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Can a Keto Diet Help with Epileptic Seizures?

Can a Keto Diet Help with Epileptic Seizures?

From celebrities to sports stars to your next-door neighbor, it seems like everyone is talking about the effectiveness of a ketogenic diet when it comes to losing weight. But, if you or a loved one lives with epilepsy, you may be surprised to learn that the low-carb, high fat and protein diet can help reduce seizures by up to 50%. Here's what you need to know about the Ketogenic Diet.

What is the Ketogenic Diet?

The Ketogenic Diet, or "keto" diet as it is commonly called, is a low carb, high fat, and moderate protein diet. The "classical" ketogenic diet, also known as the "long-chain triglyceride diet," provides approximately 90% of total calories from fat, rather than carbs, and 3 to 4 grams of fat per gram of carbohydrate and protein. This puts the body into a state of ketosis, similar to fasting, where the body uses ketones instead of glucose as its main fuel source.


Fasting as a method of treating epilepsy has been utilized since the 5th century BC. Fasting puts your body into a ketogenic state quickly and efficiently and was typically used to help pediatric epilepsy patients between the 1920s and the 1940s until anticonvulsant medications were brought to the market. While anti-convulsants are the most common method of treatment for patients with epilepsy, the ketogenic diet is generally used as a back-up treatment for patients who the anticonvulsant medications do not work. The anti-epileptic benefit of a ketogenic diet that mimics a starvation state, but provides enough calories through fat or protein to maintain weight while inducing the brain to utilize ketone rather than glucose for energy, has been known to medical science since the 1920s, with studies in the 20s and 30s showing benefits for adolescents and adults. 

Who Recommends a Keto Diet?

One hospital that has kept the keto diet in use since the 1970s is Johns Hopkins Hospital. Their first program utilized the classic ketogenic diet focused on children, but in the years since the program has evolved to offer diet management services to adults as well, and offering several modified diets such as the modified Atkins.


In the classic ketogenic diet, the total calories are matched to the total calories needed. For example, a child eating 1400 calories in a regular diet would be prescribed a 1400-calorie ketogenic diet. There are different ketogenic diet "ratios", which is the amount of fat to protein and carbohydrates combined. A 4:1 ratio is strict and is generally used for children; a 3:1 ratio is is generally suitable for infants, children, and adolescents who require higher amounts of carbohydrates or protein for some reason. No other sources of carbohydrates can be eaten. Foods for a patient on this diet should be weighed on a gram scale, aiming for a ratio of somewhere between 3 to 4 grams of fat for each gram of protein and carbohydrates combined. A modified version of the classic ketogenic diet uses a more appealing 1:1 or 2:1 ratio. 


On a modified Atkins diet, adolescents and adults don't need to weigh food. It provides 15-20 grams of net carbohydrates daily after dietary fiber is subtracted. Instead of weighing food, food tables are used to track the fiber and carbohydrate content and ketosis is assessed by using a test strip to measure urine ketones.


One keto diet option with promising results used to treat epilepsy is a medium-chain triglyceride low-carbohydrate. medium-chain triglyceride (MCT) oil is a commercially produced product made from palm kernel or coconut oil. With this diet, ketosis is induced when 30-60% of total calories come from MCTs.


Because the amount of carbohydrates and protein in a ketogenic diet is restricted, it is important to prepare meals carefully. For very young children, the diet prescription may be based on weight. Because it can be complicated, you'll need a dietician's help to teach parents and children what can and cannot be eaten when using this diet and you will typically work with a neurologist to monitor medications and assess the overall benefits.   

What Kind of Benefits Are There to A Keto Diet?

Several recent studies have shown that a ketogenic diet reduces or prevents seizures in many children whose seizures could not be controlled by medications. A ketogenic or modified ketogenic diet has been proven in many studies to be particularly helpful at relieving some epilepsy conditions, including:

   • Doose Syndrome

   • Dravet syndrome

   • Tuberous sclerosis complex

   • Rett syndrome

   • Infantile spasms

   • GLUT-1 deficiency 


In one study at the Johns Hopkins University Adult Epilepsy Diet Center in Baltimore, ketogenic diets were proven to be a viable option for drug-resistant epilepsy in older adolescents and adults, and according to Dr. Cervenka, over half of the children who go on a ketogenic diet have at least a 50% reduction in the number of their seizures, and between 10-15% of children become seizure-free. In a review paper, Dr. Cervenka stated that of 206 adolescent and adult patients who experienced seizures and tried a ketogenic diet, 100 of the patients saw a 50% reduction in seizures, 13 of which were seizure-free, and that some patients with multiple seizure types and with symptomatic generalized epilepsy may experience a greater reduction in seizures. 


By Colleen De Koning 

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