Low-carbohydrate and ketogenic diets for the treatment of epilepsy

Posted by Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital.

The classic low-carbohydrate and ketogenic diet (KD) has been used in some epilepsy treatment centers. Many studies have found improvement in more than half of study participants.

Carbohydrates include sugar, starch, and fiber content in fruits, grains, vegetables and dairy products and products. Although the perception of the use of dosage of the above foods is still misleading and inaccurate, but it cannot be denied that they are one of the basic and important food groups for a healthy diet. healthy.
According to nutritionist Paige Smathers: Carbohydrates are macronutrients, which means they are the source of energy or calories for the body. From a chemical perspective, carbohydrates are components that contain carbon, hydrogen, and oxygen.
Low carb and ketogenic diets have many health benefits.

Keto diet (Ketogenic) is a diet low in carbohydrates (carbs) and high in good fats. The Keto menu helps the body burn more energy without the need for strict diets.
When you regularly cut carbs in your diet, your body will enter a state of "Ketosis". At this time, the body increases energy burning. At the same time, the pancreas will also convert fats into ketones, providing energy for the brain. The Ketogenic diet can significantly lower blood sugar and insulin levels. This can bring a lot of benefits to your health.
For example, it is well known that they can help with weight loss and help control diabetes. However, they are also beneficial for certain brain disorders.

There are four types of carb-restricted diets that can treat epilepsy. Here are their typical macronutrient breakdowns:
Classic ketogenic diet (KD): 2–4% calories from carbs, 6–8% from protein and 85–90% from fat. Modified Atkins Diet (MAD): 10% of calories from carbs without protein restriction in most cases. The diet begins by allowing 10 grams of carbs per day for children and 15 grams for adults, with the potential for a slight increase if tolerated. Ketogenic medium-chain triglyceride diet (MCT diet): Initially 10% carbs, 20% protein, 60% medium-chain triglycerides, and another 10% fat. Low Glycemic Index Treatment (LGIT): 10-20% of calories from carbs, about 20-30% from protein, and the rest from fat. Limit carb choices to people with a glycemic index (GI) below 50.

The classic ketogenic diet (KD) has been used in some epilepsy treatment centers. Many studies have found improvement in more than half of study participants. In a 2008 study, children treated with a ketogenic diet for 3 months experienced an average 75% reduction in initial seizures.
According to a 2009 study, about a third of children who respond to the diet experience a 90% or more reduction in seizures. In a 2020 study of refractory epilepsy, children who followed the classic ketogenic diet for 6 months saw a 66% reduction in their seizure frequency (Source 16).
Although the classic ketogenic diet can be very effective against seizures, it requires close supervision by a neurologist and nutritionist.
Food choices are also quite limited. As a result, this diet can be difficult to follow, especially for older children and adults.

In many cases, the modified Atkins diet (MAD) has been shown to be as effective or nearly as effective in controlling epilepsy in children as the classic ketogenic diet, with little effect more sub. In a randomized study of 102 children, 30% of those following the modified Atkins diet experienced a 90% or more reduction in seizures.
Although most studies have been done in children, some adults with epilepsy have also seen good results with this diet.
In an analysis of 10 studies comparing the classic ketogenic diet with the modified Atkins diet, people were more likely to stick with the modified Atkins diet.

The medium-chain triglyceride ketogenic diet (MCT diet) has been in use since the 1970s. Medium-chain triglycerides (MCTs) are saturated fats found in coconut and palm oils.
Unlike long-chain triglyceride fats, MCTs can be used for rapid energy or ketone production by the liver.
MCT oil's ability to increase ketone levels without restricting carb intake has made the MCT diet a popular alternative to other low carb diets.
A study in children showed that the MCT diet was as effective as the classic ketogenic diet in controlling seizures.

Low Glycemic Index Treatment (LGIT) is another dietary approach that can control epilepsy although it has a very modest effect on ketone levels. It was first introduced in 2002.
In a 2020 study of children with refractory epilepsy, those who followed the LGIT diet for 6 months experienced significantly fewer side effects than those who followed the LGIT diet for 6 months. those on the classic ketogenic diet or the modified Atkins diet.
Bottom Line
Various types of low carb and ketogenic diets are effective in reducing seizures in children and adults with drug-resistant epilepsy.