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How Does Ketosis Help Epilepsy

The Ketogenic Diet

The Ketogenic Diet

The ketogenic diet is a high fat, low protein and low carbohydrate diet used as a treatment for epilepsy. The ketogenic diet may be ordered by the doctor for children who have severe forms of epilepsy that have not responded well to various drug treatments. The diet is very high in fat, in the form of fatty foods such as butter, margarine, oil and cream. The diet contains enough protein for your child to grow and develop normally and very small amounts of carbohydrate foods. How does the diet work? No one is certain exactly how the diet works. Normally, your body breaks down the carbohydrates in the food you eat to glucose, the fuel for the brain. When you do not have enough carbohydrate (such as during starvation) your body starts to break down your fat reserves. When fat is broken down it produces a by-product called ketones. Your brain then starts to burn ketones for energy. The ketogenic diet provides your child with enough energy to grow, but mimics the effects of starvation. The high fat content makes the body produce ketones in larger than normal quantities, and these are used by the brain for energy instead of glucose. It is the change in fuel for the brain that is thought to make the diet work. Not all children respond to the diet, but those that do may have fewer seizures of decreased intensity, and may even remain free from seizures for extended periods. Who should go on the diet? The ketogenic diet is used for children with severe epilepsy where other therapies have failed. Even though the diet involves food, it requires a great deal of effort, is restrictive and will change your child’s usual eating habits. Remember that food is not just about nutrition, we eat for social and cultural reasons as well as for pleasure, and all of these factors will be affec Continue reading >>

Ketosis For Epilepsy

Ketosis For Epilepsy

In recent years, the ketogenic diet and using ketosis for losing weight, improving overall health and boosting mental clarity spiked major interest. However, many ketogenic diet followers are surprised to find out the diet was originally designed for a specific population of people: those with epilepsy. In this article, we’ll cover some of the history of ketosis for epilepsy, how it’s used for treatment, and possible reasons ketosis has been successful in this area. History of Ketosis for Epilepsy The ketogenic diet was first developed in the 1920s as a therapy diet for those with epilepsy. Epilepsy is a chronic neurological disorder that causes unpredictable seizures among other health problems. Epilepsy affects people of all ages, and the types of seizures vary widely per person. Fasting, which leads to ketosis in the body, has been used as a treatment for epilepsy since as far back as 500 BC [1], and the ketogenic diet was created as an alternative. Those following it could still achieve the benefits of ketosis for epilepsy without abstaining from food. Causes of Epilepsy Around 2.3 million American adults and almost half a million children have epilepsy. About 150,000 new epilepsy cases are diagnosed each year in the United States. Most epilepsy diagnoses don’t have a true identifiable cause. However, there are several additional conditions that can lead to epilepsy, including infection, head trauma, strokes, and brain tumors. What’s important when it comes to ketosis and epilepsy is the mechanisms by which the ketogenic diet helps alleviate seizures is those with this chronic disorder. Let’s take a look at some ideas about why it’s been successful in some epilepsy patients. How it Works A ketogenic diet is a high-fat, moderate-protein, and very-low-carb 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 >>

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 >>

Ketogenic Diet, With Variations, Can Help Adult Epilepsy

Ketogenic Diet, With Variations, Can Help Adult Epilepsy

HOUSTON – The ketogenic diet is usually thought of as a solution of near-last resort for pediatric epilepsy, but some adolescents and adults with epilepsy can also benefit from a very low carbohydrate diet. There are also limited data to suggest that more palatable adaptations of the diet may provide benefit while improving adherence, said Mackenzie C. Cervenka, MD, speaking at the annual meeting of the American Epilepsy Society. “Ketogenic diets are a reasonable option for older adolescents and adults with drug-resistant epilepsy that’s not amenable to surgical intervention,” said Dr. Cervenka, director of the Adult Epilepsy Diet Center at Johns Hopkins University, Baltimore. Dr. Cervenka said that a review paper found that of 206 adolescents and adults who had seizures and received a ketogenic (or related) diet, 100 (49%) experienced at least a 50% reduction in seizures, and of those, 13 were seizure-free (Epilepsia. 2011 Nov;52[11]:1941-8). These numbers are not that different, she said, than the results for many antiepileptic drugs in some populations. Overall, “patients with symptomatic generalized epilepsies may have greater seizure reduction, as may patients with multiple seizure types,” Dr. Cervenka said. The antiepileptic benefit of a diet that induces ketogenesis, forcing the brain to utilize ketone bodies rather than glucose for energy, has been known since the 1920s, with benefit seen for adolescents and adults in studies completed in the 1930s. These diets mimic a starvation state, but provide enough calories through fat or protein to maintain weight. Calories in the traditional ketogenic diet, Dr. Cervenka said, are about 90% fat. Food for patients on this diet should be weighed on a gram scale, and those preparing meals should aim for a ratio Continue reading >>

Treating Childhood Epilepsy: The Origins Of The Ketogenic Diet

Treating Childhood Epilepsy: The Origins Of The Ketogenic Diet

Many people use the ketogenic diet today to manage symptoms of diabetes, lower triglycerides, and lose body weight. However, the high fat, adequate-protein, low-carbohydrate ketogenic diet was not first used for any of these purposes. Instead, doctors created it to help treat epilepsy in children. Below we give a brief overview of epilepsy, specifically pediatric epilepsy, and the origins of using keto to treat it. Then, we investigate the hard evidence from high-quality research showing its effectiveness. We hope that children and adolescents who utilize the ketogenic diet to treat epilepsy can use Ruled.me to live a healthy, fulfilling lifestyle. A Brief Primer on Epilepsy Epilepsy is a disorder of the nervous system in which someone experiences recurrent, unpredictable seizures. It is a result of abnormal activity in the human brain. Epileptic seizures can include physical symptoms such as muscle spasms, convulsions, and unconsciousness, as well as mental symptoms such as strange behavior, unusual emotions, and a warped perception of the outer world. Epilepsy is not a one-size fits all disorder. Some people experience severe, disabling seizures while others experience ones that are much less life threatening and more infrequent. Additionally, while epilepsy is a disorder of the brain and nervous system, its underlying causes can vary greatly. It can result from changes in channels between brain cells, unevenness between chemicals in the brain called neurotransmitters, a disruption of brain wiring, or any combination of these or other causes. Someone is formally diagnosed with epilepsy when she or he has had two or more seizures without a clear cause in a period over 24 hours. [1] If someone has a single seizure due to something such as a head injury, alcohol withdraw Continue reading >>

Epilepsy’s Big Fat Miracle

Epilepsy’s Big Fat Miracle

Once every three or four months my son, Sam, grabs a cookie or a piece of candy and, wide-eyed, holds it inches from his mouth, ready to devour it. He knows he’s not allowed to eat these things, but like any 9-year-old, he hopes that somehow, this once, my wife, Evelyn, or I will make an exception. We never make exceptions when it comes to Sam and food, though, which means that when temptation takes hold of Sam and he is denied, things can get pretty hairy. Confronted with a gingerbread house at a friend’s party last December, he went scorched earth, grabbing parts of the structure and smashing it to bits. Reason rarely works. Usually one of us has to pry the food out of his hands. Sometimes he ends up in tears. It’s not just cookies and candy that we forbid Sam to eat. Cake, ice cream, pizza, tortilla chips and soda aren’t allowed, either. Macaroni and cheese used to be his favorite food, but he told Evelyn the other day that he couldn’t remember what it tastes like anymore. At Halloween we let him collect candy, but he trades it in for a present. At birthday parties and play dates, he brings a lunchbox to eat from. There is no crusade against unhealthful food in our house. Some might argue that unhealthful food is all we let Sam eat. His breakfast eggs are mixed with heavy cream and served with bacon. A typical lunch is full-fat Greek yogurt mixed with coconut oil. Dinner is hot dogs, bacon, macadamia nuts and cheese. We figure that in an average week, Sam consumes a quart and a third of heavy cream, nearly a stick and a half of butter, 13 teaspoons of coconut oil, 20 slices of bacon and 9 eggs. Sam’s diet is just shy of 90 percent fat. That is twice the fat content of a McDonald’s Happy Meal and about 25 percent more than the most fat-laden phase of the 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 >>

Ketogenic Diet Linked To Seizure Reduction In Dogs With Epilepsy

Ketogenic Diet Linked To Seizure Reduction In Dogs With Epilepsy

A ketogenic diet rich in medium-chain triacylgylycerols achieved clinically meaningful levels of ketosis and helped prevent seizures in dogs with epilepsy, according to a randomized, double-blind, placebo-controlled, crossover trial. A ketogenic diet rich in medium-chain triacylgylycerols (TAG) achieved clinically meaningful levels of ketosis and helped prevent seizures in dogs with epilepsy, according to a randomized, double-blind, placebo-controlled, crossover trial published in the British Journal of Nutrition. Of 21 dogs in the trial, three became seizure-free, and another seven experienced at least a 50% drop in seizure frequency while on the diet, said Tsz Hong Law, BSc, MRes, of the Royal Veterinary College in Hatfield, United Kingdom. Epilepsy affects an estimated 0.6% to 0.75% of dogs, making it one of the most common canine neurological disorders. Seizures in about a third of affected dogs are refractory to currently available treatments, the investigators noted. “A myriad of anecdotal reports and some published literature have suggested the importance of dietary manipulation in seizure management,” they added. A ketogenic diet, which is characterized by a high ratio of fat compared with protein and carbohydrates, has been used in human epilepsy since the early 1920s, but this and other nonpharmacologic treatments for epilepsy are not used in routine veterinary practice, and seldom have been studied in dogs. Therefore, the researchers recruited 18 purebred and three mixed-breed adult dogs with a diagnosis of idiopathic epilepsy and a history of at least three seizures in the past 3 months. The dogs averaged 4.6 years of age and were as old as 12 years. All were receiving phenobarbital, and 18 dogs also were receiving potassium bromide for seizure control. 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 >>

Review Article How Does The Ketogenic Diet Induce Anti-seizure Effects?

Review Article How Does The Ketogenic Diet Induce Anti-seizure Effects?

Highlights • Clinical and experimental interest in the ketogenic diet has grown rapidly over the past decade. • Ketone bodies have been linked to inhibitory neurotransmitter release and activation of ATP-sensitive potassium channels. • The ketogenic diet enhances overall cellular bioenergetics and reduces oxidative stress. • Glycolytic diversion and/or restriction may play an important role in the clinical activity of the ketogenic diet. • Modulation of tricarboxylic acid cycle flux may also underlie ketogenic diet effects. Abstract The high-fat ketogenic diet (KD) is a remarkably effective treatment for medically intractable epilepsy and has been part of the clinical armamentarium for nearly a century. However, the mechanisms underlying the KD’s actions have remained elusive. Over the past decade, there has been phenomenal international growth of clinical centers offering metabolism-based therapies for epilepsy, and rapidly expanding research into the cellular and biochemical effects induced by the KD. At present, there are many hypotheses regarding KD action, and while each is uniquely compelling, it is becoming more apparent that the KD likely works through multiple mechanisms that target fundamental biochemical pathways linked to cellular substrates (e.g., ion channels) and mediators responsible for neuronal hyperexcitability. This is not altogether surprising given the complexity of the epileptic brain, and the many different pathophysiologic mechanisms that underlie seizure genesis and epileptogenicity. The scientific literature involving the KD strongly supports the notion that epilepsy may indeed in part represent a “metabolic disease”, and that this concept could serve as a novel framework for the development of more effective anti-seizure drugs Continue reading >>

New Study Validates Ketogenic Diet For Epilepsy Treatment In Adults

New Study Validates Ketogenic Diet For Epilepsy Treatment In Adults

Epilepsy can be caused by a variety of different conditions including head trauma, infection, brain tumor, and stroke, but by and large most cases of epilepsy have no readily identifiable cause. Epilepsy affects some 2.3 million adults in America and close to half a million children. Further, about one in 26 people will be diagnosed with epilepsy at some point in their lives. It’s been estimated that there are approximately 150,000 new cases of epilepsy diagnosed in the United States each year and overall about $15.5 billion in medical costs as well as lost earnings and production are attributed to this disease. The mainstay of treatment for epilepsy is pharmaceutical intervention. As I recently noted, more and more we are seeing surgical procedures being performed for those individuals who have not had a significant improvement with drugs. I indicated that at least some individuals are gluten sensitive and may benefit from a gluten-free diet which potentially could keep them from undergoing potentially life-threatening surgery as a treatment for their epilepsy. But it is also important to understand that there’s another extremely effective dietary intervention that has proven itself quite useful in the treatment of epilepsy. In 1920 a New York physician, Dr. Galen, reported at the American Medical Association convention that he had had significant success in treating epilepsy by initiating a program of fasting. At that time the only pharmaceutical interventions that were available included phenobarbital and bromides. Interestingly, the patient he treated was actually a young cousin who had aggressive seizures. On the second day of fasting the child’s epilepsy abated and did not return over the next two years of follow-up. Further studies appearing in 1923, 1926, Continue reading >>

Ketogenic Diet

Ketogenic Diet

The ketogenic diet is a diet with a strict ratio between fat and protein intake. Many forms of the ketogenic diet have been successfully used to treat children whose seizures are not responding to medication; however it is not usually used as a first-option treatment. About 4 out of 10 children on the ketogenic diet have half the number of seizures they had before being on the diet. Some children have an even greater reduction. The ketogenic diet may also have some positive side effects, including improvements in mood, behaviour, attention, and social functioning. Improved mental alertness and behaviour have been seen in some children, even if seizure control hasn’t been obtained. However, some families notice mood changes such as hyperactivity or irritability. Like most forms of medical treatment, the diet does have side effects, mostly gastrointestinal. Occasionally severe side effects are experienced, so close monitoring by a dietician and doctor is advised. 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 >>

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 >>

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