The “ketogenic diet” and its effect on epilepsy

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In the ketogenic diet, carbohydrates are low and fat intake is high. Evidence suggests it can reduce the incidence of seizures, and some people with epilepsy who follow this type of diet generally stop their seizures. Typically, people who try the diet for this purpose also take antiepileptic drugs. However, a keto diet may be especially effective for children with refractory epilepsy who do not respond to medication. Modified versions of the diet may be more appropriate for adults and adolescents. It is important to note that a specialist physician should monitor the person using the ketogenic diet to help improve epilepsy. This is to ensure that the person gets the most benefit from a safe diet. Medical supervision is especially important for infants and other children. In this article, we discuss the potential benefits of a ketogenic diet for adults and children with epilepsy.

Is a ketogenic diet helpful?

Under medical supervision, a ketogenic diet may help control seizures. According to a 2019 study, the ketogenic diet appears to reduce or prevent seizures in children and adults with drug-resistant epilepsy. The Epilepsy Foundation recommends diet as a potential treatment for partial epilepsy. They report that more than half of children with refractory epilepsy who follow the ketogenic diet reduce their seizures by at least 50%. Also, according to the report, the incidence of seizures has been reduced by about 10% to 15% in these children.

How it works?

When a person is on a ketogenic diet, his body does not get enough carbohydrates to burn energy, so he should use fat instead. Fat burning causes acids called ketones to form in the body. When this happens, the body is in ketosis. To achieve this, one must adhere to the diet for a considerable time.

Ketosis also occurs during fasting periods. As noted in a 2013 study, people have used fasting for centuries to treat seizures, and scientists have documented the effects of this approach in the 1920s. However, experts are not yet sure how exactly ketosis or the ketogenic diet will help people with epilepsy. Epilepsy is a metabolic disease and one theory is that the ketogenic diet is effective through altering one’s metabolism. Keto diet results in metabolic changes in blood and cerebrospinal fluid, and these changes, along with other factors, may alter neuronal excitability. According to experts, this can have a stabilizing effect on seizures. A ketogenic diet can take time to work. To see the benefits, people should continue with ketosis for at least 3 months. A healthcare professional needs to monitor anyone who uses the keto diet for treatment. They can make sure that the diet has safe effects and that the body goes into ketosis.

Children and adults

Both children and adults with drug-resistant epilepsy can benefit from a ketogenic diet. This is especially effective for people with certain types of epilepsy, including:

  • Doose Syndrome
  • Deficiency of glucose transport type 1 or GLUT-1
  • Neonatal spasms
  • Rett Syndrome
  • Tuberous Sclerosis Complex

This diet may also be effective for children with focal seizures.

Doctors often do not recommend the classic keto diet to teens and adults because it is difficult to maintain. Instead, they may recommend a modified keto diet that is more palatable and comfortable. Experts suggest that about 30 to 40% of adults with epilepsy who follow the keto diet experience at least 50% less seizure attacks. However, less than 10% of these adults achieve a 90% reduction in seizures or stop their seizures.

Other risks and benefits

Anyone who intends to use the keto diet to control epilepsy should be aware of its potential risks and other benefits.

A modified keto diet may have benefits beyond epilepsy management. Adults may experience improvements in:

  • Vigilance
  • Focus
  • Psychological performance
  • Quality of Life

Children and adults who follow keto diets should see their doctor or dietitian at least every 3 months. These regular visits are important to monitor the progress and growth of any side effects of the diet.

The dangers of a ketogenic diet include:

  • Constipation
  • Weight Loss
  • Increased cholesterol or triglycerides
  • Irritability
  • Lethargy
  • Nausea
  • Vomit
  • Kidney stone
  • Developmental problems in children

Since the diet allows few fruits, vegetables, grains and other nutrients, carbohydrate-free multivitamin supplementation is essential. When a person has maintained control of their seizures for some time, your doctor may interrupt your diet. Doctors usually recommend this after 2 years.

** Sudden interruption of the diet will make the seizure worse.

A healthcare provider should carefully monitor anyone who uses the keto diet as a treatment. This is especially important for children and infants. A physician and nutritionist can monitor a person’s progress, recommend supplements, and evaluate side effects.

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