Ketogenic Diet For Epilepsy

keto diet for epilepsy

The solution to your child’s epilepsy might be a diet with butter, cream, oil and mayonnaise? It may sound strange – and perhaps less than appetizing – but the ketogenic diet for epilepsy is real. And in many kids, it works. But the super-high-fat, super-low-carb ketogenic diet isn’t for everyone. It’s strict and complicated. And it’s not really “healthy” in the true sense of the word. If you’re considering it, you need to think about how it affects your child’s life — and the impact on the whole family.

What is a Ketogenic Diet?

A ketogenic diet, or keto diet, is a medical or therapeutic diet – a diet designed to help control or treat a condition. It is recommended that children with epilepsy continue on a keto diet even after they have been treated with medication.

The keto diet is high in fat, adequate in protein and very low in carbohydrates (carbohydrates). A typical keto diet consists of 70 to 80 percent fat, 20 percent protein and 5 to 10 percent carbohydrates.

Who May Benefit from a Keto Diet?

Doctors often recommend a ketogenic diet to treat epilepsy in children of all ages, including infants. The ketogenic diet is not usually the first choice for adults because the limited food options make this diet difficult to maintain over time.

The ketogenic diet has been used for other neurological (brain-related) disorders, including Alzheimer’s disease and autism spectrum disorders.

People with diabetes or Class III obesity may also benefit from a keto diet. The keto diet can be easier to observe than other diabetic diet recommendations, and it can retrain the body of a person with obesity to start burning fat.

How does the Diet Reduce Seizures?

During a seizure, neuronal networks kick in when they shouldn’t. This may occur because brain cells are more easily excited and release large amounts of excitatory neurotransmitters, such as glutamate. Or it may be that neighboring brain cells are unable to use inhibitory neurotransmitters (such as gamma-aminobutyric acid or GABA) to inhibit the spread of excitability as they normally would.

A ketogenic diet reduces the amount of glutamate in the brain and enhances the synthesis of GABA, making seizures less likely to occur. This diet also reduces inflammation in the brain, which can trigger seizures due to infections such as meningitis, encephalitis or autoimmune diseases.

There have also been several very interesting recent studies that have examined how the ketogenic diet alters the gut microbiome, the trillions of microbes that inhabit the digestive tract. These studies found that a ketogenic diet can increase certain bacterial species and promote an increased ratio of GABA to glutamate in the brain.

What to Expect

The ketogenic diet is not something you try just anywhere. It’s a big commitment, and it’s risky for you to start on your own. You and your child need to work closely with a team of experts.

  • Prepare for a few days in the hospital. Doctors usually want to observe children when they start a diet to make sure they are doing well.
  • Work closely with a dietitian. The ketogenic diet is customized for each child. So the dietitian will give you detailed information on exactly what and how much your child can eat. Because the ketogenic diet is low in important nutrients, your child may need to supplement with calcium, vitamin D, iron, folic acid, etc.
  • Watch out for carbs in everything. Tiny amounts of carbs show up in unexpected places, like toothpaste.
  • See the doctor often. Initially, your child will need regular checkups every 1 to 3 months. The doctor will record their growth and weight, test their blood and urine, keep an eye on cholesterol, and decide whether to adjust their diet or medication dosage.
  • Stick with the diet for a few months at least. If it works, by then you should notice a reduction in seizures — even earlier. If the diet doesn’t help, your child will gradually return to a normal eating plan. If they suddenly stop the ketogenic diet, it may trigger seizures.

What are the Risks of the Ketogenic Diet?

Despite its success in treating seizures, the keto diet is not without risk. Side effects that occur with long-term use of the diet include:

  • Low bone density and bone fractures.
  • Constipation.
  • High cholesterol.
  • Kidney stones.
  • Slower growth than typical.
  • Sluggishness (tiredness).

If your child is having side effects, tell their doctor. You may be able to treat them by changing their diet or medication.

Bottom Line

Epilepsy can be a challenge for children and parents alike. About two-thirds of people with epilepsy can achieve seizure control with the right medication. When epilepsy is drug-resistant, other options should be considered, such as epilepsy surgery and a ketogenic diet. If your child has epilepsy, talk to your healthcare provider about trying a ketogenic diet.

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