Ketogenic Diets For Epilepsy
What is the ketogenic diet?
The Ketogenic Diet (KD) is a high-fat, low-carbohydrate, and adequate protein diet that has been shown to be helpful in improving some neurological conditions including epilepsy. The body’s metabolism changes from burning carbohydrates to burning fat for energy, putting the body in a state of ‘ketosis’. Though the KD has been around for a long time, the exact mechanism is still unknown as to how it helps control seizures.
The Classic KD is very strict requiring foods to be measured on a gram scale and meals/snacks must be finished in their entirety. There are other diet options available including the Modified Atkins Diet (MAD) and Low Glycemic Index Treatment (LGIT) that are less strict and may be more feasible with some people’s lifestyles.
Who is the ketogenic diet used for?
The KD has been studied and is used most frequently to treat intractable epilepsy or seizures that are difficult to control with medications.
What products are available?
The KD is used by people that eat foods by mouth and people that receive nutrition through tube feeds.
There are many formulas available for use on the KD. Formulas such as KetoCal and KetoVie can be consumed orally for extra calories or fat and are also used as a sole source of nutrition through tube feeds. These formulas are available in a variety of different flavors and ratios. Your ketogenic dietitian can help you decide which formula is appropriate for you.
In addition to liquid formulas, there are also high-fat baking mixes such as KetoCuisine available to bake foods such as rolls and desserts.
How is the ketogenic diet started?
For safety and in order for the diet to be most effective, the KD and other forms of diet treatment require close medical supervision. Historically, the Classic KD has been initiated primarily through an inpatient hospital stay of approximately 3-4 days.
It is becoming more common, especially during the COVID-19 pandemic, for diets to be initiated on an outpatient basis with the use of telemedicine. When a KD is started at home, it will likely be started gradually and take a little longer to reach the full diet ratio (or strength of the diet) in order to ensure safety and tolerability. The MAD and LGIT are both commonly started on an outpatient basis.
Is the ketogenic diet right for me or my child?
Talk to your doctor if you are thinking about starting a KD. There are labs that must be obtained to ensure safety. Sentido Health has ketogenic dietitians that are available to work alongside your doctors if a Ketogenic Diet Team is not available at your hospital or clinic.
References:
Kossoff E., Zupec-Kania B., et al. Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. 2018; 3:175-192.
Kossoff E.H., Turner Z., Adams J., Bessone S.K, Avallone J, et al. Ketogenic diet therapy provision in the COVID-19 pandemic: Dual Center experience and recommendations. Epilepsy Behav. 2020;111:107181.
Keywords:
Ketogenic Diet, Modified Atkins Diet (MAD), Low Glycemic Index Treatment (LGIT), MCT diet, Ketosis, telemedicine, high-fat diet, low-carbohydrate diet, epilepsy, seizures, enteral nutrition, tube feeds, KetoCal, Liquigen, KetoVie, KetoCuisine, Beta Quick & MCT Procal