Ketogenic diet for epilepsy

This diet is VERY HIGH in fat and VERY LOW in carbohydrates. It forces the body to burn fat instead of carbohydrates....
Mahitab Hany, BS Pharm, PGDipClinPharm, PGDipClinNutrition

As a nutrition support pharmacist, you will hear more about the use of ketogenic diet in special situations like intractable epilepsy. Many people started talking about the keto diet for epilepsy, especially since the TV movie, First Do No Harm in 1997. This is NOT quackery. It's a legitimate medical therapy...

The ketogenic diet (table 1) has been around for about 70 years. It fell out of favor when phenytoin and newer antiepileptics came out. But some children aren't controlled with drugs and the diet can make a dramatic improvement for SOME of them. This diet is VERY HIGH in fat and VERY LOW in carbohydrates. It forces the body to burn fat instead of carbohydrates. This causes ketosis, which sometimes controls seizures. It's used mainly in children under 10 years. About a third of them become seizure-free and stop their seizure medications. Another third have fewer seizures and the rest don't improve or can't tolerate it.

Table (1). Sample Menu for One Day on Ketogenic Diet
MEALS CONTENTS
Breakfast Breakfast quiche with bacon beef
Lunch Belgian salad
with avocados, pineapple, and pecans
Dinner Sausage, potato, sauerkraut
Creamy milkshake
Snacks Cheesecake with blueberries
(Total: 1000 calories/ 3.8:1 ratio)
This information form...
Hartman AL, Vining EP. Clinical aspects of the ketogenic diet. Epilepsia. 2007 Jan;48(1):31-42.

The diet is hard to follow and MUST BE MEDICALLY SUPERVISED. About 80% of calories come from fat. Carbohydrates must be STRICTLY controlled, including the sweeteners in liquid medications, vitamins, etc. For example, just the daily dose of Depakene (valproate sodium) syrup alone exceeds the carbohydrate limit!. Too many carbohydrates reverse ketosis and can result in seizures. Refer interested patients to a nutritionist and medical center that specializes in this. We can point you towards some excellent resources and information about the keto-diet (see Note below).

Note...

References