Ketogenic diet is one approach to epilepsy treatment in children. Indeed, this is a feasible approach, especially in those who have used anti-epileptic medication but their seizures have remained unresponsive.
Going down the memory lane, ketogenic diet was first developed in 1920, when it was found that starvation has a beneficial effect on seizure activity. Ketogenic diet produces effects similar to starvation and was also found useful for decreasing seizures. Later, after the development of anti-epilepsy medication, it was not much popular as a treatment for epilepsy until recently, when awareness about its benefit was increased in children with seizures not responding to the anti-epileptic medications.
Nutritional Content of Keto Diet
A classic keto diet includes a high fat diet with very low carbohydrates and controlled proteins. Most of the fat content is provided in the form of long-chain triglycerides. The ratio of fats to carbohydrates and protein combined is maintained at 1:4. Higher ratio is associated with better seizure control but restricts diet variety and causes poorer compliance. Food with high fat content like butter, cream, fishes, bacon, eggs and nuts are used in the diet.
Function of Keto in the Body
Basically, ketogenic diet is so called because it increases the production of ketones in the body. Normally, carbohydrates are the primary fuel for the body and the only source of energy for the brain. When a person is starved or deprived of carbohydrates, his/her body starts breaking down fats to maintain the energy requirement.
So, breaking down of fats leads to production of ketones in the body. Ketones can easily cross the blood brain barrier and can be consumed for energy production in the brain. Also, ketones are not harmful to the body and can be detected in blood, urine and breaths. Ketones are responsible for the beneficial effect of ketogenic diet. Experts say that higher ketone levels are associated with better seizure control.
Relevant Studies and their findings
Studies have been conducted to better understand the mechanism by which the ketogenic diet prevents seizures. It has been revealed that ketogenic diet is associated with an increased gene expression in certain parts of the brain. Furthermore, these studies showed that the genes were pertaining to enzymes of energy metabolism. Finally, the study on rats revealed that these areas were also resistant to the effect of hypoglycemia, so it is capable of withstanding metabolic challenges and have better neuronal stability and seizure control.
A new study has demonstrated a possible link between gut bacteria and the effect of ketogenic diet in rats. It was found that two specific species of bacteria were involved in the mechanism of keto-diet. In completely sterile rats with no bacteria in their gut, keto-diet did not have any anti-seizure effect. Adding these specific bacteria to the rats even in absence of keto diet lead to seizure protective effect. Further studies are required to prove this relationship in humans and could possibly prove beneficial for development of newer treatment approaches for the management of seizures.
Ketogenic Diets on Seizures in Children
From research findings, ketogenic diet decreases both severity and the number of episodes of seizure in children. Studies have also found a 50% decrease in number of seizure episodes in children compared to those on a normal diet. About 10% of these children had complete recovery and stopped using anti-epilepsy medication after the diet. Children are kept on this diet for 1-2 years and gradually withdrawn. The beneficial effect of ketogenic diet is found even after the diet is stopped.
Ketogenic diet is generally recommended only for children and infants. It is the best available treatment for metabolic conditions like glucose transporter protein deficiency and pyruvate dehydrogenase deficiency. Moreover, ketogenic diet is effective in infantile spasms, myoclonic seizures and other seizures of childhood.
Since it carefully regulates the intake of calories, there is a risk of children developing deficiencies of important nutrient, especially in their growing periods. Hence it is mandatory that this diet be prescribed by a physician and carefully monitored and calculated by a dietitian. It is a strict diet with carefully measured intake of proteins and carbohydrates. Besides, it is difficult but very essential that once started on this diet, the child remains adherent to the diet. Sudden withdrawal of the ketogenic diet may lead to worsening of seizures.
Keto-diet has improved attention, understanding and improved brain activity but has side effect related to nutritional deficiencies. Lower carbohydrates and proteins in the diet can cause lack of weight gain and poor growth in children. They may develop constipation or kidney stones. Regular follow up with health-care providers and monitoring can help prevent such adverse effects.
If you are a parent whose children are having a hard time going through seizures, this educative piece reassures you that ketogenic diets could just be the remedy. Has your child been diagnosed with seizure that is not controlled with anti-epileptic medication? In this case, ketogenic diet is one of the many different treatment methods available to you.