Ketogenic Diet

Background Information
This is a diet used to control seizures that won't go away no matter what drugs/therapy/surgery have been used. You may have heard of it - but it's often labelled as maverick, unpalatable or old fashioned. Obviously there is a degree of potential truth in each of these things, but the negative connotations these descriptions conjure should not put people off as there are few disadvantages that can't be overcome with information, imagination and careful management.

The Diet
The diet centres around using extremely high fats, adequate protein and very, very low carbohydrates. The ratio of fat to carbohydrate and protein combined is usually 4:1 but can be lower or higher, depending on what the dietician recommends. Most peoples' bodies use glucose from carbohydrates to keep the brain supplied with energy. However, the ketogenic diet removes these carbohydrates and replaces them with fat, forcing the body to use this as energy instead. Because the body cannot burn fat completely when we take out the carbohydrates, it produces 'ashes' - called ketones. These can take the place of glucose in providing energy to the brain. It is thought that the use of ketones instead of glucose changes the structure of cell membranes in the brain, making them more electrically stable.

The diet sounds like the Atkins diet, and in a sense it is like that, except that the ratio of fat to carbohydrate is much higher than in the Atkins diet. Also the ketogenic diet requires much more rigorous adherence and you need to work more closely with a dietician than for Atkins.

Side Effects of the ketogenic Diet
Contrary to what one might think, this doesn't make a person fat, nor does it usually increase their chances of heart disease. That said, everything must be consumed according to a strict plan: no more, no less. It is absolutely essential that you find a dietician willing to work with you, because the diet will not work unless it is followed to the letter. There is a slightly higher risk of kidney stones, and a slightly higher risk of constipation. Some people feel extra hunger and thirst in the first few days of starting the diet, but usually these go away within a few days/weeks.

Evidence for the Diet
Most evidence for the ketogenic diet is anecdotal, but there have been some studies validating the claims that the diet works. There have been reported hugely positive effects - reports of intractable seizures being brought completely under control and sometimes even eradicated within a matter of months - to the extent that the patient was weaned off all medication. Whilst this may not be the case for every person, there was one study in which 50% of people claimed some improvements from the diet. Also the diet need not be adhered to permenantly - if it is stuck to through the vulnerable stages (e.g. growth spurts, childhood), there is a good chance that the person can come off the diet and remain seizure free.

If you think this diet could help then talk to your dietician about it. Some dieticians have not heard of it, or have heard the stereotypical view of it, or don't believe in it. Whilst they are experts and I am not, I would highly recommend getting a second opinion before dismissing the idea of the diet.

Links

A complete nutrition ketogenic oral/tube feeding formula
http://www.shs-nutrition.com/products/ketocal

A family who have a daughter following the ketogenic diet. They demonstrate how to make tasty ketogenic recipes, whilst following the strict diet.
http://www.youtube.com/user/tscottshell

A website about the use of the ketogenic diet, including recipes and testimonies
http://www.charliefoundation.org/