If adequate ketosis is maintained, and seizure control improves, a further reduction in medications is often possible. In some cases, all medications can be tapered and stopped. Many experts believe, however, that the potential risk is much less than the benefits of improved seizure control and reduced dosages of antiepileptic drugs for brain development and intellectual and social functions. The most dangerous potential risk of the ketogenic diet is low blood sugar during the period of starvation. Other potential problems include a deficiency of the B vitamins, vitamin C, and calcium.
Many parents worry about the potential effects of large amounts of dietary fat.
We know that high-fat diets in adults can accelerate atherosclerosis, which contributes to heart attacks, stroke, and other disorders of blood vessels. However, there is no evidence that the ketogenic diet accelerates atherosclerosis in children or adolescents. Unfortunately, we cannot be sure that the diet has no long-term effects on the blood vessels. Weight gain is not usually a problem on this diet. The ketogenic diet can cause a slight delay in a child's growth, which is usually compensated for when the diet is stopped.