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The use of the [[Ketogenic Diet]] to treat epilepsy is well established, and continues to evolve. This page is intended to be an introduction that will provide sufficient background for those that are interested to help them pursue the diet further through deeper reading and conversations with their epilepsy healthcare professionals.
=History=
The use of fasting and the Ketogenic diet has a long histotryhistory<ref name="Wheless2008"/>. From early times the use of fasting to treat epilepsy was well known, but it was only in the 1920s that the use of a Ketogenic diet emerged to achieve the benefits in a sustainable manner.
==Pre-modern Fasting==
It has long been known that fasting is a treatment for epilepsy. As long ago as 500 BC the Hippocratic collection noted fasting as the therapeutic treatment for epilepsy. In the Gospel of Mark, Jesus says that a boy with the symptoms of epilepsy can only be cured with fasting.
* [[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. The MAD is stricter than the usual Atkins Diet.
* [[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.
Here's part of a comparison table available from [http://www.biomedj.org/temp/BiomedJ3619-222263_061026.pdf biomedj.org]<ref name="Liu-2012"/>:
{| class="wikitable"
! Question
! [[Ketogenic Ratio Diet]]
! [[MCT Diet]]
! [[Low Glycemic Index Treatment]]
! [[Modified Atkins Diet]]
|-
| Medical Supervision
| Yes
| Yes
| Yes
| Yes
|-
| High in fat?
| Yes
| Yes
| Yes
| Yes
|-
| Low in Carbs?
| Yes
| Yes
| Yes
| Yes
|-
| [[Ketogenic Ratio]]?
| 4:1 to 1:1
| Not ratio based
| ~1:1
| ~1:1
|-
| Carbs allowed on 2000 Cal diet?
| 7g (4:1) to 110g (1:1)
| 95g
| 40-60g
| 20-30g
|-
| How is foot measured?
| Weighed
| Weighed
| Weighed or estimated
| Estimated
|-
| Initiation
| Hospital
| Hospital
| Home
| Home
|-
| Calorie controlled?
| Yes
| Yes
| Yes
| No
|-
| [[Health Checks for the Ketogenic Diet]]
| Yes
| Yes
| Yes
| Yes
|-
| Side Effects?
| Yes
| Yes
| Yes
| Yes
|}
=Notes=
* The [[Ketogenic Diet]] has traditionally been fine tuned to maintain urine ketone levels to 3-4+ (80-160 mmol).
<references>
<ref name="Wheless2008">James W. Wheless, History of the ketogenic diet, Epilepsia, volume 49, 2008, pages 3–5, ISSN [http://www.worldcat.org/issn/00139580 00139580], doi [http://dx.doi.org/10.1111/j.1528-1167.2008.01821.x 10.1111/j.1528-1167.2008.01821.x]</ref>
<ref name="Liu-2012">YM. Liu, HS. Wang, Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets., Biomed J, volume 36, issue 1, pages 9-15, doi [http://dx.doi.org/10.4103/2319-4170.107154 10.4103/2319-4170.107154], PMID [http://www.ncbi.nlm.nih.gov/pubmed/23515148 23515148]</ref>
<ref name="Kossoff-2011-2220">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2220</ref>
<ref name="Kossoff-2011-4020">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 4020</ref>
<ref name="Kossoff-2011-2469">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2469</ref>
</references>
