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How Does Ketosis Help Epilepsy

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 >>

Epilepsy

Epilepsy

Tweet Epilepsy is a neurological condition which only has one visible symptom - repeated seizures, the severity of which can vary from person to person. While epilepsy is most commonly diagnosed during childhood, it can develop at any age, even in people who are over 65 years old. It is possible for people to have type 1 diabetes or type 2 diabetes alongside epilepsy, but the relationship between diabetes and epilepsy is unclear - there is currently a lack of research investigating a link between the two conditions. How do seizures happen? Seizures happen when there is too much electrical activity in groups of neurons in the brain. There are two main types of seizures: generalised and focal. Generalised seizures occur when large areas on both sides of the brain are affected by disruptions to its normal activity. Consciousness can often be lost during generalised seizures. In focal seizures a specific region of the brain is affected, and while consciousness may be altered, it is not always lost. Focal seizures can often present as if a person is daydreaming. Most times people recover quickly from seizures, which normally end within a few minutes. But frequent seizures can severely limit a person’s quality of life – for example, people can be prevented from driving and some might require regular supervision. Diabetes and seizures Seizures that happen as a direct result of diabetes, notably if very low sugar levels occur, are known as non-epileptic seizures. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being Continue reading >>

Three Anti-seizure Diets That Could Change Your Life… | October 4, 2009

Three Anti-seizure Diets That Could Change Your Life… | October 4, 2009

Just when you feel that all is lost, and you’re about to give up on your meds, there is another option. (In fact, there are three!) They may not beat your epilepsy (although some people say they do!) but they can help reduce your seizures and the amounts of medication needed. The Ketogenic Diet — one of the oldest treatments for epilepsy. There are many children for whom epilepsy medications like Lamictal, Depakote, and Zarotin are ineffective in controlling or even reducing seizures. These drugs, especially in combination, can also cause unpredictable and serious side-effects. That’s why many parents have turned to alternative therapies for seizure management. Because ketones seem to have an anti-convulsive effect, one of the most promising and least invasive alternative treatments for seizures has been the Ketogenic Diet. The diet is a high fat, adequate protein, low carbohydrate diet which works by fasting which in turn, creates ketones, which are by-products of the fat-burning metabolism that happens while fasting. And during this time, the body goes into a state known as ketosis— which has an anti-convulsant effect. Seizures often lessen or disappear during these periods of fasting. With careful and proper monitoring, the Ketogenic Diet has been found to reduce seizures in two-thirds, and eliminate seizures in one-third, of all children for whom anti-epileptic drugs are ineffective. And if it is successful, it’s usually continued for two years. During this time, children are often gradually able to lessen or discontinue the amount of medication they take for seizures. And interestingly, many children seem happier and more alert on the diet, even before medication is significantly lessened. The Atkins Diet — may reduce seizures in children with epilepsy. Continue reading >>

Ketogenic Diet

Ketogenic Diet

This article is about a dietary therapy for epilepsy. For information on ketogenic diets as a lifestyle choice or for weight loss, see Low-carbohydrate diet and No-carbohydrate diet. The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain-function. However, if there is very little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Almost half of children, and young people, with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones, and is no longer considered beneficial.[2][3] The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was develope Continue reading >>

The Ketogenic Diet

The Ketogenic Diet

The Ketogenic Diet is one of the oldest treatments for epilepsy. It is intended to maintain the starvation or fasting metabolism over a long period of time. When the body is in a fasting state, it creates ketones, a by-product of fat-burning metabolism. It has long been recognized that seizures often lessen or disappear during periods of fasting in some individuals with epilepsy. The diet is very high in fat and low in carbohydrates. When fat is the primary source of calories, ketones are formed. The diet must be followed very strictly and requires a significant commitment to work effectively. Children on the diet often will not gain weight or grow much during the time the diet is in use. After that, however, growth is expected and should be carefully monitored. The diet has been used mostly in children with difficult-to-control, generalized epilepsies such as those with the Lennox-Gastaut syndrome. Lennox-Gastaut is a generalized epilepsy which is characterized by drop attacks or tonic-clonic attacks (with violent, rhythmic convulsions) and often occurs in children with other neurological conditions such as paralysis and mental retardation. It’s often very resistant to treatment. In this group of individuals, the diet can be as successful as medications. Thus, it is most often recommended for children ages 2 through 10 or 12 years old who have been diagnosed with a generalized type of epilepsy, and who have failed to respond to a variety of drugs. Recent studies have shown that the diet may also be effective in those with partial seizures. The diet is typically started with a period of fasting lasting until the body produces a moderate to large amount of ketones. This initiation period usually takes place in the hospital, so that the individual can be monitored for p 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

Dr. Thio is an Assistant Professor of Neurology at Washington University School of Medicine and an epileptologist in the Pediatric Epilepsy Center at St. Louis Children’s Hospital. Introduction The ketogenic diet is only one of several methods available for treating epilepsy. Other treatment options include antiepileptic drugs, epilepsy surgery, and the vagal nerve stimulator. If your child’s epilepsy is treated, most neurologists will try using an antiepileptic drug first. Generally, the ketogenic diet will not be the first choice, though exceptions exist. The ketogenic diet is a high fat, low carbohydrate, and low protein diet designed to increase the body’s dependence on fat rather than glucose for energy. It mimics the fasting state, and can treat disorders of the brain. The two disorders most commonly treated with the ketogenic diet are epilepsy and certain inborn errors of metabolism involving glucose utilization. This paper will briefly review the history, physiology, efficacy, mechanism of action, indications, contraindications, deficiencies, adverse effects, and some of the practical aspects of initiating and maintaining the ketogenic diet as related to epilepsy. History The ketogenic diet has its origin in the observation that fasting reduces seizures. This observation is old since Hippocrates used fasting to treat seizures, and the Bible mentions fasting as a treatment for seizures. In 1921, Wilder proposed a high fat, low carbohydrate diet as a means of mimicking fasting, which is not practical for extended periods. After phenobarbital and phenytoin became available, interest in the diet declined. However, interest has increased recently because 20-30% of epileptic children have seizures that are resistant to antiepileptic drugs. The introduction of se Continue reading >>

The Ketogenic And Related Diets

The Ketogenic And Related Diets

The ketogenic diet The ketogenic diet (also called ketogenic therapy) is a specialist medical diet. It’s a treatment option for children with epilepsy whose seizures can’t be reduced or stopped with epilepsy medicine. It’s recommended in the National Institute for Health and Care Excellence (NICE) guideline for the management of epilepsy which is difficult to control. The ketogenic diet is much higher in fats and lower in carbohydrates than a typical diet. If you think your child might benefit from the ketogenic diet, you will need to discuss this with an epilepsy specialist. This isn’t a treatment option for adults on the NHS yet. This is because there is currently no reliable evidence to support its use. This can make transition to adult services difficult for teenagers on the ketogenic diet. How does the ketogenic diet work? We don’t completely understand how the ketogenic diet works but there is some evidence that the brain needs energy from glucose (a sugar) to create a seizure. The ketogenic diet makes the body think that it’s in a state of starvation or fast. In this situation, our bodies use fat instead of carbohydrates (complex sugars or starches) as the main energy source. So the ketogenic diet gives a much higher amount of fat than is found in a normal diet, enough protein for growth and a very small amount of carbohydrate. This makes the body’s ketones. The brain uses these for energy instead of glucose. It also reduces the amount of glucose available for the brain. Why do you need medical supervision to go on this diet? The ketogenic diet is not a ‘natural’ treatment for epilepsy as it’s not a natural diet. It should only be managed by a team of a paediatrician and a paediatric dietician who are experts in the diet. This is because the b Continue reading >>

Types Of Ketogenic Diet For Epilepsy

Types Of Ketogenic Diet For Epilepsy

In a previous blog post, we looked at how the ketogenic diet could be used as a treatment option for both children and adults with refractory epilepsy. When we look at the practical use of the ketogenic diet, there are more than one option that can be followed. All the forms of ketogenic diets for epilepsy have different pros and cons and practical implications to consider. 1. The Classical Ketogenic Diet The Classical Ketogenic Diet was the original form of diet developed to mimic the ketosis which was observed with fasting. It is the strictest form of the ketogenic diet available with a macronutrient ratio of 4:1 or 3:1 being employed. What Is the 4:1 and 3:1 Ketogenic Diet? The ratio is based on fat: carbohydrate + protein. What this means in practical terms is that for every 5 grams of food you eat, 4 grams comes from fat and 1 gram comes from protein and carbohydrates combined. This means that people are eating around 90% of their calories from fat and 10% from protein and carbohydrates combined on a 4:1 approach. On a 3:1 approach it is around 87% from fat and 13% from protein and carbohydrates added together. The exact make up of this type of ketogenic diet is calculated out for each individual person to make sure all the nutritional needs are met, including energy intake (calorie level). Why is it Difficult to Follow the Classical Ketogenic Diet? Foods need to be weighed and measured out to ensure 100% accuracy of the diet. The exact ratios of the diet can be adjusted depending on the severity of seizure control needed and tolerability. It is normally started in an in-patient setting meaning that the individual is required to stay in hospital for a set period. Due to the severe restrictive nature of this form of ketogenic diet and the adverse side effects that h 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 >>

Epilepsy Ontario

Epilepsy Ontario

“One of the most exciting recent developments in the treatment of epilepsy has been the ‘rediscovery’ of the ketogenic diet. This diet is helping children whose seizures have resisted even the best of the modern anticonvulsant drugs.” – Dr. McIntyre Burnham, former president of Epilepsy Ontario. The ketogenic diet a rigid, strictly calculated, therapeutic diet very high in fats and very low in protein and carbohydrates. It requires a strong commitment as children will have to cope with a high intake of fatty foods and a lack of sweet and tasty foods. Children may be better able to accept the diet if they know they are “special kids with a magic diet.” It has been recognized for centuries that fasting helps to stop seizures in some people. During fasting, the body breaks down fat to create a residue of ketone bodies in a process called ketosis. This creates a metabolic state that helps to prevent seizures, although the exact mechanism by which this diet works is still unknown. Standard Ketogenic Diet – The SKD restricts carbohydrates, forcing the person to go into ketosis and stay there for long periods. This method is also used for fat-loss goals. People on the SKD sometimes go back on carbs for a couple days or a week at a time. Targeted Ketogenic Diet (TKD) – The TKD is similar to an SKD. The only difference is the person consumes 25 to 50 grams of carbohydrates about 30 to 60 minutes before weightlifting workouts to supply energy for the muscles. (Note: These carbs will be burned during the workout, and are not counted towards the daily limit of 30 grams of carbs.). Cyclic Ketogenic Diet – A person on the CKD will go into ketosis during the week and do “carb-ups” on the weekends. An alternative to the “classic” ketogenic diet is the Medium Continue reading >>

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 There Any Risks? The keto 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 >>

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 >>

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