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How Does A Ketogenic Diet Work For Epilepsy?

Ketogenic Diet

Ketogenic Diet

The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour. Up to 70% of people with epilepsy could have their seizures controlled with anti-epileptic drugs (AEDs). For some children who continue to have seizures, the ketogenic diet may help. However, the diet is very specialised. It should be carried out with the care, supervision and guidance of trained medical specialists. What is the ketogenic diet? The ketogenic diet (KD) is a high fat, low carbohydrate, controlled protein diet that has been used since the 1920s for the treatment of epilepsy. The diet is a medical treatment and is usually only considered when at least two suitable medications have been tried and not worked. The ketogenic diet is an established treatment option for children with hard to control epilepsy. Some adults may benefit from dietary treatments, but more data is needed about the impact and results for adults, and adult treatments are currently only available in a few UK clinics. Dietary treatments for epilepsy must only be followed with the support of an experienced epilepsy specialist and dietitian (food specialist). How does the diet work? Usually the body uses glucose (a form of sugar) from carbohydrates (found in foods like sugar, bread or pasta) for its energy source. Chemicals called ketones are made when the body uses fat for energy (this is called ‘ketosis’). The body uses ketones instead of glucose for its energy source. Research in 2015 has shown that another chemical, decanoic acid, is also produced as a result of the diet. These chemicals help to reduce seizures for some people. Who is the diet suitable for? The Continue reading >>

How Can A High-fat Diet Treat Epilepsy? Dr. Besser Reports

How Can A High-fat Diet Treat Epilepsy? Dr. Besser Reports

Imagine treating childhood epilepsy with bacon, heavy cream and hot dogs. This may sound like an unlikely approach, but the extremely high-fat and low-carb ketogenic diet has been shockingly effective in treating kids with drug-resistant epilepsy. ABC News' senior health and medical editor Dr. Richard Besser sat down with the director of pediatric epilepsy at Massachusetts General Hospital, Dr. Elizabeth Thiele, to discuss this unusual approach to fighting epilepsy. For more information on the ketogenic diet and pediatric epilepsy, watch 'World News With Diane Sawyer' Thursday at 6:30 p.m. ET on ABC Dr. Richard Besser: So what is the ketogenic diet? Dr.Elizabeth Thiele: The ketogenic diet is a high-fat, low carbohydrate diet, and it was developed in the 1920s after people noticed that when epileptics fasted, for various reasons, seizures would be markedly reduced. Besser: So the ketogenic diet mimics what you'd see in someone who's fasting? Thiele: Right. When this was noticed, this observation was made in the 1920s, people started thinking, "Gee, what happens when someone fasts?" And when a person fasts, your body starts breaking down your fat stores. Obviously, fasting is not great for a treatment for epilepsy or other conditions because it doesn't provide adequate nutrition, so the thought was, "Gee, how could we mimic starvation and trick our bodies into thinking we're starving by using fats as the main energy source?" Besser: So this treatment is solely based on diet? Thiele: This treatment is solely based on diet. Besser: No medicines, nothing else? Thiele: We do supplement vitamins, because with the high-fat, kids can become deficient in some vitamins -- so while on the diet, all children are supplemented with vitamins and also calcium. Besser: So on this diet, s Continue reading >>

Diet Stops Seizures When Epilepsy Drugs Fail

Diet Stops Seizures When Epilepsy Drugs Fail

When Jackson Small began having seizures at 7, his parents hoped and assumed at least one of the many epilepsy drugs on the market would be enough to get things under control. But one seizure quickly spiraled to as many as 30 a day. "He would stop in his tracks and not be aware of what was going on for 20 or 30 seconds or so," his mother Shana Small told CBS News. Jackson was eventually diagnosed with juvenile myoclonic epilepsy, a type of epilepsy characterized by brief but often frequent muscle jerking or twitching. But a number of medications typically prescribed to patients with this type of epilepsy were not effective. And so the quest to help Jackson gain control over his seizures led the family from their home in Orlando, Florida, to the office of a registered dietician at the NYU Langone Comprehensive Epilepsy Center in New York City. They were there to discuss the medical benefits of heavy cream, mayonnaise, eggs, sausage, bacon and butter. A lot of butter. The plan was to treat Jackson with a diet that is heavy in fat, low in protein and includes almost no carbohydrates. It's known as the ketogenic diet and has long been in the arsenal of last-resort options for patients with epilepsy who are unresponsive to medication. Doctors may recommend a patient go on this special diet after unsuccessfully trying two or three prescriptions. The diet works by putting the body in a "fasting" state, known as ketosis. "When we're fasting the body needs to find fuel so our body will break down fat storage and break down their own fat and enter a state of ketosis," Courtney Glick, the registered dietician who coordinated and fine-tuned Jackson's diet plan, told CBS News. "But with this diet, instead of breaking down the body's fat, the body breaks down dietary fat." The ketoge Continue reading >>

Ketogenic Diet

Ketogenic Diet

What the Diet Does Normally, our bodies run on energy from glucose, which we get from food. We can’t store large amounts of glucose, however. We only have about a 24-hour supply. When a child has no food for 24 hours — which is the way the diet begins, usually in a hospital — he or she uses up all the stored glucose. With no more glucose to provide energy, the child’s body begins to burn stored fat. The ketogenic diet keeps this process going. It forces the child’s body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting. In fact, the diet gets most (80 percent) of its calories from fat. The rest comes from carbohydrates and protein. Each meal has about four times as much fat as protein or carbohydrate. The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person. Doctors don’t know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others. Trying to put a child on the diet without medical guidance puts a child at risk of serious consequences. Every step of the ketogenic diet process must be managed by an experienced treatment team, usually based at a specialized medical center. Chances of Success Often, a period of fine-tuning is needed before it’s clear whether or not a child is going to respond to the ketogenic diet. Doctors often ask parents to try the diet for at least one month, and even as long as two or three, if it’s not working at first. A child on the diet usually continues taking anti-seizure medicine, but may be able to take less of it later on. If a child does very well, the doctor may sl Continue reading >>

Eat To Beat Seizures: The High-fat Ketogenic Diet Can Help Stop Seizures In Hard-to-treat Epilepsy. Doctors And Dietitians Explain How It Works And How It Is Implemented.

Eat To Beat Seizures: The High-fat Ketogenic Diet Can Help Stop Seizures In Hard-to-treat Epilepsy. Doctors And Dietitians Explain How It Works And How It Is Implemented.

Issue Table of Contents Carr, Coeli Download Article PDF Outline Back to top Luella Klein had her first seizure at 13 months and was prescribed antiseizure medication. But by the time she was two and a half, the drugs had stopped working and she had developed new symptoms, including a severely imbalanced gait. During a visit to the Columbia University Medical Center in New York City, Luella underwent a spinal tap to measure glucose levels in her cerebral spinal fluid. Based on the results, she was diagnosed with glucose transporter type 1 deficiency syndrome (Glut1 DS), a genetic metabolic disorder that occurs when glucose, a sugar in the blood, doesn't reach the brain in levels high enough to be used for fuel. That lack of fuel disrupts brain growth and function and can cause a variety of symptoms, including seizures, movement disorders, speech problems, and developmental delays. Luella's doctors recommended that she be put on the ketogenic diet, a high-fat, low-carbohydrate regimen that is standard care for Glut1 DS because it provides an alternate source of fuel—fat—for the glucose-starved brain. FATS FOR FUEL [ Click here to enlarge ] Normally, the body converts the carbohydrates in food into glucose, which then becomes fuel for all parts of the body, including the brain. On the ketogenic diet, which restricts carbs and loads up the fat, a different mechanism kicks in: The liver converts fat into fatty acids and ketone bodies, chemicals that “can cross the blood-brain barrier and be used as fuel and may even be anticonvulsant,” explains Eric H. Kossoff, MD, a professor of neurology and pediatrics and medical director of the Ketogenic Diet Center at Johns Hopkins Hospital in Baltimore, MD, and a member of the American Academy of Neurology (AAN). When the body Continue reading >>

Unraveling The Secrets Of The Epilepsy Diet

Unraveling The Secrets Of The Epilepsy Diet

For decades, neurologists have known that a diet high in fat and extremely low in carbohydrates can reduce epileptic seizures that resist drug therapy. But how the diet worked, and why, was a mystery — so much so that in 2010, The New York Times Magazine called it “Epilepsy’s Big, Fat Miracle.” Now, researchers at Dana-Farber Cancer Institute (DFCI) and Harvard Medical School (HMS) have proposed an answer, linking resistance to seizures to a protein that modifies cellular metabolism in the brain. The research, to be published in the May 24 issue of the journal Neuron, may lead to the development of new treatments for epilepsy. The research was led jointly by Nika Danial, HMS assistant professor of cell biology at Dana-Farber Cancer Institute, and Gary Yellen, professor of neurobiology at Harvard Medical School. The first author was Alfredo Giménez-Cassina, a research fellow in Danial’s lab. Epilepsy is a neurological disorder characterized by an electrical storm in the brain that can manifest as convulsions, loss of motor control, or loss of consciousness. Some epilepsy cases can be improved by a diet that drastically reduces sugar intake. Such a diet causes neurons to switch from their customary fuel of sugar to fat byproducts called ketone bodies. The diet, which mimics the effects of starvation, was described more than 80 years ago and received renewed interest in the 1990s. Recent studies corroborate that it works, but shed little light on how. Yellen was introduced to the ketogenic diet by his wife, Elizabeth Thiele, professor of neurology at HMS and director of the Pediatric Epilepsy Program at MassGeneral Hospital for Children, who was not involved in the study. “The connection between metabolism and epilepsy has been such a puzzle,” said Yellen. Continue reading >>

Low Carb, High-fat Diets May Reduce Epileptic Seizures

Low Carb, High-fat Diets May Reduce Epileptic Seizures

A ketogenic diet calls for minimizing carbohydrates and replacing them with healthy fats and moderate amounts of high-quality protein In children, ketogenic diet is frequently used as a first line approach when medications fail Among adult epileptics, 32 percent of those on a ketogenic diet and 29 percent of those on a modified Atkins diet reduced their seizures by about half By Dr. Mercola A ketogenic diet calls for minimizing carbohydrates and replacing them with healthy fats and moderate amounts of high-quality protein. This kind of diet is now being investigated for its potential to prevent and treat cancer, but it has long been established as an excellent treatment for epileptic seizures. A high-fat, low-carb diet will also help optimize your weight and virtually all chronic degenerative disease, as eating this way will help you convert from burning carbs to burning fat as its primary fuel. In the US, epilepsy affects an estimated 2.3 million adults and nearly 468,000 children below the age of 17. It's a chronic neurological condition characterized by recurring seizures, which can have a significant impact on a person's quality of life, given the heightened risk of accidents and injuries.1 Ketogenic Diet—An Accepted First Line Approach for Epilepsy in Children Standard treatment for epilepsy includes anti-epileptic drugs, which tends to work for 60-65 percent of patients.2 For the remainder, the drugs don't work—but oftentimes a ketogenic diet will. Clinical medicine began recognizing the ketogenic diet as a valuable option in the treatment of epilepsy in the late 90s, and there's even a Ketogenic Diet Special Interest Group at the American Epilepsy Society. The special interest group was organized by Dr. Thomas Seyfried, who today is one of the leading academi Continue reading >>

Ketogenic Diet

Ketogenic Diet

Certain children who are having problems with medications, or whose seizures are not being well controlled, may be placed on a special diet called the ketogenic diet. This type of diet is low in carbohydrates and high in protein and fat. No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. The ketogenic diet works in approximately half of all children with intractable epilepsy; however, the diet does not work for everyone. What is the ketogenic diet? The ketogenic diet is very high in fat (about 90 percent of the calories come from fat). Protein is given in amounts to help promote growth. A very small amount of carbohydrate is included in the diet. This very high-fat, low-carbohydrate diet causes the body to make ketones. Fat is used for energy instead of sugars and carbohydrates. If your child eats too many carbohydrates, then his body may not make ketones. Ketones are the measurement we use to see how the body is burning the fat. The presence of ketones is important to the success of the diet. The diet: Is managed by a doctor. A dietician will create the plan. Contains three to five times as much fat as carbohydrate and protein. Makes the body burn fat for energy instead of glucose (sugar). Strictly limits calories How does the diet work? No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. The body’s main fuel is sugar (glucose). Normally, the body burns sugar to make energy and maintain a normal blood sugar level. After the glucose is gone, the body begins to burn fat for fuel. The body does not burn fat completely; but breaks it down into ketones in the blood. When is the ketogenic diet used? The diet is used for people of any age with myoclonic, absence, and ato Continue reading >>

What Is A Ketogenic Diet?

What Is A Ketogenic Diet?

What Is a Ketogenic Diet? If medicine doesn't control seizures in epilepsy, sometimes doctors prescribe a ketogenic (or keto) diet. A ketogenic diet is a strict high-fat, low-carbohydrate diet that can reduce, and sometimes stop, seizures. It's called "ketogenic" because it makes ketones in the body. Ketones are made when the body uses fat for energy. By replacing carbs with fat in the diet, the body burns more fat and makes more ketones. The ketogenic diet is prescribed by a doctor. Kids on the diet need to be followed closely by a dietitian to make sure they follow the diet and get the nutrients they need. The diet starts with fasting during an overnight hospital stay. Who Needs a Ketogenic Diet? Children with seizures that are not well-controlled by medicines (called intractable epilepsy) and severe epilepsy syndromes (such as infantile spasms or Lennox-Gastaut syndrome) might benefit from a ketogenic diet. Studies show that the ketogenic diet also may help treat other conditions, such as diabetes, obesity, and even cancer. How Does a Ketogenic Diet Work? Although the ketogenic diet for epilepsy has been around since 1920, doctors aren't exactly sure how the higher ketone levels works. Some seizure types seem to respond better than others to the ketogenic diet. In babies, the keto diet is given in formula. Young children may be fed by a tube that is place in the stomach by a surgeon. This helps the child stay on the diet. How Long Do Kids Need a Ketogenic Diet? You should know if a ketogenic diet works for your child within a few months. If it does, your doctor may recommend weaning your child off the diet after 2 years of seizure control. The weaning process is done over several months to avoid triggering seizures. Some people stay on a ketogenic diet for years. Are Continue reading >>

Low-carb, High-fat Diets May Reduce Epilepsy Seizures

Low-carb, High-fat Diets May Reduce Epilepsy Seizures

Approximately 60-65% of patients with epilepsy become seizure free with antiepileptic drug treatment. The remaining 35% are resistant to medications. However, a review of current research published in Neurology presents a promising alternative treatment for epileptic seizure reduction - diets high in fats and low in carbohydrates. Researchers aimed to review the high-fat, low-carbohydrate ketogenic and modified Atkins diets for the treatment of refractory epilepsy (drug-resistant epilepsy) in adults. Both diets have proved successful in children, yet they are studied in adults insufficiently. The modified Atkins diet and the ketogenic diet include high-fat foods such as bacon, eggs, mayonnaise, butter, hamburgers and heavy cream, with certain fruits, vegetables, nuts, avocados, cheeses and fish. The ketogenic diet is restrictive, not very palatable and logistically difficult to execute. The Atkins diet has been modified for use in patients with tough-to-treat epilepsy as an easier-to-execute variety of the ketogenic diet. The ratios of fat to carbohydrate and protein are as follows: Ketogenic diet: 3:1 or 4:1 [fat]:[carbohydrate 1 protein] ratio by weight, with 87-90% of calories derived from fat Modified Atkins diet: 0.9:1 [fat]:[carbohydrate 1 protein] weight ratio, with approximately 50% of calories derived from fat. By contrast, the typical American diet derives about 50% of calories from carbohydrate, 35% from fat and 15% from protein. US governmental guidelines for adults recommend 45-65% calories from carbohydrates, 10-20% from fat and 10-35% from protein. Study author Pavel Klein, MB BChir, of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, MD, and a member of the American Academy of Neurology, says: We need new treatments for the 35% of people with epil Continue reading >>

Epilepsy Treatment: Ketogenic Diet Vs Drugs

Epilepsy Treatment: Ketogenic Diet Vs Drugs

The ketogenic diet is well known in the epilepsy treatment field because it has been used in the past, and is currently experiencing a revival as a treatment for epileptic seizures, especially in children. The diet is extremely effective and more importantly, it's non-toxic and well tolerated. The implementation of the diet is administered differently, depending on the hospital. Some hospitals start the diet out by putting children on a 36 hour fast, and reducing calories and liquids to increase ketosis, others don't. Recent papers have suggested that fasting and caloric restriction are not necessary. In addition, some hospital protocols seems to favor drugs before the diet, which I find puzzling, given that the drugs have toxic side effects, don't work as well, and are less effective than the ketogenic diet. The following studies highlight just how effective the ketogenic diet is as an epilepsy treatment. Diet Over Drugs For Epilepsy Treatment In this study, A total of 150 children were entered into a study of the ketogenic diet's efficacy and tolerability. The results were remarkable. Of the original 150 patient cohort, 20 of the children (13%) became seizure-free and an additional 21 (14%) had a 90% to 99% decrease in their seizures. In addition, twenty-nine of the children became free of medications, and 28 were on only 1 medication. And in this study, 14 children with intractable epilepsy and RC complex defects who were treated with the classic ketogenic diet involving a 4:1 lipid to nonlipid ratio (% by weight), but without an initial fast and fluid restriction. The results again were amazing. Of the 14 patients, half became became seizure-free after commencing the diet. One patient with a greater than 90% seizure reduction, and 2 patients had seizure reductions b Continue reading >>

Ketogenic Diet

Ketogenic Diet

What is the ketogenic diet? The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not respond to medications. It is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured. The name ketogenic means that it produces ketones in the body. (keto = ketone; genic = producing) Ketones are formed when the body uses fat for its source of energy. Usually the body uses carbohydrates (such as sugar, bread, pasta) for its fuel. Because the ketogenic diet is very low in carbohydrates, fats become the primary fuel instead. The body can work very well on ketones (and fats). Ketones are not dangerous. They can be detected in the urine, blood, and breath. Ketones are one of the more likely mechanisms of action of the diet, with higher ketone levels often leading to improved seizure control. However, there are many other theories for why the diet will work. Who will it help? Doctors usually recommend the ketogenic diet for children whose seizures have not responded to several different seizure medicines. The classic diet is usually not recommended for adults, mostly because the restricted food choices make it hard to follow. However, the modified Atkins diet does work well. This also should be done with a good team of adult neurologists and dietitians. The ketogenic diet has been shown in many studies to be particularly helpful for some epilepsy conditions. These include infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency. Using a formula-only Continue reading >>

What Is A Ketogenic Diet?

What Is A Ketogenic Diet?

Alright, here’s what the ketogenic diet (often referred to as “keto”) is and the basics of how to follow it. What is the ketogenic diet? For those who don’t know the ketogenic diet is a low-carb, high fat diet (LCHF) with many health benefits. It involves drastically reducing carbohydrate intake, and replacing it with fat. The reduction in carbs puts your body into a metabolic state called ketosis. When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain. Benefits: Ketogenic diets generally cause massive reductions in blood sugar and insulin levels. This, along with the increased level of ketones provide the numerous cited health benefits. Ketogenic benefits include: Fighting diabetes Epilepsy control Alzheimer’s disease Certain cancers Cognitive performance High blood pressure control Satiety Weight/fat loss Reduced cholesterol levels The most obvious and commonly cited benefits is the decreased insulin levels. This is why fasting becomes a great solution to people’s type 2 diabetes, cushing’s disease and many other metabolic diseases. Fasting as well as the ketogenic diet increases insulin sensitivity, improves insulin resistance and allows your body to use the hormone insulin more effectively (which is important for fat loss). There are also four different classifications of the ketogenic diet. The standard ketogenic diet is accepted as reducing your carbohydrates intake to 5% carbs, with just enough protein (20%, let’s say) and the rest coming from fats. Inflammation is the root cause of so many of our ailments, which lower insulin levels decrease. Energy use: The basic principle around ketogenic diets is that our bodies first port of call f Continue reading >>

Pediatric Ketogenic Diet

Pediatric Ketogenic Diet

A ketogenic diet is a high-fat, adequate-protein, and very-low-carbohydrate diet which has been found to help many children whose seizures are not well-controlled by anti-seizure medications. In some children, the ketogenic diet is combined with standard anticonvulsant medications. While the actual mechanism of the ketogenic diet's effectiveness against seizures is unknown, many children on the diet are able to have their epilepsy medication dose lowered, decreasing unwanted medication side effects. We are consistently ranked among the top hospitals in U.S.News & World Report, distinguished for our pediatric care. Read More Because this is a medical treatment, the ketogenic diet must be supervised by a medical team, consisting of a neurologist and dietitian, who can anticipate and manage possible nutritional deficits or other medical side effects or complications. The team helps children and their families establish and maintain the diet, and learn how to incorporate the diet into daily living. Children on the ketogenic diet are seen several times throughout the year for close monitoring, while they continue to follow with their primary neurologist for potential medication changes. In addition, the team also implements the Modified Atkins Diet and Low-Glycemic Index Therapy, other dietary therapies for which there is increasing data about benefit in the treatment of difficult-to-treat epilepsy. Conditions treated by the Ketogenic Diet Team include: Epilepsy such as Myoclonic Astatic Epilepsy and other epilepsies Glucose transporter type-1 deficiency Lennox Gastaut syndrome Pyruvate dehydrogenase deficiency Dravet syndrome What is a ketogenic diet? The ketogenic diet is sometimes offered to children who continue to have seizures while on seizure medication. When medicati Continue reading >>

Review Article The Role For Ketogenic Diets In Epilepsy And Status Epilepticus In Adults

Review Article The Role For Ketogenic Diets In Epilepsy And Status Epilepticus In Adults

1. Introduction of ketogenic diets Since as early as 400BC, diet therapy has been described in the treatment of epilepsy with Hippocrates reporting the belief by contemporaries that certain foods (particular types of fish, fowl, goat, etc.) could exacerbate or cause seizures (Hippocrates., 400BC). Moreover, reference is made in the bible of a patient with epilepsy being cured through “prayer and fasting” (The Bible. Mark 9:14–29, 1982). Despite early reports of seizure reduction and improvements in cognition in adolescents and adults treated with high-fat, carbohydrate limited diets in the 1920s, interest in diet therapy waned following the introduction of anti-epileptic drugs until the 1990s when research studies and clinical trials in children demonstrated its efficacy in drug-resistant patients and particular pediatric epilepsy syndromes (Bastible, 1931; Barborka, 1930, 1928; Martin et al., 2016). There has subsequently been increasing interest worldwide in the use of ketogenic diets to manage drug-resistant epilepsy in adults as approximately 19.5 million people with epilepsy have seizures uncontrolled by medications (Moshé et al., 2015). Moreover, patients with seizures resistant to two or more anti-epileptic drugs have a less than 5% chance of seizure-freedom with additional drugs added and many patients may not be surgical candidates due to a generalized epilepsy, multifocal nature, or nonresectable location of ictal onset (Brodie et al., 2012; Kwan and Brodie, 2000). Thus, there remains a significant demand for additional effective therapeutic options that the ketogenic diet can supply. The classic ketogenic diet (KD) is a high fat, low carbohydrate diet that induces ketone body production through fat metabolism with the goal of mimicking a fasting state Continue reading >>

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