There are many different types of seizures, and many diagnoses that go with them. Different seizure disorders can have different causes, ranging from high fevers to trauma, infection, and chemical intoxication. In some cases the precise cause may be elusive, but most seizure disorders have one thing in common: they can be managed entirely by diet.
If you think this is just another one of my controversial statements, think again! The diet in question, known as the ketogenic diet, was developed in the early decades of the 20th century under the aus pices of the American Medical Association. It has continued to be researched to the present day in such meccas of mainstream medicine as Johns Hopkins Hospital. A history and a detailed description of the diet can be found in the book “The Ketogenic Diet: a Treatment for Epilepsy” by John Freeman, MD.
A parent’s report in the foreword to this book is quite revealing: “After thousands of epileptic seizures, an incredible of array of drugs, dozens of blood draws, eight hospitalizations, a mountain of EEGs, MRIs, CAT scans, PET scans, and one fruitless brain surgery, Charlie’s seizures were unchecked, his development delayed, and he had a prognosis of continued seizures and progressive retardation. Since we started the diet Charlie has been virtually seizure-free, completely drug-free, and a terrific little boy ever since.” So what is the ketogenic diet, and how can it be so effective? The major feature of this diet is that it severely restricts sugar and all other carbohydrates until the body’s metabolism switches from burning sugar for energy to burning fat. When this happens, benign compounds known as ketone bodies are produced. They circulate in blood and can be measured in urine with so-called ketone sticks. Positive readings on ketone sticks indicate that the diet is being implemented correctly, and so the diet itself has come to be known as ketogenic or ketone-inducing.
Our brains require relatively enormous amounts of energy. In fact, the adult human brain represents only 2% of total body mass but accounts for 15% of total energy needs of the body (Guyton, 8th edition, p. 684). The brain will always burn sugar for energy, as long as it’s available; but when it runs out, the brain adjusts easily and very efficiently to burning ketones.
Although there would seem to be a benefit to the brain from burning ketones, this benefit is not nderstood and we don’t know exactly how this diet works to control seizures. Another and perhaps overlooked aspect of this diet is that it completely eliminates sugar and severely restricts all carbohydrates. I have observed consistent behavioral and attention-related improvements with only moderate reductions in sugar and carbohydrate intake. Could it be that the complete elimination of these items has even greater brain-healing benefits for these severe cases?
Not only is this diet effective, it is completely safe. Studies have found consistently that children, even infants, on this diet develop normally. A recent study looked at the safety of the diet in infants as young as 3 months old without finding evidence of any detriment in terms of general health or growth and development (Pediatrics, 2002; 109 (5): 780). While it is known that protein and fat are essential to human life, we apparently do just fine without carbohydrates.
So why haven’t you heard about this diet from your neurologist? The answer to this question may lie primarily with a medical bias towards drugs and surgery. According to medical standards of care, the diet should only be considered in severe cases when drug therapy fails. Although I disagree with this policy, it does provide further evidence of the diet’s effectiveness.
From what I hear, in everyday practice the diet is rarely mentioned, even when drugs don’t work. In one case, when the mother of one of my patients asked her child’s neurologist about the diet, she was told with a smile that “yes, the diet could work in theory but it’s just too difficult to follow.” The neurologist’s recommendation in that case was experimental brain surgery.
In reality, the medical textbook description of the ketogenic diet makes it unnecessarily complicated and difficult to implement. A simpler version of this diet is the Atkins diet. The Atkins diet is also ketone-inducing, plus it has the added benefit that most people have a basic familiarity with it and there are books in every bookstore telling us how to follow it. Could it be just as effective?
This is exactly what a recent study performed at Johns Hopkins Hospital found. Researchers concluded that the Atkins diet is a “well-tolerated alternative to the ketogenic diet for treating medically-resistant epilepsy” (Epilepsia 44 Suppl. 9: 282 (Abst. 2. 310), 2003).
Now, you may be thinking that the Atkins diet is for weight loss and your child would wither away on it. However, it has been shown that carbohydrate-restricted diets have a “weight-optimizing” effect and it is just as likely for underweight people to gain weight on these diets as it is for overweight individuals to lose weight. For a more comprehensive discussion of the weight-optimizing effects of low-carbohydrate diets, see “Life without Bread” by Wolfgang Lutz, MD.
When implementing the Atkins diet, it is important to make healthy choices, avoiding man-made fats like margarine and the low-carb “fake” foods that are now becoming prevalent in restaurants and on grocery store shelves.