By Amber Kaiser

Have you ever thought about diet being able to help with seizure control in people with epilepsy? I’ve found that the ketogenic diet is more often recommended for children than adults with epilepsy who have seizures that are difficult to control. It was created in the 1920s and children’s parents must follow a strict diet with their child. I think success could depend on the parent or guardian’s drive, learning and management of a different way of eating that they may not be used to. It may also often be hard for many people to start and maintain particular diets. I did some searching to find any scientific research and information about people who have tried it and if the ketogenic diet actually helps prevent seizures. How does it work and is it healthy for the rest of the body long-term? Often, a ketogenic diet is a supplement to people who are already on AEDs, so what happens if a ketogenic diet reduces seizures—does the person still need to take their medications and other supplements?

The ketogenic diet for seizures

What is a ketogenic diet for epilepsy and does a keto diet help with seizures? The Epilepsy Foundation makes note that a ketogenic diet is known as a high fat, low carb diet that can help control seizures in some people with epilepsy. It also requires “careful measurements of calories, fluid, and proteins and the foods have to be weighed and measured” and typically the diet is started in a hospital setting, so it’s definitely something to talk to your doctor about before attempting.

According to the Epilepsy Foundation, children on the ketogenic diet continue to take medications and they are able to “take smaller doses or fewer doses of medicines. . .after 1 month of being on the diet.” When the ketogenic diet does work to help reduce seizures, the parents or person with epilepsy can finally feel a sense of control over their seizures and “over half of children who get on the diet have at least a 50% reduction in their number of seizures and 10-15% have even become seizure free.”

Just like with AEDs or epilepsy medications, when trying a strict ketogenic diet, there are a handful of potential long-term side effects to consider, including kidney stones, high cholesterol levels in the blood, constipation, slowed growth and bone fractures. Some people may find these better than medication side effects and be open to trying a diet change instead of increasing medication dosage or trying another AED.

To find a plethora of information and resources about the ketogenic diet, be sure to check out Epilepsy Foundation’s Keto News. Also, this recent study published in the National Library of Medicine in 2019, shows some interesting information regarding what we know so far about the ketogenic diet and epilepsy and how an “individually designed diet” should be considered for a person of any age with epilepsy even though adults may have a more difficult time maintaining it, especially long-term.

Less restrictive diets and other ways of healthful eating for people with epilepsy

According to the Epilepsy Foundation, recent evidence has shown that less restrictive diets like the modified Atkins diet and low glycemic index treatment (LGIT) may also be helpful for people with epilepsy. Eating a low sugar diet (especially simple sugars) with more natural, whole foods (less processed and packaged foods) could also help and is generally healthy for anyone.

In the modified Atkins diet, the main difference from the ketogenic diet is that there are no restrictions on protein and the foods don’t have to be weighed and measured with limits or calorie restrictions. For people with daily seizures, studies say it has “helped about half of people with a 50% seizure reduction within 6 months and many were able to reduce medications.”

In 2002, an alternative diet was created called low glycemic index treatment (LGIT). In addition to monitoring daily carbohydrates like the ketogenic diet, the LGIT focuses on eating carbohydrates with a low glycemic index, which refers to how high your blood glucose level rises after eating certain foods. This diet is also different from the ketogenic diet, including allowing more carbohydrates, and it goes by portion size rather than weight. Common food examples in the LGIT include heavy cream and high fat meats. High fat is actually something all the epilepsy diets have in common and I wonder if that’s because fat is so important in the brain. The brain utilizes glucose and ketone bodies to operate which are made from certain kinds of fat. In fact, according to this study in the National Library of Medicine, “the human brain is nearly 60% fat. . .and the fatty acids are among the most crucial molecules that help determine your brain’s integrity and ability to perform.”

My thoughts on diet and epilepsy

Over the years, none of my neurologists ever recommended I try diet changes for my epilepsy (probably because I was a young adult when I was diagnosed, and gratefully, I never had daily seizures). After doing my own research for this article, I definitely understand how it can be difficult and challenging to change your diet–particularly a ketogenic diet for adults with seizures–and stick to some of the strict rules especially in the ketogenic and modified Atkins diets. I would also be concerned about ketogenic diet foods for epilepsy and the long-term effects on the rest of the body.

In conclusion, I can definitely understand how it may be difficult for adults to try the traditional ketogenic diet, but if you are interested, the modified Atkins may be a little easier. For children with epilepsy, it still sounds like the ketogenic diet plan for seizures is more popular to try since it has been around for about 100 years, ketogenic diet therapies for epilepsy and other conditions are widely available in larger hospitals throughout the world, and studies have shown improvement in seizure reduction in some children who have uncontrollable seizures multiple times a day. Understandably, I think parents are more open to trying it when medications haven’t worked and there have been some good results in the diet. I’m not sure about the long-term effects of the diet on children, but if it’s successful, I found that many people seem to wean their children off the diet within about 2 years.

If you have experience or thoughts with any of these special diets for epilepsy and would like to share, I’d love to hear from you. Feel free to email me at amber@neureka.ai.