The ketogenic diet is a way of treating patients with poorly controlled epilepsy. The diet – high in fats and low in carbs -- works by changing how the brain gets energy to function. Although not well understood, this diet has successfully reduced seizures in many patients.
What are the side effects of the ketogenic diet for epilepsy?
Mild side effects include: Fatigue Dizziness Weight gain Loss of bone density Skin rashes Loss of coordination Speech problems Memory and thinking problems
Is ketogenic diet truly effective in mitochondrial epilepsy?
We have the following comments and concerns. There are reports describing a beneficial effect of ketogenic diet in treating epilepsy in 75% of mitochondrial disorders. Mitochondrial respiratory chain defects: underlying etiology in various epileptic conditions.
How do I get Started on the ketogenic diet?
- Ground beef, chuck roast, steaks
- Pork chops, ground pork, pork sausage
- Chicken, ground chicken, chicken sausage (most recommend dark meat only since it is higher in fat, but all protein is good)
- Bacon, summer Sausage, breakfast sausage, kielbasa, hot dogs
- Peanut butter, almond butter, cashew butter, sunflower butter
What is the best diet for epilepsy?
Foods to Eat With Epilepsy
- Unrefined Carbohydrates. Carbohydrates are one of the main macronutrients that make up a balanced diet, according to a July 2021 StatPearls article.
- Lean Protein. Protein is another important macronutrient that provides energy and helps your body fight infection, per the National Institute on Aging (NIA).
- Healthy Fat. ...
- Fluids. ...
How does Keto help with epilepsy?
The ketogenic diet reduces the amount of glutamate in the brain and enhances the synthesis of GABA, making it less likely for a seizure to occur. The diet can also reduce inflammation in the brain, and inflammation due to infections like meningitis, encephalitis, or autoimmune disorders can trigger seizures.
Is the keto diet good for adults with epilepsy?
The ketogenic diet is one treatment option for children or adults with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and may have other positive effects.
Why does fasting help epilepsy?
In the new study, they showed in a mouse seizure model that mTOR signaling was reduced in the brain after fasting. Additional studies of cultured rat neurons in a dish suggest that this fasting effect is primarily driven by the lack of three amino acids (leucine, arginine, and glutamine).
What is the best diet for epilepsy?
The classic ketogenic diet, a special high-fat, low-carbohydrate diet, is prescribed and monitored by a physician and nutritionist and can help control seizures in some people. It can help both children and adults with refractory seizures.
How long does it take for keto to work for epilepsy?
After an average of 20 weeks of treatment, 50% of the patients had a >90% reduction in seizures.
Does not eating affect epilepsy?
How does diet affect epilepsy? Although there is little evidence that a balanced diet has a direct effect on seizures, it provides essential nutrients and keeps our energy levels steady. A balanced diet may also help you to keep a regular sleep pattern and keep active, both of which are good for overall health.
Can fasting stop seizures?
Four children had 50-99% reduction in seizures with the intermittent fasting approach, although it didn't last long in three of them. Several families found this approach difficult to do due to hunger.
Can hunger trigger epileptic seizures?
Skipping meals Low blood sugar can sometimes trigger a seizure in people with epilepsy. Eating regular meals can help your seizures stay controlled.
Does low carb diet help epilepsy?
The ketogenic diet is a way of treating patients with poorly controlled epilepsy. The diet – high in fats and low in carbs -- works by changing how the brain gets energy to function. Although not well understood, this diet has successfully reduced seizures in many patients.
What foods should epileptics avoid?
Stimulants such as tea, coffee, chocolate, sugar, sweets, soft drinks, excess salt, spices and animal proteins may trigger seizures by suddenly changing the body's metabolism. Some parents have reported that allergic reactions to certain foods (e.g. white flour) also seem to trigger seizures in their children.
What should epileptics avoid?
Here are some of the seizure triggers that have been reported by people with epilepsy:Not taking epilepsy medicine as prescribed. ... Feeling tired and not sleeping well. ... Stress. ... Alcohol and recreational drugs. ... Flashing or flickering lights. ... Monthly periods. ... Missing meals. ... Having an illness which causes a high temperature.
Does losing weight help with epilepsy?
This is promising news for people whose epilepsy is not well controlled with medications alone. “We often think of dieting for weight loss, but it can also be an important part of treating conditions such as epilepsy,” said Paul H. McCabe, M.D., neurologist at Geisinger Wyoming Valley Medical Center in Wilkes-Barre.
What is the only treatment for epilepsy?
Fasting is the only therapeutic measure against epilepsy recorded in the Hippocratic collection. Two Parisian physicians, G Guelpa, and A Marie, recorded the first modern use of starvation as a treatment for epilepsy in 1911 (Wheless, 2008).
What is the KD diet?
The Ketogenic Diet (KD) is a modality of treatment used since the 1920s as a treatment for intractable epilepsy. It has been proposed as a dietary treatment that would produce similar benefits to fasting, which is already recorded in the Hippocratic collection. The KD has a high fat content (90%) and low protein and carbohydrate.
What is the term for a child with migrating focal seizures?
Epilepsy of infancy with migrating focal seizures
What is included in a nutritional evaluation?
The nutritional evaluation includes a nutritional anamnesis including a 3-day food report, food habits, allergies, aversions, and intolerances. Baseline weight, height, and the ideal weight for stature and body mass index (BMI) are needed to calculate the ketogenic ratio, calories, and fluid intake.
Is epilepsy a metabolic disease?
Because epilepsy is a metabolic disease (Clanton et al., 2017), interest in studies of alterations of metabolism by anticonvulsants such as the KD has increased, as has their importance for the treatment of drug-resistant epilepsy.
Is dietary therapy good for epilepsy?
Kossoff et al. (2018)proposed that dietary therapy should be considered earlier as an option for treatment of intractable epilepsy, because of its proven efficacy, the poor chance of improvement with further anticonvulsant administration, and the possibility of using the MAD (Kossoff et al., 2006) and low-glycemic-index treatment (LGIT) (Pfeifer and Thiele, 2005), which are easier to manage in adults.
Is KD good for epilepsy?
Recent studies have found a significantly positive outcome with the use of the KD for treatment of refractory epilepsy in children and adults (Barborka, 1928; Neal et al., 2008; Kverneland et al., 2015; Liu et al., 2018).
What is a keto diet?
A ketogenic diet is a very high-fat low-carbohydrate diet that is designed to induce fat metabolism. When the body is depleted of glucose stores, it shifts to metabolizing fat and fatty acids, which produces compounds called ketones.
What is the major part of epilepsy?
In talking with my patients, a major part of epilepsy they struggle with most is the lack of control. They worry about going out in public and suddenly having a seizure — there’s just no predictability to it whatsoever, and I think that causes major anxiety. A diet is something in their environment they can control. They can be in control of their treatment and seizures, and I think that empowers them.
How much fat is in a keto diet?
The classic ketogenic diet used as far back as the 1920s is a four to one ratio (in grams) of fat to carbohydrates plus protein. That’s about 90 percent of calories coming from fat. We typically teach our patients a modified Atkins diet, which limits the net carbohydrate intake to 20 grams per day without any limitations on the amount of protein and fat they eat. Typically, about 60 to 70 percent of their daily calorie intake comes from fat. (That’s more than double what the USDA Dietary Guidelines recommend.)
Why do neurons fire during seizures?
This can happen because the brain cells are more excitable and are releasing lots of excitatory neurotransmitters, like glutamate. Or it could be that neighboring brain cells aren’t able to suppress the spread of excitability like they normally would using inhibitory neurotransmitters like gamma-aminobutyric acid, or GABA.
Does keto diet affect the gut microbiome?
There have also been a couple of really interesting studies recently that examined how the ketogenic diet can alter the gut microbiome, the trillions of microorganisms inhabiting the digestive tract. These studies found the ketogenic diet can increase certain bacteria species that promote an increased proportion of GABA to glutamate in the brain.
Can epilepsy cause sedation?
For patients with treatment-resistant epilepsy, the dose of a drug or combination of drugs necessary to stop seizures can sometimes cause significant sedation. I’ve seen instances where patients have been able to control their seizures, but their quality of life is really impacted by side effects.
Does diet help with epilepsy?
Yulia Furman/Shutterstock.com. Diets aren’t just for weight loss. What, how much, and even when we eat all affect the way our brains work. For people with epilepsy, diet can reduce the likelihood of seizures.
How effective is the keto diet for epilepsy?
The effectiveness of the ketogenic diet was significantly higher in cases of generalized epilepsy than partial epilepsy. About 10% of children discontinued their diet due to distaste, and 3.7% experienced vomiting and nausea [12].
How does ketogenic diet affect seizures?
In randomized clinical trials, 778 patients participated in 11 trials; 712 children and adolescents and 66 adults. Reported seizure freedom rates ranged from 0 to 55% after three months, and reported seizure reduction rates reached up to 85%. One trial found no significant difference between the fasting-onset and gradual onset ketogenic diet of seizure freedom, and a greater seizure reduction rate was found in the gradual-onset ketogenic diet group. All studies had adverse effects of dietary interventions. The most commonly reported adverse reactions were gastrointestinal syndromes. Side effects were the most common reason for participants dropping out of research. Other reasons for giving up were lack of effectiveness and lack of diet acceptance. One study assessed the impact of dietary interventions on quality of life, cognition and behavioral functioning, participants in the ketogenic diet study being more active, productive, and less anxious after four months compared with the control group. However, there was no significant difference in quality-adjusted years of life between the ketogenic dietary group and the control group after four or 16 months [20]. It should be borne in mind that these positive findings from studies spanning a decade, were obtained by different clinical groups in children with highly refractory epilepsy.
What is the condition that causes seizures?
Epilepsy is a chronic brain disorder that is characterized by recurrent seizures, which are short episodes of involuntary movement that can affect part or all of the body, sometimes accompanied by loss of consciousness and control of bladder or bowel function. Epilepsy is defined as the occurrence of 2 or more unprovoked seizures. A common type of epilepsy affecting 6 in 10 people is idiopathic epilepsy, which means that in over 50% of global cases, the cause of the disease is not identified [1]. Epilepsy of known cause is called secondary or symptomatic epilepsy. Causes of secondary or symptomatic epilepsy are: brain tumors, stroke, brain infection and severe head injury, congenital abnormalities associated with brain defects, brain damage as a result of prenatal or perinatal injuries, and certain genetic syndromes [2]. About 50–70 million people worldwide suffer from epilepsy [2,3]. It is estimated that 2.4–4.6 million people worldwide are diagnosed with epilepsy each year [3]. These global load estimates are falling more on the populations of low- and middle-income countries, where the cumulative estimate of annual incidence of epilepsy is much higher (139 per 100,000 people) than in high-income countries (49 per 100,000 people) [3]. Regardless of the country’s income, the public health burden of epilepsy carries a high risk of disability, economic loss, social isolation, and premature death [4]. Epilepsy is a serious and costly health problem worldwide and includes estimated indirect and direct costs annually of around EUR 15.5 billion in Europe [4] and USD 15.5 billion in the United States [5]. In this regard, the World Health Organization has made this a priority, calling for the development of national healthcare plans for the treatment of epilepsy, not only to ensure the availability of effective care, but also to prevent its causes. Almost 80–90% of people diagnosed with epilepsy live in low- and middle-income countries [2,6]. Recent studies in low-, middle-, and high-income countries have shown that up to 70% of adults and children with epilepsy can be successfully treated with antiepileptic drugs. After 2 to 5 years of successful therapy and no seizures, medications can be withdrawn in approximately 70% of children and 60% of adults without recurrence. As the above information shows, available pharmacological treatment for epilepsy has limited effectiveness. Surgical intervention can lead to seizure control in a selected subset of patients, but still leaves a significant number of patients with uncontrolled seizures. The ketogenic diet has proven useful in cases of epilepsy in which pharmacological and/or surgical treatment is not effective as shown below. The purpose of this review was to provide a comprehensive overview of what was published about the benefits of ketogenic diet treatment in patients with epilepsy. Clinical data on the benefits of ketogenic diet treatment in terms of clinical symptoms and adverse reactions in patients with epilepsy have been reviewed. Variables that could have influenced the interpretation of the data were also discussed. The data in this review contributes to a better understanding of the potential benefits of a ketogenic diet in the treatment of epilepsy and informs scientists, clinicians, and patients, as well as their families and caregivers, about the possibilities of such treatment. Since 1990, the number of publications on attempts to treat drug-resistant epilepsy with a ketogenic diet has grown so rapidly that it has become a challenge to see the overall trajectory and major milestones achieved in this field. In this review, we hope to provide the latest data from randomized clinical trials, practice guidelines, and new research areas over the past 2 years.
How much seizure reduction is a keto diet?
In the latest meta-analysis study in children and adolescents with refractory epilepsy after a classic ketogenic diet, the percentage of patients whose seizure reduction ≥50% was 62, 60, 52, 42, and 46% in 1, 3, 6, 12, and 24 months of diet, respectively [22].
How to treat epilepsy?
Classic epilepsy treatment includes pharmacological and surgical therapy or vagus nerve stimulation. Despite these therapies, approximately 30% of patients with epilepsy do not have sufficiently controlled seizures and become resistant to drugs [7]. This is defined as insufficient seizure control, despite optimal therapy using a combination of two or more appropriately selected antiepileptic drugs. Under these circumstances, adding next antiepileptic drug often does not significantly reduce seizures. Although epilepsy research is ongoing, the mechanisms of this disease have not been completely elucidated and fully effective therapy for all epilepsy patients has not yet been developed. Epilepsy is the highest research priority for many pharmaceutical companies, which makes epilepsy one of the most studied brain disease in the pharmaceutical industry, but despite such tremendous commitment, we are not seeing significant progress in developing new effective drugs. Patients with drug-resistant epilepsy are addicted to informal care of family and friends as well as healthcare professionals such as social workers, neurologists, and psychologists. Problems associated with drug-resistant epilepsy in children, adolescents, and adults cause repeated hospitalizations of numerous patients. Living with uncontrolled epilepsy has a negative impact on the quality of life of patients with epilepsy and their caregivers.
Can a ketogenic diet be used for epilepsy?
The randomized clinical trials presented in this review show promising results in the use of ketogenic diet in drug-resistant epilepsy. However, the limited number of studies, the small number of patients and the limited studies in adults cause low to very low overall quality of evidence. All studies experienced side effects such as short-term gastrointestinal upset, high cholesterol, and other [6,7]. The study times were short, so the long-term risk associated with these adverse effects is unknown. Only few studies used the ketogenic diet in adults with drug-resistant epilepsy; therefore, further studies could be useful. For people with difficult-to-treat epilepsy or people who are unsuitable for surgical intervention, a ketogenic diet remains an important option; however, further research is needed regarding this issue. Future randomized clinical trials are needed to confirm the efficacy of the ketogenic diet in various types of epilepsy and to provide further information on some unresolved practical problems, i.e., how long the ketogenic diet should be continued.
Does keto diet help with epilepsy?
The mechanisms by which the keto genic diet exerts an anticonvulsant effect are likely to be numerous and may vary in different types of epilepsy. Recent articles describe a new mechanism for ketogenic diet to prevent seizures by changing gut microbiota in animals and humans [40,41,42]. To date, very few studies have focused on the role of gut microbiota in the treatment of epilepsy using a ketogenic diet [40,41,42,43]. Olson et al. [40], presented very interesting research on gut microbiota-dependent anticonvulsant properties of the ketogenic diet in which two mouse models of refractory epilepsy were used, demonstrating the relationship between the ketogenic diet and gut microbiota to obtain a therapeutic effect. Diet significantly increases the relative abundance of Akkermansia muciniphila, from 2.8% to 36.3% during 4 and 14 days of dietary treatment. Parabacteroides merdae, Sutterella, and Erysipelotrichaceaealso increased significantly, while Allobaculum, Bifidobacterium, and Desulfovibriowere lower in mice fed the ketogenic diet compared to mice fed the control diet. Akkermansia muciniphilaand Parabacteroides merdaehave been shown both to be necessary to achieve the anti-seizure effect of a ketogenic diet. The combination of these two bacterial taxa restored protection against seizures in antibiotic-treated mice after administration of the ketogenic diet. On the contrary, colonization with only Akkermansia muciniphilaor Parabacteroides distasonisdid not protect against seizures and there was no significant increase in seizure threshold. Similarly, colonization of Akkermansia muciniphilaand Parabacteroidestogether, but not separately, protected against seizures in germ-free mice fed a ketogenic diet [40].
What is the best diet for epilepsy?
One of the oldest treatments for epilepsy is the classic ketogenic diet, which involves consuming high-fat foods and very few carbohydrates. Johns Hopkins is a longstanding pioneer in this mode of therapy.
What doctor prescribes seizure medication?
Your local neurologist will continue to be your primary neurologist and prescribe your seizure medications and the clinic provides consultative services.
What to expect after a dietary therapy visit?
After the visit you can join other new dietary therapy patients at a teaching session presented by the Adult Epilepsy Diet Center team that introduces you to the diet. You will receive helpful references and recipes to get you started, and also have an opportunity to meet with the dietitian one-on-one for individualized counseling.
When was the Atkins diet developed?
Johns Hopkins developed the modified Atkins diet in 2002 as a treatment for adolescents and adults and opened the world’s first adult epilepsy diet center.
Can epilepsy patients use keto?
Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual.
Can a neurologist handle seizures?
If you are from outside the Baltimore/Washington area, your your local neurologist will continue to be your primary neurologist and handle your seizure medications. We will need all your medical records in advance so we can review them and ensure the modified Atkins diet or ketogenic diet is appropriate for you. International patients should request appointments through the Johns Hopkins International Office.
Is keto a science?
In many ways, the ketogenic diet is as much an art as a science, and effective fine-tuning of any child’s diet depends on experience.
How does keto work for epilepsy?
Epilepsy is a metabolic disease, and one theory is that the keto diet works by altering a person’s metabolism. Neurons, or hyperexcitable nerve cells, in the brain may contribute to the onset of seizures. The keto diet leads to metabolic changes in the blood and cerebrospinal fluid, and these changes, along with other factors, ...
How much reduction in seizures does keto diet help?
Experts suggest that around 30–40% of adults with epilepsy who follow a keto diet experience at least a 50% reduction in seizures. However, fewer than 10% of these adults achieve a 90% reduction in seizures or stop experiencing them.
What happens when you are on keto?
When a person is on the keto diet, their body does not receive enough carbohydrates to burn for energy, so it must use fat instead. Burning fat for fuel causes acids called ketones to build up in the body. When this occurs, the body is in ketosis. To achieve this, a person must adhere to the diet for a significant period.
How long does it take for keto to work?
The keto diet can take time to have an effect. In order to see the benefits, people should continue with it for at least 3 months after reaching ketosis.
Can you eat keto with epilepsy?
Both children and adults with drug resistant epilepsy can benefit from a keto diet . It may be especially helpful for people with certain types of epilepsy, including: glucose transporter type 1, or GLUT-1, deficiency. The diet may also be effective for children with focal seizures.
Does keto diet help with seizures?
The keto diet is low in carbohydrates and protein and very high in fat. Evidence suggests that it can reduce the frequency of seizures, and some people with epilepsy who follow the diet stop experiencing seizures altogether.
What is the rarest type of epilepsy?
There is a rare type of epilepsy, called reflex epilepsy, in which certain foods can trigger seizures. These triggers vary from person to person.
What is keto diet used for?
The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses
Why is the keto diet used in McArdle disease?
The ketogenic diet also has been used in glycogenosis type V (McArdle disease), which is caused by a defect in the muscle-specific isozyme of glycogen phosphorylase. Glycogen phosphorylase is necessary to break down glycogen into free glucose for use as an energy source in muscles. When the ketogenic diet was applied to a patient with this disorder (presumably providing an alternative means of energy production), the patient’s exercise tolerance improved and there was a trend toward decreased baseline creatine kinase levels [22, Class III].
How does ketosis affect the body?
The ketogenic diet has many potential effects and is likely to have different mechanisms in different diseases [8]. In metabolic conditions, cancer, trauma, and ischemia, the ketogenic diet may confer a protective effect by providing an additional energy substrate to tissue at risk of cell death. However, ketosis may have more complicated effects. In one model, rats fed the ketogenic diet show marked upregulation of both the ketone transporter and the glucose transporter type 1 (GLUT-1), promoting the influx of nutrients into the brain [9]. These authors provided evidence that the ketogenic diet increases capillary density without increasing overall blood flow, providing a way that the diet may help nourish tissue at risk. This finding is particularly interesting in light of findings in animals with tumors, in which the diet is associated with an anti-angiogenic effect [10,11]. These discordant results eventually will need to be reconciled; they may be due to differences in angiogenic stimuli in normal cells versus malignant cells.
Why do children with epilepsy have seizures?
Children with epilepsy due to mutations in GLUT-1, which transports glucose across the blood-brain barrier, suffer from seizures in infancy. If not identified and treated, they develop microcephaly, mental retardation, spasticity, and ataxia as a consequence of relative brain hypoglycemia.
Does ketogenic diet help mitochondria?
The ketogenic diet appears to enhance mitochondrial function via a number of potential pathways. Given the important role of mitochondrial dysfunction in many neurodegenerative diseases, it is important to outline potential mechanisms of apparent disease-modifying effects of the ketogenic diet. It is unclear whether there is something specific or direct about the ketogenic diet (ie, provision of ketone bodies or fatty acids) or, perhaps more importantly, the metabolic changes it induces.
When was the keto diet invented?
The ketogenic diet initially was developed in the 1920s in response to the observation that fasting had antiseizure properties [1]. During fasting, the body metabolizes fat stores via lipolysis and then the fatty acids undergo beta-oxidation into acetoacetate, β-hydroxybutyrate, and acetone—ketone bodies the cell can then use as precursors ...
Does calorie restriction help Alzheimer's?
In the case of Parkinson’s disease (PD) and Alzheimer disease (AD) models, there are data suggesting that calorie restriction itself is protective [31,32••], raising the question of whether manipulations of some critical metabolic pathways also may possess disease-modifying properties. The ketogenic diet originally was designed to mimic fasting, and thus it may regulate a family of proteins known as sirtuins, which play a major role in mediating “anti-aging” effects of calorie restriction [33•]. Alternatively, the ketogenic diet may regulate a master energy-sensing protein in the cell, 5′-adenosine monophosphate (AMP)–activated kinase [34]. Both proteins have a number of downstream effectors that may possess neuroprotective properties.
How can a Ketogenic Diet Help a Person with Epilepsy?
With that in mind, it is important to focus attention on the most important question, how a Ketogenic diet can help people with overcoming the frustration associated with epilepsy . Healthcare professionals highly encourage children who are dealing with epilepsy in order to go ahead and follow Ketogenic diets. It is often being prescribed as a part of epilepsy control medicine. The ability of Ketogenic diet to provide amazing results has contributed towards the above mentioned fact as well.
What are the health conditions that can be treated with keto diet?
Some of the most prominent health conditions that can be treated along with the assistance of ketogenic diet plans include Doose syndrome, Dravet syndrome, tuberous sclerosis complex, Rett syndrome and infantile spasms. In addition, it can provide effective results in helping individuals with controlling epilepsy as well.
