Ketogenic Diets for Epilepsy

Introduction/Summary.

This article is under construction. Caution: This a skeleton article, so only a rough outline exists. This may consist of semi-completed sections, isolated bullet point and notes to the author. You are welcome to read what exists so far, and feedback is welcomed. Email "feedback <at> fellrnr <dot> com"

Contents

1 History

• Medieval history
• Fasting in early 20^th century
• Rise of the Ketogenic Diet
• Displacement with drug therapy
• Resurgence and the Charlie foundation

2 Evolution of the Ketogenic Diet for Epilepsy

• Calorie restriction no longer used
• Fluid restriction no longer used
• New diets – MCT Diet, Modified Atkins Diet MAD
• Wider usage

3 General

• The experts suggest that if the Ketogenic Diet is going to help with childhood seizures, it will do so within 3 months.
• The Ketogenic Diet has traditionally been fine tuned to maintain urine ketone levels to 3-4+ (80-160 mmol).
• Studies have shown a correlation between >90% seizure control and lower blood glucose levels.
• The availability of blood testing for Measuring Ketones is likely to improve our knowledge, as urine testing is rather limited.
• It is unclear if the Ketogenic Diet is safe for pregnancy in the general population, but it is probably much safer than anticonvulsant drugs that have known birth defect risks
• Taking a large drink can cause some (but not all) children to experience 'breakthrough seizures'.

4 Initiation and Fasting

• Value of fasting
• Hospitalization requirements
• After the fasting period, the calorie intake is typically increased in a stepwise fashion; 1/3^rd the first day, 2/3^rd the second day, then the full allotment from then on.

5 Success rate for Epilepsy

So far the ketogenic diet has only been used on children who have not responded to multiple medications, so the success rate could be quite different if it were applied sooner. Also 'success' can be subjective; for some only a total prevention of all seizures would constitute success, whereas others might consider a reduction in the seizure frequency successful. Generally with the ketogenic diet around of 50% of patients have a 50% reduction in seizures, 25% have 90% reduction in seizures, and around 10% become seizure free. The success rate also varies with the type of epilepsy – please read chapter 5 ("Is my child a good candidate for the Ketogenic Diet") of "Ketogenic Diets: treatments for epilepsy and other disorders" by Eric Kossoff for more details. In adults, weight loss is correlated with better response, though this could be due to the weight loss indicating better compliance with the diet.

• 50% of patients have a 50% reduction in seizures
• 25% have 90% reduction in seizures
• Around 10% become seizure free.
• The success rate also varies with the type of epilepsy
  • chapter 5 ("Is my child a good candidate for the Ketogenic Diet") of "Ketogenic Diets: treatments for epilepsy and other disorders" by Eric Kossoff for more details.
• In adults, weight loss is correlated with better response, though this could be due to the weight loss indicating better compliance with the diet.

6 Types of Ketogenic Diets for Epilepsy

There are several types of Ketogenic Diet used for epilepsy treatment:

• Ketogenic Ratio Diet. This diet has a strict controls over calorie intake and the ketogenic ratio, which is typically between 3:1 and 4:1. The diet is normally started with a hospital stay and includes a short fast.
• MCT Diet. This is a variant of the traditional diet that uses MCT oil that produces more ketones than other oils.
• Modified Atkins Diet (MAD). The MAD started by accident, when a child was put onto the Atkins diet prior to starting the traditional Ketogenic Diet and their seizures stopped.
• Low Glycemic Index Treatment (LGIT). The LGIT restricts the carbohydrate intake to only those foods with a Glycemic Index of less than 50. However, the LGIT is more than just restricting the glycemic index, and requires a fat intake of 60% with a ketogenic ratio of 1:1. The LGIT is similar to the MAD and restricts carbohydrates to 40-60 grams/day.

7 General

The experts suggest that if the ketogenic diet is going to help with childhood seizures, it will do so within 3 months. The ketogenic diet has traditionally been fine tuned to maintain urine ketone levels to 3-4+ (80-160 mmol. Studies have shown a correlation between >90% seizure control and lower blood glucose levels. It is unclear if the ketogenic diet is safe for pregnancy in the general population, but it is probably much safer than anticonvulsant drugs that have known birth defect risks

8 See Also

• The classifications and types of Low Carbohydrate Diet.
• An introduction to the Ketogenic Diet.
• My experiences with ultrarunning on the Ketogenic Diet
  • How the Ketogenic Diet can be used for the treatment and management of disease.
    • Using the Ketogenic Diets to mitigate and treat Epilepsy
    • How Ketogenic Diets might help with Cancer
    • A look at the possible mechanisms of action of the Ketogenic Diet
  • Health Risks of the Ketogenic Diet
    • Health Checks for the Ketogenic Diet
    • Supplements for the Ketogenic Diet
  • The time frame and changes that occur with Ketoadaptation
  • What are Ketones
    • How to measure Ketones
    • What ketone levels to aim for
  • The pros and cons of the Ketogenic Diet for athletes
    • The Science of Ketogenic Exercise
  • The Types of Ketogenic Diet
    • The "traditional" Ketogenic Diet based on the Ketogenic Ratio
      • The ways the Ketogenic Ratio can be calculated
        • The different definitions of Net Carbohydrates
    • Low Glycemic Index Treatment
    • MCT Diet
      • MCT
    • Modified Atkins Diet (M.A.D.)
• My Ketogenic Recipes
• Non-Ketogenic Low Carbohydrate Diets