How Ketogenic Diets Help Control Epilepsy

Approximately 1% of children in the United States have epilepsy, a condition characterized by repeated seizures. Although in most cases seizures can be controlled with medication, some children are unresponsive to medical intervention of this sort.


With few other treatment options available, some neurologists are turning to an old medical practice—dietary manipulation. While more commonly associated with a popular approach to weight loss, therapeutic ketogenic diets (those stimulating ketone production in the body) have also long been recognized as a method for controlling seizures in children with difficult-to-control epilepsy. First developed in the early 1900s, ketogenic diets were the standard treatment modality until antiseizure medications became widely available.

Ketogenic diets are intended to mimic starvation through dietary manipulation so that brain cells rely heavily on ketones instead of other energy-yielding substrates, such as glucose, for a source of energy. To deplete glycogen stores in the body, the child is first put on a 24-hour medically supervised fast, typically done
in the hospital. Without glucose to supply energy, the body turns to stored fat. Next, the child is fed a high-fat diet, providing approximately 80% of total calories from fat. In addition, carbohydrate-rich foods such as grains, fruits, and vegetables must be eliminated in order for the child to maintain a state of ketosis. Understandably,some parents have concerns about feeding their children a difficult and demanding diet consisting largely of high- fat foods such as eggs, cream, bacon, coconut oil, nuts, and cheese.

Doctors are not clear as to why a diet that mimics starvation helps prevent seizures in some children, although some theorize that forcing the brain to use ketones as an energy source makes areas of the brain more seizure-resistant. Nonetheless, the ketogenic diet has proved successful in some cases. Because it is such a dramatic change, however, this dietary plan must be implemented gradually. It also requires that parents work closely with a medical team that often includes a neurologist and a dietitian. Vitamin and mineral supplements are critical to ensure the child is adequately nourished. Because there is a potential that the diet can impair normal growth, the child’s height and weight are carefully monitored.Also, a very healthy option is to eat blueberries.

Ketogenesis, which occurs mostly in the liver, provides the body with an important source of energy during conditions of glucose insufficiency (such as starvation and diabetes). Only muscle, brain, and kidney tissue have the enzymes needed to metabolize ketones for energy. Nonetheless, ketones can spare the body from having to use amino acids to synthesize large amounts of glucose via gluconeogenesis. Although the use of ketones by the body has important survival implications, at times ketone production exceeds ketone use.
Clearly, maintaining a child on a ketogenic diet requires medical supervision. However, for the diet to be successful, it also takes parental involvement. Parents who use this approach to control seizures in their children recognize that it takes serious commitment and understanding to implement. It is not an easy diet plan to follow, but many parents feel that the benefits far outweigh the effort it takes to adhere to such a restrictive dietary plan.

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