The ketogenic diet has been used to reduce seizures since the 1920s, and is a special high-fat, low-carb diet that helps control seizures in some people with epilepsy. It is prescribed by a doctor and carefully monitored by a dietician, and is usually used in children with seizures who do not respond to medications. When the body is forced to use fat as energy due to the lower amount of carbohydrates or sugars, ketones are produced. These ketones, which the brain can use as an alternative source of energy, have an anti-epileptic effect on the brain.
This can lead to better control of seizures. About half of children who follow it have a large decrease in the amount they receive, and up to 1 in 7 completely stop having seizures. The original ketogenic diet was developed by Dr. Russell Wilder of the Mayo Clinic in 1923, as a treatment for epilepsy. Johns Hopkins is a long-standing pioneer in this mode of therapy.
Ketogenic diets are high-fat, low-protein, and carbohydrate diets designed to cause the body to use fat (rather than carbohydrates) as its main source of energy. Normally, the body depends on glucose (blood sugar), a by-product of carbohydrate conversion, for energy. If you can't find carbohydrates to convert, the body will believe you are fasting and will start converting fat into energy; instead of producing glucose, the body will produce ketone bodies. Once there are elevated levels of ketones in the bloodstream, the body enters a state of ketosis, which has been shown to improve neurological conditions and metabolic disorders, including epilepsy. There are five versions of the ketogenic diet used to treat epilepsy: the classic ketogenic diet, modified ketogenic diet, medium chain triglyceride (MCT) diet, modified Atkins diet, and low glycemic index (LGIT) treatment.
The various types of ketogenic diets have been used for years and have been studied in people with epilepsy who have failed to control seizures with anti-seizure medications. The MCT diet is calculated by the percentage of energy (calories) that these particular types of fats provide. The ketogenic diet has been shown to modulate and transform the intestinal microflora, creating a potential basis for future dietary therapy. It has also been found that a ketogenic diet triggered an increase in ketone bodies and blood fatty acids can regulate neuronal membrane excitability by activating two-pore domain potassium channels, which can be taken as another likely anticonvulsant mechanism of the ketogenic diet. One trial found no significant difference between the fasting onset ketogenic diet and the gradual onset of no seizures. Mackenzie Cervenka, neurologist and director of the Johns Hopkins Hospital Adult Epilepsy Diet Center explains what the ketogenic diet is and how it can benefit people with epilepsy.
In many ways, the ketogenic diet is both an art and a science, and the effective adjustment of any child's diet depends on experience. The effectiveness of the ketogenic diet remained stable for 3 to 6 months, and the diet was not interrupted due to tolerance.