While researchers continue to investigate promising treatments for managing and curing epilepsy, there are many effective protocols for reducing symptoms. Typical treatments range from anti-seizure medications to brain surgery.
However, more than a third of people with epilepsy do not respond to current treatments. There is also a sizable group of individuals who cannot undergo more invasive procedures.
For this reason, many epilepsy treatment protocols also include holistic treatments, including biofeedback, supplements, and dietary changes, such as following the ketogenic diet. Many studies have shown the benefits of a ketogenic diet for epilepsy management.
What Is the Ketogenic Diet?
Commonly known as the keto diet, the ketogenic diet is a high-fat, low-sugar diet that induces the ketogenic state. This is in contrast to the common Standard American Diet, which has a high proportion of carbohydrates.
When carbohydrates enter the body, it is transformed into glucose, an energy source. When glucose enters the bloodstream, it raises blood sugar levels and triggers insulin production. Any glucose that the body doesn’t immediately consume gets stored as visceral fat.
Following a keto diet reduces carbohydrate intake, thus lowering the introduction of additional glucose. The body starts to remove glucose from fat stores as energy.
When the stored glucose runs out, the body starts to break down ketones, a byproduct of excess fat, for energy. This state is known as ketosis. Most people following a keto diet will enter ketosis after two to five days of restricting their carbohydrate intake.
How Does Ketosis Treat Epilepsy?
What some people may not know is that the keto diet was developed to treat epilepsy in children. Ketosis can help manage symptoms in children who do not respond to anticonvulsant drugs.
While the underlying process is not well understood, some evidence shows that the keto diet affects brain activity.
In the excitable brain model of epilepsy, seizures occur due to the overabundance of the excitatory neurotransmitter glutamate or an inadequate or ineffective level of the inhibitory neurotransmitter GABA.
When the body is in ketosis, GABA production goes up while glutamate levels decline. This lowers the likelihood of seizing. More recent research has noted that ketosis may also change the gut biome, which is inhabited by billions of bacteria species. These changes also reduce neural excitability.
Long-term ketosis is associated with positive outcomes for epilepsy patients. More than half see their seizure frequency decline, while 1 in 5 experience no seizures at all.
Some research suggests the results are enduring in children who follow the diet for at least two years. These patients remained seizure-free even after resuming a standard diet.
Keto Diet Guidelines for Epilepsy Treatment
All keto diets have the same basic principles: Only 5 percent to 10 percent of food intake should contain carbohydrates, while the remaining percentage depends on the type of diet.
In the classic keto diet, adherents consume a 3:1 ratio of fats to protein and carbohydrates. The classic keto diet is one of the strictest forms and requires medical supervision. Most children prescribed the keto diet for epilepsy management follow the 3:1 ratio.
The modified Atkins diet is more flexible and appropriate for adolescents and adults. This diet doesn’t restrict protein or caloric intake. Adherents also have more autonomy over the kinds of food they eat.
Benefits and Risks of the Keto Diet
The keto diet is safe for most people and offers numerous health benefits. Excess glucose is linked with many chronic conditions, including insulin resistance, diabetes, and hypertension.
Studies have also found that ketosis improves cognitive processes. This is because the brain consumes ketones more efficiently than glucose. Keto diets can also lower the likelihood of some diseases and reduce systemic inflammation.
Despite all the benefits of the keto diet, there are some risks. Just as a carbohydrate-rich diet can cause health problems, consuming too much fat can negatively affect the body. In the keto diet, most of the fat comes from animal fats, such as dairy and bacon. A high-fat diet is linked to higher rates of cardiovascular disease.
Due to their restrictive nature, keto diets also increase the likelihood of vitamin deficiencies. Some deficiencies can lead to chronic problems, like bone loss, fatigue, and memory problems.
The keto diet also has several known side effects. Reducing carbohydrate consumption can lower fiber intake. This can cause digestive issues and bowel discomfort.
Many people also experience the keto flu in the initial stages of their diet. Symptoms of the keto flu include diarrhea, headaches, and dizziness. These side effects usually subside within a few weeks.
Keto diets are also very restrictive and can be difficult to maintain. The classic keto diet requires adherents to measure out every meal. This can make it exceedingly difficult to eat spontaneously or go out to restaurants. For this reason, many people follow the modified Atkins or other more flexible alternatives.
The ketosis process is also extremely sensitive. Consuming a single oversized serving of carbohydrates can undo the process. Returning to the ketosis state can take a minimum of five to seven days.
Further information:
https://my.clevelandclinic.org/health/treatments/7156-ketogenic-diet-keto-diet-for-epilepsy
https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/diet-therapy.html