"One of the most exciting recent developments in the treatment of epilepsy has been the 'rediscovery' of the ketogenic diet. This diet is helping children whose seizures have resisted even the best of the modern anticonvulsant drugs." — Dr. McIntyre Burnham, President, Epilepsy Ontario
The ketogenic diet is a rigid, strictly calculated, therapeutic diet used in the treatment of difficult-to-control epilepsy in children. This diet is very high in fats and very low in protein and carbohydrates.
Who can use the Ketogenic Diet?
The ketogenic diet is used to treat intractable epilepsy in children. It may be prescribed when seizures are out of control, and when the side effects of anticonvulsant drugs, and/or surgery are considered unacceptable.
It may effectively treat some cases of childhood myoclonic, absence, and atonic seizures as well as tonic-clonic seizures, multi-focal seizures, and Lennox-Gastaut Syndrome.
It has also been used to treat structural brain disorders such as microcephaly, hypoxic brain damage, prior strokes, and developmental abnormalities.
The ketogenic diet is usually directed at children 1 to 8 years of age. Children below the age of 1 are not usually put on the diet as they may experience side effects such as hypoglycemia. The diet has had some success with select older children and adolescents too.
It is prescribed only when both the child and the family are highly motivated.
The diet may be prescribed for 2 to 3 years.
It is said that adults may have problems maintaining essential nutrients and therefore may not benefit from the diet, but in-depth studies are rare and inconclusive. Many adults would not want to eat such a diet — most adults find it unpalatable — and find it very difficult to stick to it.
How does the Diet Work?
When starting the diet, your child will fast for 2 to 3 days. By doing this, all of the glucose (sugar) in the blood will be used up for energy.
The ketogenic diet works by tricking the body into reacting as if it is starving or fasting: it causes the body to burn fats rather than carbohydrates. When fats are burned in the absence of sugars, they do not burn completely. Instead, a residue of ketone bodies remains: the body is in a state of ketosis.
Despite the use of this diet in the treatment of seizure disorder since the 1920s and before, its exact mechanism is unknown. Research was largely discontinued when newer anti-epileptic drugs became available in the 1940s.
Safety & Side Effects
The ketogenic diet is both safe and effective, with rare side effects only when it is not strictly followed. There is documentation of rare kidney stones formation, lowered immune functions, low blood sugar, and implication of increased serum lipid profile which requires close monitoring.
During the initial fast, your child's blood sugar level should be checked every four to six hours. The level often falls, which may lead to hypoglycemia.
The ketogenic diet must be supervised by qualified specialists.
Is the Diet Nutritionally Complete?
Dietary supplements, such as multivitamins and calcium, must be taken.
These must be given in sugar-free form.
Living with the Diet
After consultation, if you opt for the diet, you may be asked to participate in a trial period.
Also, there may be several days of training time when you will be given a diet designed specifically for your child. Everything your child consumes must be weighed and accounted for in the diet.
Your child may feel hungry during the first week or two. However, ketosis decreases the appetite.
Some children on the ketogenic diet will feel very thirsty. Some parents give their children a regular dose of water or caffeine-free diet soda every 1 or 2 hours during the day.
Always consult your child’s paediatrician or neurologist about the specifics of the ketogenic diet in your case.
When rigidly adhered to, the ketogenic diet may successfully control epilepsy in 30-50% of children with intractable seizures. Many others will experience a marked decrease in seizure frequency. Many will be able to return to a normal diet within 2 to 3 years, free of seizures or medication.
Most people investigate this diet as a last resort. The diet can be unpalatable and demands a great commitment from the entire family for a considerable period of time.
Most people who make it past the first month will stick with the diet until they can return to a normal diet.
Where is the Diet Administered?
In Ontario, the ketogenic diet is administered at the larger children's hospitals and several clinics.
Some hospitals and clinics are now considering the implimentation of the ketogenic diet for adults.
A key to success with the ketogenic diet is commitment.
You and your child will have to cope with
the lack of sweet and other tasty foods.
Many children embrace the diet more easily
knowing that they are
"special kids with a magic diet."