The ketogenic diet is a commonly used and successful diet for children with epilepsy. This diet does not replace anti-epileptic medications but is an alternative therapy intended to complement traditional epilepsy treatments. A child who experiences regular epileptic seizures despite taking anti-epileptic medications may find the ketogenic diet effective in reducing overall seizure activity. The ketogenic diet works by simulating the effects of starvation, using the body's natural processes in response to a low-carbohydrate, high-fat regimen to bring seizures under control.
Function
The ketogenic diet works on a process called ketosis. Ketosis occurs when, in the absence of available carbohydrates, the body converts fat for energy use. This conversion produces ketones, which function as an energy source for the brain. Ketones are known to have an anticonvulsant effect, although it is not fully understood why this is so. A ketogenic diet is designed specifically to produce ketosis and the resulting ketones. In a June 2008 study published in "The Lancet," a team of researchers led by E. G. Neal found that roughly half of children following a ketogenic diet experienced a reduction in seizure activity.
Starting the Diet
The diet is typically started with a supervised fast as a hospital inpatient. The ketogenic diet should not be attempted without full medical supervision and a doctor's prescription. After the period of in-hospital fasting, which most typically lasts for 24 hours, the family will be given instructions and recommendations for the child's continuing diet. The ketogenic diet places nutritional emphasis on both saturated and unsaturated fats, such as butter, cream, mayonnaise and oils. An overall daily calorie limit will be established, appropriate to the child's age and height. Strict limitations on carbohydrate and protein intake will be established.
Discontinuing the Diet
As with starting the diet, stopping a ketogenic diet should only be done under medical supervision. Children may see an overall decrease in seizure activity as they get older. If seizures come to be quite well controlled over time, your doctor may recommend discontinuing the ketogenic diet. In this case, the child will be transitioned gradually back to a more typical diet --abrupt discontinuation of the ketogenic diet can increase a child's seizures as the body struggles to adapt.
.
Medication Interactions
The ketogenic diet is typically used in conjunction with a full regimen of anti-epileptic medications -- these medications are not likely to be reduced just because a child is following a ketogenic diet. Typically, your doctor will want to see your child regularly -- at least four times per year -- to monitor the effects of the ketogenic diet and any anti-epileptic medications.
Side Effects
Obviously, a high-fat diet like the ketogenic diet can have negative side effects. An increase in cholesterol levels is a likely effect of long-term adherence to a ketogenic diet. Also, certain vitamins and minerals are lacking in the ketogenic diet, so it is possible the child will experience vitamin deficiencies. The dietitian overseeing the child's diet may recommend supplements to counteract any deficiencies that arise. Additionally, the diet may make the child feel lethargic to start with. Side effects in the long term include decreased growth rate, constipation, kidney stones and a higher risk of bone fractures. However, the possible side effects of the ketogenic diet should be weighed against the possible side effects of a continuing high seizure rate.
