What is a ketogenic diet?
The ketogenic diet is constructed very differently from what the food pyramid suggests. In the ketogen diet, fatty foods are the dominant energy source, while foods, high in carbohydrates, are very limited. Typically, such a diet will require you to consume 3-4 grams of fat per carbohydrate and protein. Usually, this type of diet is unhealthy for the body, but in some patients with epilepsy, it can appear more effective than the drugs that are available on the market. The diet should only be initiated after directions from your GP, and it is necessary to be monitored by a dietician to ensure that the body’s nutritional requirements are met.
The name is based on the diet’s ability to increase the production of ketogenic substances in the blood – fat in particular can be converted into ketogenic substances and used as an energy source. The body usually uses carbohydrates as an energy source, but with this diet composition, the ketogenic substances become the primary energy source. This means that foods, herein cream, mayonnaise and oil, will be some of the primary elements in this diet.
Who benefits from a ketogenic diet?
Physicians can consider recommending a ketogenic diet for children with epilepsy if several of their antiepileptic medicine has no effect. This is especially important if the child is suffering from the so-called Lennox-Gastaut syndrome, Rett syndrome, Dravet syndrome or of infantile spasms. The diet is normally not recommended for adults as it is very strict and difficult to follow, despite studies suggesting that the effect appears to be equally as effective in both children and adults. If the child’s seizures have been thoroughly controlled after 2 years on this diet, the physician can consider whether the child can return to a normal diet. The process of changing diets should be slow and gradual over a couple of months to reduce the risk of losing control over the epileptic seizures.
What does research say about this treatment?
An investigation of about 150 children in the age of 2-16 years, who had at least one epileptic seizure each day and who did not respond adequately to at least two different anti-epileptic drugs, has shown a significantly beneficial effect of a ketogenic diet. The number of epileptic seizures dropped notably in the group of children, who were on the ketogenic diet. 38 % of the children, treated with the ketogenic diet, experienced a reduction of over 50 % in epileptic seizures, while 7 % experiences a reduction of over 90 %.
A study has investigated the effect on 9 adults with epilepsy, but 7 of them failed to finish the study. The results from the 2 remaining study subjects did, however, show a reduction in epileptic seizures of over 50 %. According to Epilepsy Research UK, about 40 % of children show a decrease of more than 50 % after 3 months on this diet.
What are the side-effects?
Initially, this diet can cause fatigue in the patient. If the patient continues this diet, there is an increased risk of developing:
- Kidney stones
- Increased cholesterol from the fats in the diet
- Constipation from too little fibres
- Slow growth from a lack of protein and carbohydrates
- Dehydration
- Bone fractures from a lack of calcium
Therefore, a ketogenic diet should may be considered if the treatment with antiepileptic drugs are not adequately effective. It is important to keep in mind that it is a very strict diet which should be monitored constantly and without cheating. Hence, the use of this type of treatment is limited, but research suggests that it is effective.
