Growth is also slowed somewhat by being on the diet. Children tend to follow the growth curves, but mostly stay around the 5th percentile.(5) Children under age 2 years are at the most risk for growth disturbance, and therefore we tend to use lower ketogenic diet ratios (e.g. 3:1) in this age group to allow for more protein. In children on the diet for over 6 years, nearly all were at the 5th percentile. It is hard to argue that this is probably a minor problem for a child having hundreds of daily seizures, but it is worth monitoring to keep children as healthy and normal as possible.
Very recent information also suggests that bone density can be a problem while on the diet, similar to being on medications. Children appear to have lower bone mineral density, which can lead to an increased risk of bone fractures, especially in children on the diet for over 6 years.(6) Christina Bergqvist, MD, found that Vitamin D levels initially increase due to supplementation on the diet, and after several months they decline, and this may partially explain the problems with bone density.(7) Studies are underway using DEXA scans to monitor children on the diet.