Ketogenic diet plan for epilepsy is a very effective diet for controlling epileptic seizures. It is one of the oldest dietary therapies for epilepsy that has been adapted for children beginning as young as a year old. The ketogenic diet works by stimulating the body to produce ketones, which are derived from fats. Studies have shown that the ketogenic diet decreases the number of seizures a person dramatically. A ketogenic diet plan for epilepsy is not the same as a diet plan to lose weight. To start it, you need a prescription.
Ketogenic Diet Plan For Epilepsy
Is it effective at reducing seizures?
A unique diet known as the ketogenic diet for epilepsy (KDE) has helped many children and some adults gain greater (or even complete) control over their seizure activity. For a few particular epilepsy syndromes, such as epilepsy brought on by GLUT-1 mutations or pyruvate dehydrogenase deficiencies, it serves as the first line of treatment.1
Background
Hugh Conklin, a medical professional from Michigan, invented the ketogenic diet for treating epilepsy in the 1920s. The diet was used less and less frequently, nevertheless, as new treatments emerged.2
It has regained popularity and evolved into a common back-up strategy for kids whose epilepsy symptoms are challenging to manage with medication.1 It’s a significant addition to the therapy options for epilepsy given that there are more than 470,000 children living with seizure disorders in the United States, according to statistics from the Centers for Disease Control and Prevention.
Additionally, researchers are starting to consider how it can benefit adults with epilepsy and those suffering from a number of neurologic illnesses.
The Ketogenic Diet and Epilepsy
What It Entails
The ketogenic diet is a very high-fat diet with very little carbohydrate and just enough protein for body maintenance and growth.
The body enters what is known as a “ketogenic state” when fats are broken down for energy, during which it produces molecules referred to as ketones. The KDE seeks to maximize the brain’s usage of ketones rather than glucose (sugar) as an energy source.
Since ketones are (mostly) soluble in water, they are quickly delivered to the brain. Although the brain cannot use fatty acids as an energy source, it can use ketones for the majority of its energy needs.1
Although there may be a tendency away from both of these prerequisites, the KDE is typically started in a hospital setting and frequently starts with a one- to two-day fast.3
After determining the appropriate protein intake (based on factors such as age, etc.), the diet is designed as a ratio of fat to protein and carbohydrate grams. Usually, a 4 to 1 ratio is used as a starting point, and it can be adjusted from there. Often, the diet has calorie and hydration restrictions.4 Additionally, for at least the first month, no packaged low-carb items (shakes, bars, etc.) are permitted.
This equation indicates that at least 75% of the calories in the diet originate from fat because a gram of fat has more than double the calories of a gram of protein or carbohydrate. It takes time to learn how to put together meals that adhere to the very rigorous rules of this diet. Weighing and recording all food is required.
Though some kids are kept on the diet for longer, weaning off the diet is frequently attempted after two years.
Why It Works
Researchers are beginning to understand why the ketogenic diet works to lower seizure frequency. According to a 2017 review of studies, it appears that several mechanisms may be at work, including the following.
- The diet seems to change the brain’s metabolism of ketone molecules in a way that improves the production of the calming neurotransmitter GABA.1
- Significant anti-inflammatory and anti-oxidative effects of the diet appear to change the expression of some genes linked to epilepsy.
- Dietary fats with anticonvulsant properties have even been demonstrated to enhance the effects of valproic acid, a major anti-seizure drug.
- Dietary polyunsaturated fatty acids may prevent overexcitation of brain cells.
- The food component decanoic acid also appears to have a direct inhibitory effect on the brain’s AMPA receptors. Some epileptic drugs aim to block these receptors because they are thought to be involved in seizures.
- Effects on a crucial cellular energy sensor seem to aid in preventing excessive brain cell firing.
- The diet may have a positive effect on circadian activities and the expression of a growth factor in the brain.
Effectiveness
According to studies, one third of children with epilepsy who follow the ketogenic diet will see a reduction in seizures of at least 90%, and a second third will see a reduction of between 50% and 90%.46
Given that these patients typically have seizures that are poorly managed by medication, this is extraordinary.
In Adults
Studies on the KDE and modified Atkins Diet in adults with seizure disorders are increasing, and the outcomes are consistent with those of research on kids.
According to a 2014 study, 45% of adult and adolescent participants experienced a 50% reduction in seizure frequency or more. Those with symptomatic generalized epilepsy seemed to tolerate it better.
It’s interesting that, despite the fact that adults undoubtedly have greater control over their diet, it was harder to keep them on it. More studies are required because there is still a lack of research in this area.
In Pregnancy
A 2017 report on use of these diets during pregnancy suggests they may be an effective way to control seizures and could possibly allow pregnant women to use lower doses of epilepsy medication. However, the safety of this still needs to be examined.8
Work With Your Medical Team
Anyone adopting this diet to treat a seizure problem must do so under the guidance of a qualified healthcare professional and dietician. The precise diet recommendations for each person might vary widely, and it can be challenging to coordinate this eating plan with medications. You shouldn’t try it on your own at any time.
A Typical Day’s Menu
Below is a shortened description of a menu appearing in the 2015 Pediatric Annals article, “The Ketogenic Diet: A Practical Guide for Pediatricians.” It’s meant to give the idea of what children eat on the diet, not serve as an exact prescription. Remember, all of these foods are carefully weighed and measured.
- Breakfast: Eggs made with heavy cream, cheese, and butter; small serving of strawberries, pineapple, or cantaloupe
- Lunch: Hamburger patty topped with cheese; cooked broccoli, green beans, or carrots with melted butter; whipped heavy cream
- Dinner: Grilled chicken breast with cheese and mayonnaise; cooked vegetables with butter; whipped heavy cream
- Snacks: Whipped heavy cream, small servings of fruit, sugar-free gelatin
Variations substitute coconut oil or MCT oil for some of the heavy cream and butter.
Eating While at School
With a school-aged child, keeping them on the diet during the school day is difficult but essential. Thinking and planning ahead can help you be successful. You may want to try some of the following strategies:
- Talk to your child: Make sure your child understands the diet and why sticking to it is essential. Let them know they shouldn’t trade food with other kids. As hard as it is, they also shouldn’t eat food from vending machines or treats handed out in class.
- Talk to the school: The teacher, guidance counselor, nurse, and administration all need to be aware of your child’s special dietary needs (as well as other health-related matters). You’ll want to have regular conversations with them, and you may want to have a 504 plan or individualized education plan (IEP) in place as well.
- Become a planner: Gather several recipes for appropriate meals that can make convenient, easy-to-pack lunches. If possible, you may want to provide appropriate treats for your child for holiday parties and other special events that you may know about ahead of time. The Charlie Foundation and Clara’s Menu are good resources for child-friendly keto recipes.
- Educate family members: It’s important that family members and any regular caregivers know how to prepare a meal for the child with epilepsy.
- Establish routines: The timing of meals and snacks needs to be consistent in order for your child’s glucose levels to remain as stable as possible. You may need to work with your child’s teacher(s) on this.
- Involve a friend: Having a friend at school who understands the importance of your child’s diet may help them feel less awkward about being “different” and give them someone to lean on for support when needed. Make sure your child is OK with this and give them input on which friend to choose.
Additionally, you should inform the parents of your child’s friends’ children about the special diet and the possibility that what some may perceive as “a little harmless cheating” may not actually be harmless at all. It’s a good idea to give your kid some food to bring to get-togethers and playdates.
Ketogenic Diet for Epilepsy?
Could a diet high in butter, cream, oils, and mayo be the answer to your child’s epilepsy? The ketogenic diet is genuine, despite how strange and possibly unappetizing it sounds. And it works on a lot of kids.
But not everyone should follow the extremely high-fat, extremely low-carb ketogenic diet. It’s rigid and challenging. Additionally, it isn’t truly “healthy” in the traditional sense. If you’re thinking about it, you should examine how it will affect your child’s life as well as the effects on the entire family.
Who Should Think About Trying the Ketogenic Diet?
When they first learn about the ketogenic diet, some parents of kids with epilepsy are dubious. Is there a diet that can stop seizures and manage epilepsy without the need of medication? It almost has a shady vibe to it.
The ketogenic diet, however, is an actual and legal diet. The problem is that it’s demanding and challenging to adhere to. In fact, it is so challenging to adhere to that the majority of medical professionals only advise it for patients who have failed to manage their seizures with medication.
Since it was created in the 1920s, the ketogenic diet has reduced seizures. The number of them that follow it drops significantly for about half of the children. As many as 1 in 7 people fully stop having seizures.
The Lennox-Gastaut syndrome, myoclonic astatic epilepsy (Doose syndrome), and other kinds of epilepsy respond particularly well to the diet. While most adult epilepsies do not benefit from the ketogenic diet, some pediatric epileptic disorders do.
Doctors typically only advise the ketogenic diet if a child has already tried two or three drugs and they haven’t worked because it is so demanding.
Kids can frequently reduce or stop taking their medications when the diet is successful. Furthermore, even after returning to a regular diet, most children who follow the ketogenic diet for at least two years have a strong probability of becoming seizure free.
What Foods Can Your Child Eat?
The diet of your youngster will be high in fat. To put it into perspective, between 25% and 40% of the calories in a balanced diet for children are made up of fat. About 80% to 90% of the calories consumed when on the ketogenic diet are made up of fat.
As a result, your child’s meals are high in fat and low in protein and especially carbohydrates. Kids on a typical ketogenic diet consume three to four times as much fat every meal as they do protein and carbohydrates combined.
What does that actually mean? The majority of high-carb items, including pasta, bread, desserts, and more, are off-limits. This is typically where your doctor will start, although there are other alternatives. If it succeeds, you can typically scale down to a more modified Atkins diet and gradually add carbohydrates. This typically entails keeping track of the carbohydrate to fat ratio and tracking calories.
In order for nurses and doctors to monitor the first few days, your kid may begin the diet while still in the hospital. They will most likely need to fast for 36 to 48 hours before starting the diet. The following few days see an increase in food intake.
Your child will likely need to take sugar-free vitamin supplements because this diet does not give the body all the vitamins it requires.
How Does It Work?
We still don’t know, even though it has been around for over 100 years. Many specialists thought it had anything to do with the ketosis process. The name of the diet is derived from this. When your body runs out of carbs to burn for energy, it switches to burning fat, which is when ketosis occurs.
The same mechanism that occurs when someone fasts—whether on purpose or out of starvation—enters ketosis. For millennia, people have used fasting as a seizure cure.
In a significant study, researchers at Johns Hopkins University looked at 150 epileptic kids. After a year on the ketogenic diet, 50% of kids experienced a reduction in seizures. 90% of the children had a reduction in their seizure frequency. Many of these children no longer need any medicine after a few years on the diet.
However, many specialists are unsure as to whether ketosis has any role in the effectiveness of the diet. It might be connected to a different effect that we are unaware of.
What to Expect
The ketogenic diet is not something you try out casually. It’s a big commitment, and starting it on your own is risky. You and your child need to work closely with a team of experts.
- Be ready to stay in the hospital for a few days.When children begin the diet, doctors frequently want to monitor them to make sure everything is going well.
- Be in close contact with a dietician.Each child’s ketogenic diet is unique. Therefore, a dietician will provide you with precise information on what and how much your child can eat. Your child will likely require calcium, vitamin D, iron, folic acid, and other supplements because the ketogenic diet is deficient in key nutrients.
- Be cautious of carbs everywhere.Tiny amounts of carbohydrates are found in unanticipated areas, such as toothpaste.
- Visit the doctor frequently.At initially, your child will require routine checkups every one to three months. The doctor will keep track of their weight gain and growth, perform blood and urine tests, monitor their cholesterol levels, and determine whether to adjust their diet or medication dosage.
- Maintain your diet for at least a few months.By then, if it works, you should start having fewer seizures. Your youngster will gradually return to a typical eating schedule if the diet is ineffective. They risk having seizures if they abruptly cease the ketogenic diet.
What Are the Side Effects?
Right after your child starts the diet, they may feel tired. Other side effects include:
- Constipation
- Kidney stones
- Slow growth and low weight
- Weak bones (which may be more likely to break)
- High cholesterol
Tell their doctor if your child experiences any adverse effects. You might be able to treat them by making dietary adjustments or giving them medicine.
Ask the doctor about other epilepsy diets like the modified Atkins diet and the low glycemic index treatment diet if the negative effects are too great for your child. They might be a bit simpler to manage.
The Drawbacks of the Ketogenic Diet
There can be problems following the ketogenic diet:
- Weighing food precisely is important.
- Even little lapses — like sneaking the crumbs of a cookie or swallowing a nasal decongestant — can result in a seizure.
As you can expect, most parents find it difficult to maintain their kids on this diet. At school or at a friend’s house, youngsters can accept meals from other kids. Older kids could have strong preferences for certain foods. Young children with weak dietary preferences respond best to the ketogenic diet.
Children on the ketogenic diet frequently experience extreme hunger, at least initially. All the food in the house, including that in the dog’s dish, needs to be kept under close observation.
You might be worried about the consequences of consuming too much butter and cream. After all, shouldn’t fat be harmful for you? According to a study, kids on the ketogenic diet do have significantly higher cholesterol levels than the majority of kids. However, the effects of a high-fat diet usually take years to manifest. Usually, children only adhere to the ketogenic diet for a short period of time.
Starting the Ketogenic Diet
This protein-heavy diet may seem familiar to you if it is rich in fat and low in carbohydrates. In reality, a few well-known protein diets make the same claim about starting the ketosis process. However, you cannot follow the ketogenic diet on your own because it differs from a regular protein-based diet.
A nutritionist can assist you in translating the restrictive requirements of the diet into actual menu items so you can create dishes your child might like.
Don’t assume your youngster will object to the rigorous guidelines if you’re thinking about trying the ketogenic diet. Include your neurologist in the conversation as you discuss it. Your youngster may cooperate gladly because they both likely want the seizures to end.
Is the Ketogenic Diet Right for Your Child?
You must determine whether your household is prepared for the ketogenic diet. The food you keep in your house and the meals you eat will need to change. If you have additional children in the home, that can be challenging.
All of your child’s caregivers, from nannies to teachers, must be aware of the diet and support it. A seizure could be brought on by even a small amount of food plan cheating.
Consult the doctor of your child if you feel up to it. Although eating “keto” is never simple, it can be very successful for many children.
FAQS
Certainly! Here are some frequently asked questions about the ketogenic diet, commonly referred to as the “keto” diet:
Q: What is a ketogenic diet? A: A ketogenic diet is a low-carb, high-fat diet that aims to shift the body into a state of ketosis, where it primarily burns fat for fuel instead of carbohydrates. The typical macronutrient ratio for a ketogenic diet is high fat (70-75% of calories), moderate protein (20-25% of calories), and very low carbohydrates (5-10% of calories).
Q: What foods are typically allowed on a ketogenic diet? A: Foods that are typically allowed on a ketogenic diet include healthy fats (such as avocados, coconut oil, nuts, seeds, and olive oil), meat and poultry (such as beef, chicken, lamb, and pork), fish and seafood, eggs, non-starchy vegetables (such as leafy greens, broccoli, cauliflower, and zucchini), dairy products (such as cheese and butter), and some low-carb fruits (such as berries).
Q: What foods are typically restricted on a ketogenic diet? A: Foods that are typically restricted on a ketogenic diet include high-carb foods like grains (such as bread, rice, pasta, and cereals), sugar and sugary foods (such as candy, soda, and desserts), starchy vegetables (such as potatoes and corn), most fruits (such as bananas, grapes, and oranges), and legumes (such as beans and lentils).
Q: What are the potential benefits of a ketogenic diet? A: Some potential benefits of a ketogenic diet may include weight loss, improved blood sugar control, reduced cravings for sugary foods, increased satiety (feeling full), improved mental clarity, and potential benefits for certain medical conditions such as epilepsy, metabolic syndrome, and some neurological disorders. However, more research is needed to fully understand the long-term effects of a ketogenic diet.
Q: Are there any potential risks or side effects of a ketogenic diet? A: Like any diet, there are potential risks and side effects of a ketogenic diet. Some common ones include the “keto flu” which may cause symptoms such as headache, nausea, fatigue, irritability, and constipation during the initial phase of transitioning into ketosis. Other risks may include nutrient deficiencies if the diet is not well-balanced, potential for increased intake of saturated fats, and the potential for negative impacts on cholesterol levels. It’s important to ensure that you’re getting all the necessary nutrients and staying hydrated when following a ketogenic diet.
Q: Can I still exercise on a ketogenic diet? A: Yes, you can still exercise on a ketogenic diet. However, it’s important to keep in mind that your body may take some time to adapt to using fat as a fuel source instead of carbohydrates, which could affect your performance initially. Some people find that they may need to adjust their exercise routine, increase their intake of protein, or include targeted carbohydrates before or after workouts to support their energy levels and performance during exercise.
Q: Is a ketogenic diet suitable for everyone? A: A ketogenic diet may not be suitable for everyone, and it’s important to consider individual factors such as medical conditions, nutrient needs, and personal preferences before starting any new diet. For example, pregnant or breastfeeding individuals, people with certain medical conditions (such as liver or pancreatic diseases), and athletes with high energy requirements may have different dietary needs that may not align with a ketogenic diet. It’s always best to consult with a healthcare professional or a registered dietitian to determine if a ketogenic diet is appropriate for you.