What
is the Ketogenic Diet?
The ketogenic diet, is a specific diet, very
high in fats and low in carbohydrates. It makes
the body burn fat for energy instead of glucose.
When carefully
monitored and controlled, the diet can
help two out of three children who are
tried on it and may prevent seizures completely
in one out of three. |
It is a very strict diet, and needs to be closely
monitored by a dietician. It takes a strong
commitment from the whole family. It is a serious
form of treatment that, like other therapies
for epilepsy, has side effects that have to
be watched for.
Its exact mechanisms are unknown, but more
research is being done to learn about the reasons
for the diet's positive effect. New
studies by a research team at Emory University
School of Medicine show that the diet alters
genes involved in glucose metabolism in the
brain, which in turn helps stabilise the function
of neurons exposed to the challenges of epileptic
seizures.
How
the diet affects the body
Our bodies usually run on energy which we get
from glucose in food. Our body can't store large
amounts of glucose, and we only have about a
days supply.
Sometimes the diet is commenced by a period
of fasting, so our body uses up any stored glucose.
What happens then is the body begins to run
on energy from our fat supplies. When our body
burns fat, it creates molecules called ketones.
Scientists have understood that these molecules
somehow cause a change in metabolism leading
to a strong anticonvulsant effect.
The ketogenic diet keeps this process going.
It forces the body to burn fat 24 hours a day
by making fat products the primary food that
the child is getting.
The diet provides most (80 percent) of its
energy from fat. The rest comes from carbohydrates
and protein. Each meal has about four times
as much fat as protein or carbohydrate
The food and liquid at each meal have to be
carefully calculated and weighed for each person.
It is a very precise method.
Following
the ketogenic diet requires a team approach—including
doctors, nurses, and especially dieticians
specifically trained in the management
of people on this diet. |
Who
is the diet for?
The ketogenic diet is predominantly used in
children with poorly controlled seizures. There
is no way to predict whether it will be successful
or not.
The main
indication for the ketogenic diet is the
presence of seizures that are difficult
to control. |
Starting the diet
The diet is started under close medical supervision
in the hospital. It is started gradually and
increased to the full amount over a 3 to 4 day
period. During this time blood sugar and ketone
levels are monitored. A fasting period is not
necessary to start the diet although it is used
at some hospitals. More specific information
can be found at the Children's
Epilepsy Programme
How
soon does it to work?
It is difficult to predict. The diet may become
effective immediately or can take several months.
Each child is unique and has different seizure
patterns and frequency. However, there is usually
some improvement within the first few weeks
on the ketogenic diet. Improvement in behaviour
will be also seen in some children.
Will
medications be stopped?
Medications will continue as normal unless
changed by the neurologist. There may be a review
of the medications if the diet is successful
in controlling the seizures.
Are
there any side-effects?
Any beliefs that the diet is “holistic”
or “all-natural” are incorrect.
The diet is not without side effects. Gastrointestinal
complaints are most common and include constipation
and worsening of reflux, diarrhea and abdominal
cramps. Weight loss or gain may also occur.
Speak to the doctor about various side effects
of this diet.
Vitamin
supplementation
The diet alone is inadequate in many vitamins
and minerals. Supplements will be prescribed
for your child while on the ketogenic diet.
Discontinuing
the diet
If the diet has led to seizure freedom for
2 years, side effects are intolerable, or the
family does not feel that the diet is worth
the effort, it may be recommended discontinuing
the
diet. Like discontinuing medications, the diet
must be gradually weaned with the supervision
of your doctor and dietician..
Further
information:
Childrens
Epilepsy Programme - Royal Children's Hospital
Melbourne
The
Charlie Foundation - Set up by Charlies
parents whose seizures were successfully controlled
by the diet
A Success
Story - A personal story of Matthews success
with the ketogenic diet
Hans Van der Wiel - has developed a CDROM of
tasy and pallatable recipes to use. It also
has a program to help assists with the equations
of measuring foods. Recommended by other parents.
Email
Hans for details...
References:
Ketogenic
Diet Prevents Seizures By Enhancing Brain Energy
Production, Increasing Neuron Stability
Saurabh R. Sinha, MD, PhD, and Eric H. Kossoff,
MD. The Ketogenic Diet. The Neurologist •
Volume 11, Number 3, May 2005
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