Ketogenic Epilepsy Diet - Using the Modified Atkins Diet For Seizure Control

A very strict version of ketogenic diet has been used for many years in childhood epilepsy that failed to respond to anti-epileptic drugs. Although the mechanisms are not fully understood, the ketogenesis alters the metabolism of the brain in a way that can reduce the risk of seizures. However, this treatment for epilepsy fell out of favour over the years due to difficulty in keeping to the diet and concerns about cholesterol levels.

A new trial conducted in the UK in 2008 confirmed that a ketogenic high-fat diet can indeed significantly reduce the number of seizures in epilepsy and rekindled interest in its use. The concerns about cholesterol levels have now been shown to be groundless, so that is no longer an issue. Researchers have also discovered that the anti-seizure effect still occurs when a less strict version of the ketogenic 'epilepsy diet' is used, which means that the diet is not so difficult to follow.

Epilepsy consultant Dr Eric Kossoff has been very active in this area of research, and has shown that the traditional ketogenic diet for epilepsy is needlessly restrictive. He uses a modified version of the Atkins Diet (10 g rather than 20 g of carbohydrates for the first few months). He has also found that epileptic kids don't need to start off with a fast, so no initial hospitalization is needed, and their carers can more or less just get the Atkins book and follow it (under the epilepsy consultant's supervision). This, together with the increased availability of low carbohydrate substitutes for making bread and other foods hitherto off-limits on the ketogenic epilepsy diet, should make life much easier for epileptics and those who cook for them.

As Dr Kossoff wrote in The Lancet, 'Only a decade ago the ketogenic diet was seen as a last resort; however, it has become more commonly used in academic centres throughout the world even early in the course of epilepsy. The Atkins diet is a recently used, less restrictive, therapy that also creates ketosis and can lower the number of seizures.'

Dr Kossoff says his 'modified Atkins Diet' version of the epilepsy diet is better than the traditional ketogenic diet because no restrictions are required on fluid, calorie or protein intake. Additionally, there is no need to weigh and measure all foods. Carbohydrate counts are monitored by patients and parents. The diet is also started outside of the hospital, and doesn't require an initial fast, either. Foods can be eaten more freely in restaurants and outside the home. The diet is a 'modified' Atkins diet as it allows for less carbohydrates than traditional Atkins (10-20g/day) and more strongly encourages fat intake.

Good results have also been reported by some consultants who start the ketogenic epilepsy diet with a very low level of carbs and then increase it after a few months.

The discovery that the ketogenic epilepsy diet does not need to be as restrictive as originally thought is great news for epileptics. Even better, thanks to the explosion in popularity of the Atkins and other ketogenic diets for weight loss purposes, epileptics should have no difficulty in finding the recipes, cookbooks and substitute ingredients they need to follow the ketogenic epilepsy diet.

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