About 30 percent of children with epilepsy do not respond well to available medication. However, children with drug-resistant epilepsy sometimes benefit from dietary therapies such as a ketogenic diet. This type of eating pattern emphasizes fat and includes very few sources of carbohydrate.
Does a Ketogenic Diet Reduce Seizures in Kids?
A systematic review and meta-analysis of 12 randomized controlled trials was just published in JAMA Pediatrics (Jan. 30, 2023). It compared ketogenic diets to less restrictive diets such as low-glycemic index therapy and a modified Atkins diet.
All dietary interventions were more effective than usual care. The modified Atkins approach was better tolerated and reduced seizures by 50% or more. The authors conclude that it may be a sounder option than a strict ketogenic diet. Youngsters on the ketogenic diet reported more digestive distress, lack of energy and elevated cholesterol levels.
Adults with Uncontrolled Seizures:
Adults with hard-to-manage seizures may also get some benefit from such a diet (Neurology, Nov. 18, 2014). In one analysis, scientists reviewed 10 studies of diets rich in cream, eggs, butter, bacon, leafy green vegetables and fish. Five were specifically ketogenic diets, while the remainder were modified Atkins-style diets. Not all of the volunteers with intractable seizures responded, but many did.
About one third of subjects with epilepsy had 50 percent fewer seizures on a ketogenic diet. A small number had a remarkable response with a 90 percent or better reduction in seizures. The effects become apparent quickly.
The diet can be challenging to follow, in part because it defies conventional wisdom about a healthy diet. Ketogenic diets may have other health benefits, though, including possibly reducing the risks of diabetes and heart disease. You can learn more from this interview with Dr. Eric Westman.
More Research on a High Fat Diet for Epilepsy:
A Cochrane Review analyzed data from eleven randomized controlled trials of diet for epilepsy (Cochrane Database of Systematic Reviews, Nov. 7, 2018). The investigators found promising signals, especially for the modified Atkins diet. However, they called for more research to bolster the evidence. Other researchers are now exploring the possible uses of dietary interventions to manage other neurological diseases (Nutrients, Nov. 30, 2022).
