U.S. News & World Report: Keto Diet for Epilepsy, What to Know
By Heidi Godman
Using a keto diet for epilepsy is an ancient concept. The effects were noted in biblical times, when people with epilepsy would fast in order to find relief from chronic brain seizures. “You can look in old scriptures and see that when people would fast, the ‘demons’ would leave them – the demons meaning the seizures,” explains Dr. Mohamad Koubeissi, a neurologist and director of the Epilepsy Center at the George Washington University Hospital.
People in ancient times didn’t know it, but by fasting they were forcing the body to make chemicals that seem to help control epileptic seizures. Today we generate those chemicals with a ketogenic diet.
The keto diet for epilepsy is very high in fat, moderate in protein and extremely low in carbohydrates such as fruits, vegetables and grains – which turn into glucose, the body’s main energy source.
Without glucose, the body believes it’s fighting starvation. The liver transforms stored fat into chemicals called ketone bodies, which are consumed by the brain and body as energy.
This state of “ketosis” has a benefit for people with epilepsy. About 50% of patients who follow the keto diet for epilepsy experience at least a 50% reduction in seizures. “One of the theories is that ketones make more of the chemicals that calm down the brain and decrease epileptic activity and also decrease some of the chemicals that can naturally increase the likelihood of seizures happening,” says Dr. Ahmed Abdelmoity, a neurologist and chief of the section of epilepsy and clinical neurophysiology at Children’s Mercy Kansas City.
In children, the most common keto diet for epilepsy is either:
- A classic ketogenic diet. According to dietitian Lindsey Thompson, a ketogenic dietitian in the Comprehensive Epilepsy Center and nutrition manager at Children's Mercy Kansas City, "80% to 90% of calories come from fat, about 10% come from protein and the rest come from carbohydrates like fruits or vegetables.”
- A medium chain triglyceride or MCT diet. “The MCT diet uses MCT oil fats, as they are very ketogenic, and then that allows for a bit more carbohydrates,” Dr. Eric Kossoff says. Kossof is a neurologist and medical director of the Pediatric Ketogenic Diet Program at Johns Hopkins Medicine.
For those diets, a hospital stay is usually needed. “Children are traditionally admitted to the hospital for two to three days in order to switch their foods over from regular to ketogenic, check their labs (such as blood sugar and ketone levels), educate their parents as to how to weigh and measure foods, and make sure they tolerate the switch without side effects,” Kossoff explains.
Learn more about the Comprehensive Epilepsy Center at Children's Mercy