Each year, New Year Resolutions are set relating to getting healthy, losing weight and dieting. While there are many benefits to eating healthy and following a diet plan, some diets have been proven to successfully treat specific seizure disorders. For individuals diagnosed with certain types of epilepsy, the ketogenic diet may not only act as a weight loss tool, but also as a treatment plan1. National Keto Day is celebrated annually on January 5th and falls at a time when many people may be weighing the pros and cons of different diets.
The classic ketogenic diet consists of following a high-fat and moderate-protein and low-carbohydrate diet with restricted calories and fluids. The diet works by mimicking the body’s state of fasting, altering the metabolism to use fats as a primary fuel source. The diet puts the body into a metabolic state called ketosis. In ketosis, the body shifts from using carbohydrates as its primary food source to using fat, which produces ketones- alternative energy molecules that can have protective effects on the brain2.
The exact mechanism as to why ketosis has an impact on seizure control is not well understood, and researchers have yet to replicate the body’s response to ketosis using methods other than diet. More research needs to be done to identify exactly why the state of ketosis has such a drastic effect for some individuals living with epilepsy, offering 50% seizure reduction in many participants and even complete seizure freedom for some individuals who other treatments have not worked for3.
Other, less restrictive diets that have also been noted to effectively reduce seizure activity are:
- Modified Atkins Diet: A less restrictive version of the ketogenic diet that still emphasizes low carbohydrate intake but allows for more flexibility with protein and fat sources 4.
- Low Glycemic Index Treatment (LGIT): This diet focuses on low-glycemic foods that have minimal effect on blood sugar levels, which may help prevent seizures.
Due to the restrictive nature of the aforementioned diets, many individuals who attempt dietary therapies as treatment end up discontinuing the plan. Typically, other treatment methods, such as medications are attempted before dietary therapies are considered, due to the many barriers to effective adherence.
Dietary therapies as treatments are typically most effective in young children with epilepsy who have been considered to have medication-resistant, or intractable, epilepsy. Pediatric patients are more likely to effectively adhere to the treatment plan of dietary therapies than adults, leading to better outcomes from this treatment option. However, dietary therapies have been noted as also being effective in the adult population if proper adherence is managed6.
Dietary therapies are a more holistic approach to treating epilepsy and are only effective if there is 100% commitment (no cheat days!) to the program chosen. It is important to ensure a proper balance of nutrients when following any diet plan and it is possible that an individual’s health care team may require a patient to meet with a nutritionist prior to attempting dietary therapy as a treatment option to discuss how to safely follow the recommended plan. In some cases, it may be recommended for children with epilepsy to begin dietary treatments while staying in the hospital to undergo regular surveillance.
Maintaining a strict diet can be extremely challenging and have adverse effects on other aspects of a person’s life, including their growth and development. Dietary therapies are typically discontinued after a few years if seizures are well controlled. The timeline of the treatment will vary for each individual.
If you have questions regarding specific treatment options for epilepsy, please speak with your doctor. The information, including text, graphics, images and other material on this website and provided by the Epilepsy Foundation of Northeastern New York, is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.
If you are interested in learning more about seizure recognition and first aid, please reach out to our team by calling (518) 456-7501 or visiting our website for additional resources.
Citations:
1. Rogovik, A. L., & Goldman, R. D. (2010, June). Ketogenic diet for treatment of epilepsy. Canadian family physician. https://pmc.ncbi.nlm.nih.gov/articles/PMC2902940/
2. Rho, J. M. (2016, July 26). How does the ketogenic diet induce anti-seizure effects?. Neuroscience letters. https://pubmed.ncbi.nlm.nih.gov/26222258/
3, 6. D’Andrea Meira, I., Romão, T. T., Pires do Prado, H. J., Krüger, L. T., Pires, M. E. P., & da Conceição, P. O. (2019, January 29). Ketogenic diet and epilepsy: What we know so far. Frontiers in neuroscience. https://pmc.ncbi.nlm.nih.gov/articles/PMC6361831/
4. El-Rashidy, O. F., Abdel-Hamid, M. H., Shatla, R. H., Abdel-Hamid, A., & Nassar, M. F. (2013, May 16). Modified atkins diet vs classic ketogenic formula in intractable epilepsy. Acta neurologica Scandinavica. https://pubmed.ncbi.nlm.nih.gov/23679058/
5. Ułamek-Kozioł, M., Czuczwar, S. J., Januszewski, S., & Pluta, R. (2019, October 18). Ketogenic diet and epilepsy. Nutrients. https://pmc.ncbi.nlm.nih.gov/articles/PMC6836058/
