Low Carb Ketogenic Diet

The ketogenic diet refers to a high-fat, adequate-protein, low-carbohydrate diet or variations thereof used by doctors to treat epilepsy in children that is difficult-to-control, or refractory, using traditional antiepileptic drugs. Its use is based, in part, on various studies which have shown that it both prevents seizures and reduces dependence on anti-seizure medications in some children.

How the Diet Works

Individuals on the ketogenic diet get 80 percent of their calories from fat, with the rest coming from carbohydrates and protein.

The diet takes advantage of the brain's ability to use chemical compounds called ketones as an energy source. These are generated by fat breakdown such as when a person restricts carbohydrate intake and consumes inordinate amounts of fat, during fasting, and in poorly regulated diabetes.

Normally, the brain gets most of its energy from glucose. But when a person fasts or follows the ketogenic diet, the liver makes and releases ketones into the blood for transport into the brain. Once in the brain, ketones are thought to reduce the tendency of nerve cells in the brains of epileptic people to function abnormally so as to trigger seizures. The exact mechanism is unknown.

Clinical Studies

Clinical studies involving the ketogenic diet for epilepsy date back to the 1920s, but were flawed for various reasons. Better designed studies have since been conducted. In one review published in the March 2003 Mayo Clinic Proceedings, lead author R.G. Jarrar found that four of 10 children on the diet experienced half, or fewer, the number of seizures they had prior to going on the diet.

In the June 2008 edition of The Lancet Neurology, a paper appeared concerning the results of a randomized clinical study conducted in the U.K. from 2001 to 2006. Using baseline seizure figures on the 145 children who participated, study authors found that the number of seizures in those on the ketogenic diet dropped by more than a third, while seizures went up by a third in children not on it.

Possible Side Effects

The following side effects and complications have been connected with adherence to the ketogenic diet: weight loss; diarrhea; decrease in growth; high cholesterol and/or triglycerides; kidney stones; and bone thinning. However, a study conducted at Johns Hopkins Medical Institutions in 2010 concluded that the ketogenic diet is safe over the long term.

One Variation of the Ketogenic Diet

One variation on the ketogenic diet that readily generates ketones is the medium-chain triglycerides, or MCT, diet. This approach typically involves use of canned or bottled liquid MCT, or powders that are used to make-up a suitable beverage. But because some children experience gastrointestinal upset on MCT alone, many doctors recommend a regimen that combines the ketogenic diet with use of MCT products.

Considerations

The ketogenic diet is now part of mainstream medical care for intractable epilepsy in children. In addition, it is currently being explored with respect to its potential to favorably impact autism, certain cancers, ALS, arthritis, migraine headaches, type II diabetes and other conditions.