Ketogenic diet for epilepsy

Introduction

The ketogenic diet, or keto diet, is a medical or therapeutic diet designed to help manage or treat a medical condition. The keto diet is suggested for children with epilepsy that continues despite medication. This is one of the oldest forms of medical treatment for epilepsy. Most ketogenic diet centers have traditionally specialized in treating children ages 0 to 18 years of age; however, there is growing evidence that shows its usefulness in controlling seizures in adults.

The ketogenic diet (KD) consists of 70% to 80% fats, 20% proteins, and 5% to 10% carbohydrates, with restricted calories and fluids. The Keto diet forces the body to burn fats rather than carbohydrates. There are different versions of the ketogenic diet available but the basic principles are the same. Ketogenic diet therapy may be adapted for cultural diversity, allergies, and tube feeding. It is a therapy for both children and adults.

How does the ketogenic diet control epilepsy?

When a person follows a ketogenic diet, their body does not get enough carbohydrates to burn for energy, so it must use fat instead. Burning fat for fuel causes acids called ketones to build up in the body. When this occurs, the body is in ketosis. To achieve this, a person must adhere to the diet for a significant period. Ketosis likewise happens during times of fasting. This state of “ketosis” was found to have a benefit for people with epilepsy.

Who is the diet suitable for?

• The diet is suitable for many different seizure types and epilepsy syndromes, including myoclonic-astatic epilepsy, Dravet syndrome, infantile spasms (West syndrome), Doose syndrome, glucose transporter type 1, or GLUT-1 deficiency, Rett syndrome, and those with tuberous sclerosis.
• The diet can also be effective for children with focal seizures.
  
• The ketogenic diet can be adapted to all ethnic diets, as well as for people who are allergic to dairy products. The dietitian will calculate the diet and try to include foods you or your child likes.
  

What age range is the diet suitable for?

The diet can be used in children and adults of any age, although detailed monitoring may be needed in infants.

What kind of food is eaten on the diet?

There are 3 food groups that are required:

• Fats such as cream, butter, margarine, oils, mayonnaise, salad dressings, nuts, nut butters, avocado.
• Protein such as poultry, red meat, fish, cheese, eggs, milk, nuts.
• Carbohydrates such as vegetables and fruits.
• Small amounts of bread, pasta, rice, potato, juice.

Types of Keto diet:

•    Classical diet
In this diet, most of the fat comes from cream, butter, oil, and other natural fatty foods. The classical diet includes very little carbohydrate and protein. Each meal includes a strictly measured ratio of fat to carbohydrate and protein.

•    Medium chain triglyceride (MCT) diet
MCTs are certain types of fat. This diet allows for more carbohydrates, so may offer more variety. It includes some fat from naturally fatty foods, as well as some fat from a supplement of MCT oil or emulsion. This can be mixed into food or milk and is only available on prescription.

Unlike the classical diet's strict ratio of fats to carbohydrates and protein, the MCT diet is calculated by the percentage of energy (calories) provided by these particular types of fat.

Why do doctors recommend this kind of diet for people with epilepsy?

• The ketogenic diet can be effective in treating individuals with drug resistant epilepsy from infancy to adulthood.
• Up to 60% of children who try a supervised ketogenic diet experienced a 50% or greater reduction in seizure frequency.
• In 40-50% of adults who try a supervised ketogenic diet experienced a 50% or greater reduction in seizure frequency.

Other benefits of Keto diet:

A modified keto diet may provide benefits independent of epilepsy. Adults on the diet may experience improvements in:

• Alertness
• Concentration
• Psychological function
• Quality of life