Ketogenic diet is the oldest treatment for epilepsy. Most of the ketogenic diets centres are traditionally specialised to treat the children between ages of 0 to 18. But growing evidence has shown its importance in controlling seizures in adults. Below are the challenges and benefits of ketogenic diet for epilepsy. Please note that ketogenic diet should never be attempted by your own. It must be attempted with the support of a medical team. A ketogenic diet team includes a social worker, pharmacist, a nurse practitioner, a registered dietician, a neurologist and some other specialists.
Ketogenic diet for epilepsy
Ketogenic diet is a low carbohydrate, adequate protein and high fat diet, which is recommended to be taken in case of a difficult to control epilepsy. There are various versions of ketogenic diet but the basic principles of each of it are same. Ketogenic diet is opted as a therapy in case of tube feeding, allergies and cultural diversities. This therapy is useful for both adults and children.
Ketogenic diet for epilepsy is a choice for many families from both emotional and practical standpoint. In the first few weeks, the treatment can be very stressful and thus it is necessary for your family to provide a good supportive network.
During the course of treatment you will learn to prepare different types of dishes which involve work and time. There could be some difficulty in adapting some new meals. But the sensitivity to the difficulties and a creative planning of meals along with the ketogenic diet team support can overcome a lot of obstacles. In no time you will get adapted to these significant changes and meal preparation and time would become easier. Many families have coped up with the challenges and remarked that hard work is worth it in case the diet reduces the seizure significantly.
How can the ketogenic diet reduce seizures?
Fasting has been believed to reduce seizure frequency for long. Ketons get released during extended fasting. If the fast is broken with foods that are rich in proteins or carbohydrates, seizures will return. So fasting is of course an unsustainable treatment.
Ketogenic diet for epilepsy is reduced diet in terms of carbohydrates, adequate in proteins and rich in fat. This mimics the fasting state and produce ketons, which are the indicators of an important change in metabolism, but cannot explain the effect of anti- seizure. Researchers have studied the additional action mechanism to explain better how this diet controls seizures.
For whom is the ketogenic diet favourable?
Seizures are controlled well with the anti- seizure medicines and these medicines are tolerated by many who do not wish to consume a ketogenic diet. But in some cases, seizures are not well controlled with the anti- seizure medications. Here the medications might have resulted into some side- effects or where surgery isn’t an option, ketogenic diet is recommended at that place.
Anti- seizure diet for adults
Anti –seizure diet for adults is used to control refractory epilepsy. Some adults my start with a ketogenic diet while others will be trained in modified atkins or a ketogenic diet which allows a freedom in diet choices and affords a chance to still go to the restaurants in course of their diet therapy. With proper motivation and training, adults may remain successful to this diet and gain a control over seizers. Despite some of the flexible ketogenic diets and modified atkins, it is still regarded as a medical therapy for adults and should be maintained or initiated by the medical team.
Ketogenic diet and other disorders
Ketogenic diet is also recommended for other metabolic disorders like pyruvate dehyrogenase deficiency and glucose transporter deficiency. Ketogenic diet can be well supplied to those suffering from other neurological disorders, even brain tumours.
Ketogenic diet and its effectiveness in controlling the seizures
Ketogenic diet is effective in treating those individuals who are suffering from drug resistant epilepsy from childhood to adulthood. Nearly 60% of the children who are supervised to take a ketogenic diet have experienced a reduction of 50% in their seizure frequency. Nearly 40- 50% adults have also noticed a reduction of 50% in their seizure frequency.
Foods that control epilepsy and are to be included in ketogenic diet
There are 3 types of foods that control epilepsy and are to be included in a ketogenic diet:
- Fats: Avocado, nut butters, nuts, salad dressings, mayonnaise, oils, margarine, butter and cream
- Proteins: Nuts, milk, eggs, cheese, fish, red meat and poultry
- Carbohydrates: Fruit and vegetable juice, rice , pasta, bread and potato
In regular diet we incorporate carbohydrates and proteins in large amount and fats in small amount. But in a ketogenic diet more fat is to be eaten, enough proteins are to be incorporated for maintaining the muscles and reduce carbohydrates significantly.
Is ketogenic diet for epilepsy complete in nutrition?
No, this diet is low in minerals and vitamins. Your diet team or practitioner will suggest you some low carbohydrate mineral and vitamin supplements that are required to be taken regularly.
Most common side effects of ketogenic diet
The common side effect with ketogenic diet is constipation. But it can be supported with some laxatives and other dietary adjustments. Other side effects are relatively transient and minor which include sleepiness, diarrhea, vomiting, nausea, low sugars and kidney stones. Some of the patients have reported long term side effects such as abnormal heart rhythm, slow linear growth velocity, kidney stones, reduced bone health and higher levels of cholesterol.
Some of the rare side effects include altered patterns of growth, abnormal heart rhythm, and greater susceptibility to infections.
How to begin with the ketogenic diet?
Your ketogenic diet team will access the type of diet that has the best chance of success. The team will teach you how the diet is to be prepared. You will get extensive education on how the diet is to be followed and how will it be monitored.
Under medical supervision, ketogenic diet should be initiated by adjusting your regular diet and replacing it with high fat, adequate proteins and lower carbohydrate content. Ketogenic diet can be initiated from home only or in the hospital.