The ketogenic diet for the treatment of epilepsy is one of the oldest forms of medical treatment for epilepsy. Ketogenic diet centers have traditionally specialized in treating children under 18 years of age. There is growing evidence that shows that the ketogenic diet has usefulness in controlling seizures in adults. Most people don’t recommend that you try the ketogenic diet on your own. It is recommended that you attempt it with the support of a trained medical team. However, you can try it on your own if you are currently on medication and simply want to improve your results. There are many resources online to help you reduce your carbohydrate intake.
The Ketogenic Diet For Epilepsy
The ketogenic diet is a high fat, adequate protein, and low carbohydrate diet that has been used to control difficult forms of epilepsy. There are many versions of the ketogenic diet, but the basic principles are the same – reduce your intake of carbohydrates and increase your intake of fats. The diet may be adapted for cultural diversities, allergies and tube feeding. It is a therapy for both children and adults.
The ketogenic diet does have some side effects. As you start the diet, you may notice some flu like symptoms. This usually only lasts for a few days to a week while your body adjusts to running on fats. You may also notice more side effects from your medication. As you work with your medical professional, they may decide they want to adjust your medication. Therefore, it is important to let your doctor know that you are doing the diet.
The first few weeks of starting the ketogenic diet therapy can be a bit stressful. It is important to have a great support network. There are many people online in forums and groups that can support you through this diet from a practical and emotional standpoint.
During the ketogenic diet, you’ll need to learn to prepare meals differently. This can take time and effort. You may also face some difficulty while adapting to new meals. However, there are now plenty of ketogenic recipes that are creative that you can incorporate into your lifestyle. In time, you will adapt to the significant changes. The meal preparation and time will become easier. Many families cope well with the challenges and would agree that the hard work is well worth the effort that they took to change because it significantly reduces the seizures.
Ketosis and Epilepsy
Ketosis is the state of the body burning fats for energy. When the body burns fats for energy, it produces ketones. Ketones have a neuroprotective effect on the body. When you fast, your body starts to rely on stored fat for energy and produce ketones. Fasting has been known for years to reduce seizure frequency. Ketones are produced during extended periods of fasting. Often when a fast is broken with foods that contain carbohydrates, the seizures return. Of course, you can’t fast forever.
Since the ketogenic diet puts you into ketosis through consistently reduced carbohydrates, adequate protein and high fat, it mimics the fasting state. Ketones are an indicator of an important metabolic change. However, ketones alone will not explain the anti-seizure effect of ketosis. Researchers are still studying the mechanisms to better explain why this diet reduces seizures.
The Ketogenic Diet for Adults with Epilepsy
For decades, the ketogenic diet was only offered to children. It was assumed that a ketogenic diet would not work for adults. However, there is growing evidence that demonstrates its usefulness in controlling seizures in adults with medically refractory epilepsy. The ketogenic diet started in 1920 with New York physician, Dr. Galen. He reported at the American Medical Association convention that he had significant success in treating epilepsy by initiating a program of fasting. During that time, the only pharmaceutical interventions were phenobarbital and bromides. The patient Dr. Galen treated was a young cousin who had aggressive seizures. On the second day of fasting, the child’s epilepsy abated. It did not return over the next two years. Additional studies in 1923, 1926 and 1928 all confirmed the effectiveness of fasting as a treatment for seizures.
Some adults may be started on a classic ketogenic diet, while others may be trained in the modified ketogenic or Atkins diet, which allows more freedom in dietary choices. It affords them the ability to still enjoy going out to restaurants while maintaining this dietary therapy. Adults with epilepsy can successfully remain on this diet and gain great control of their seizures with proper training and motivation. Even though there is some flexibility on adult ketogenic diets, studies demonstrate that compliance is still low, which is one reason that it isn’t recommended.
The main treatment for epilepsy is pharmaceutical intervention, especially for adults. There are more and more surgical procedures which are being performed for these individuals who don’t have success with drugs. However, it could be that a dietary change, such as the ketogenic diet may be the answer. For many of these individuals, they are gluten sensitive and may benefit from a gluten-free diet. Avoiding foods that may be triggers, can be very helpful to people who have epilepsy.
Across all studies, 32% of KD-treated and 29% of MAD-treated patients achieved ≥ 50% seizure reduction, including 9% and 5%, respectively, of patients with >90% seizure frequency reduction. The effect persists long term, but, unlike in children, may not outlast treatment.
Efficacy of the Ketogenic Diet for Epilepsy
The ketogenic diet can be very effective in treating individuals with epilepsy, whether it is from infancy through adulthood. It has been demonstrated that up to 60% of children who try a supervised ketogenic diet will experience a 50% or greater reduction in seizure frequency. For adults, 40-50% who try a supervised ketogenic diet experience 50% or greater reduction in seizure frequency.
The ketogenic diet and the modified Atkins diet for seizures do show modest efficacy. In some patients the effect is excellent. However, the diet often is discontinued because it is very restrictive. However, in patients who are willing to try the dietary treatment, the effect is seen rapidly.
The ketogenic diet may be successful due to the elimination of carbohydrates that are irritating to your nervous system. Many foods that contain a lot of carbohydrates, also contain neurotoxins such as gluten. Processed foods also irritate the gut lining and may be creating a condition known as “leaky gut syndrome”. This allows undigested food to leak into the bloodstream and cross through the blood brain barrier, which may be triggering seizures.
How Soon Before You See Improvement in Seizures
The seizure reduction that happens with the ketogenic diet can occur very soon after it is initiated, or it may take several months. It is important to remain committed to the diet and work with your medical doctors, who will help you fine tune the diet to achieve the best seizure control. Commitment and consistency to the ketogenic diet is one of the most important things to determine the effectiveness in controlling seizures. Joining support groups can greatly help you stay committed and consistent with your ketogenic diet.
You can get started with a free ketogenic cookbook. Try out some of the recipes on your own and see if it is for you!