If you have diabetes, kidney or liver disease, take regular medication, or are pregnant or breastfeeding, talk to your doctor before cutting carbs this far (why it matters).
This article is general information, not medical advice. Talk to your doctor or a registered dietitian before making big changes to how you eat, especially if you have a health condition, take regular medication, or are pregnant or breastfeeding.
