Ketone bodies: products produced by the condensation of acetyl coenzyme A following the massive oxidation of fatty acids in the liver during starvation or diabetes. They include acetoacetate, beta hydroxybutyrate and acetone. Diet therapy has a long history in China, but not many people know about it in the past through a special diet, the ketogenic diet, to treat epilepsy. Not only the general public, but also non-epilepsy specialized physicians know little about it. The ketogenic diet was discovered in ancient times when it was observed that starvation reduced seizures. At that time, people did not understand the real cause of epilepsy and thought it might be evil possession, so they imprisoned epileptic patients and prepared them to die of starvation. However, after fasting, not only did the epileptic patients not die, but their seizures were significantly reduced, leading to the discovery that starvation therapy could treat epilepsy. Ketogenic diet burns fat for energy The ketogenic diet is actually a special diet that shifts the body’s primary metabolic energy source from using glucose to using fat. It is known that under normal conditions, the body usually gets energy from three types of food: carbohydrates, fats, and proteins. Of these, carbohydrates provide 45% (infants) to 60% (older children, adults) of the total daily energy. In general, the body produces energy primarily by converting carbohydrates into glucose, which is then metabolized. The ketogenic diet is a high-fat, low-carbohydrate and protein diet. It consists of 85% fat, 10% protein and 5% carbohydrates. Because it contains very few carbohydrates, the ketogenic diet stimulates the body’s starvation metabolic pattern, which means that when a fasting person burns up his body’s stored glucose for 24 to 36 hours, his body begins to burn up his body’s stored fat for energy. And in the presence of larger amounts of ketone bodies in the body, seizures are reduced or even brought under complete control. But no exact mechanism has been found to explain why this happens. First determine the calories per kilogram of body weight There is no international consensus on the formulation of the ketogenic diet. The commonly used ones include the traditional ketogenic diet (also known as the long-chain triglyceride diet, LCT), the medium-chain triglyceride diet (MCT), and the modified Atkins ketogenic diet (MAD). The ketogenic ratio of LCT, i.e., the ratio of fat/(protein+carbohydrate) in all food intake, is 4:1, which means that 90% of calories come from fat, especially during the first 3 months, and can be relaxed to 3:1 later. MAD is better tolerated because the calorie and fluid restrictions are more relaxed and only carbohydrates are strictly controlled. Some current studies have demonstrated that its long-term efficacy is not significantly different from that of LCT, so it is being carried out more and more. Recipes for older children need to be developed by the parents themselves under the guidance of a physician and dietitian. The development of a ketogenic diet recipe includes: determining calories per kilogram of body weight, developing ketogenic ratios, and distributing fluids. In general, children must be close to their ideal weight to ensure the strongest ketogenic state and to get the best results from this diet. For small infants, finished dairy products that meet the needs of the child and are consistent with the principles of the ketogenic diet are available and can be applied under medical supervision depending on the age and weight of the child. Special attention should also be paid to the many implied carbohydrates, such as those contained in various pharmaceutical excipients.