Reading a nutrition label
Equations (use grams):
Net carbs for the serving size = total carbohydrates – fiber
Keto Ratio = fat ÷ (net carbs + protein)
The ketogenic diet and epilepsy
Keto-for-epilepsy diets generally stick to the basic formula of being high fat and low carb. However, the diet actually comes in several forms such as the MAD (modified Atkins diet) or different minimum keto ratios required for each meal.1 For people who are not on a keto diet, the body uses carbs to create glucose to use as the main source of energy. On the keto diet, since carbs are not as available, your body creates ketones as a source of energy instead.1 Eating more fat and fewer carbs trains your body to shift its main fuel source to burn fat for energy instead of glucose. This produces ketones and puts you in a state of ketosis.2 The name “ketogenic” comes from the fact that the diet causes an increase in ketones in your blood.
Being on the ketogenic diet can help many people with epileptic conditions. The diet can be helpful for other conditions as well, like cancer, Alzheimer’s, or just helping to get a good night sleep.3,4 Sleep is important for mitigating seizures and having a balanced life. There are multiple theories about why the diet might help with epilepsy. Having a seizure takes a lot of energy because it makes neurons (nerve cells) in your brain fire signals uncontrollably. The keto diet can change how much energy is accessible to your neurons so that they can’t trigger seizures.5 Another theory is that because the keto diet can influence bacteria in your gut, that can help neurotransmitters (chemical messengers) in your brain to regulate seizures.5
- Ketogenic Diets for Epilepsy. Myketocal.com. Published November 19, 2025. (https://www.myketocal.com/ketogenic-diets-for-epilepsy/).
- Abbasi M, Jafari A, Mohtadi M, Shahabi M, Bakhshimoghaddam F, Abbasi H, Eslamian G. Illuminating the Safety, Tolerability, and Efficacy of Different Ketogenic Diets for Individuals with Epilepsy: A Scoping Meta-Review. Seizure – European Journal of Epilepsy, 2025; 125, 140-151 (https://www.seizure-journal.com/article/S1059-1311(25)00024-X/fulltext).
- Charlie Foundation. What is a Ketogenic Diet? Keto Diet Facts, Research, and Variations. Charlie Foundation. Published 2017. (https://charliefoundation.org/diet-plans/).
- Priyadarshini Mishra, Sajal Clarence Singh, Balamurugan Ramadass, Drug resistant epilepsy and ketogenic diet: A narrative review of mechanisms of action, World Neurosurgery: X, Volume 22, 2024,(https://www.sciencedirect.com/science/article/pii/S2590139724000590).
- Cleveland Clinic. Ketogenic Diet For Epilepsy / Seizures. Cleveland Clinic. Published October 6, 2020. (https://my.clevelandclinic.org/health/treatments/7156-ketogenic-diet-keto-diet-for-epilepsy).
Common keto ingredients
You may have noticed a few ingredients that seem to show up over and over in many keto recipes. I find that a recipe almost always includes at least one of the following: some sort of cooking / vegetable oil, butter, mayonnaise, or heavy cream. Those four ingredients are high in fat and have little to no other macronutrients, making them staples for boosting the keto ratio in a recipe. Eggs can also be found in many recipes because of their binding abilities when cooked and because their macronutrient value makes them pretty easy to add to a recipe on the keto diet.
Each of these ingredients, on its own, is much higher than the 4:1 target ratio. They are all high in fat and have almost no other macronutrients. However, they have different amounts of water, which doesn’t change the macronutrient ratio, but it does change how the ingredient will affect a recipe when it is added. An ingredient that is more potent in fat will change the ratio of a recipe more than an ingredient that is less potent. Below, I listed 4 ingredients in order of potency, most to least potent , that are all close to or totally fat in keto ratio. After that I talk about eggs.
Cooking / vegetable oils: There are many types, so I can’t speak specifically. Generally speaking, oils are the highest fat food you can find according to the USDA. Unlike butter, mayo, and heavy cream, the fat in vegetable oils are mostly unsaturated, which is better for cholesterol. The only difficulty is that oils are harder to incorporate into recipes with other ingredients.
Unsalted butter: Also pretty much all fat by macronutrients, but butter has more water than oils. Largely saturated fat instead of unsaturated.
Mayonnaise: Largely saturated fat instead of unsaturated. Mayonnaise can be different based on different brands. I’ve found some that have sugar in the ingredients, so makes sure to check for that.
Heavy cream: Better to get the 40% fat kind when you’re on keto because it’s fattier. On a nutrition label, heavy cream that is 40% fat will usually say that in 15ml, there are 6 grams of fat instead of 5 grams. Heavy cream has some natural sugars that are not listed on most nutrition labels because it is a small enough amount to round down to 0.
Eggs: Eggs are not supper fatty like the rest of these ingredients. The keto ratio is about 0.7. The egg yolk carries almost all of the fat. Eggs cannot make a recipe become heavy in fat like the other 4 ingredients I listed can. The reason they are so common in keto recipes is because, with so much fatty ingredients like oils, butter, mayo, and cream, recipes are often very liquidy and don’t stay together very well. Using eggs can be very helpful in keeping food from falling apart because of how eggs coagulate when cooked. They add some protein, but not much carbs.