Comments Off on What is the Ketogenic Diet? NEUROLOGICAL/EPILEPSY

What is the Ketogenic Diet?

The ketogenic diet has been in existence for 90 years

The ketogenic diet was designed in 1924 by Dr. Russell Wilder at the Mayo Clinic. Despite being highly effective in treating epilepsy, it fell out of fashion due to the surge in new anti-seizure medications in the 1940s. In 1994 Charlie Abraham’s family started The Charlie Foundation after his complete recovery from daily seizures despite trying all available anti-seizure medications and enduring a futile brain surgery. Charlie started the diet as a toddler and remained on it for 5 years. He is now a college student and remains seizure-free.

Ketosis is the unique feature

The diet is high in fat, supplies adequate protein and is low in carbohydrates. This combination changes the way energy is used in the body. Fat is converted in the liver into fatty acids and ketone bodies. Another effect of the diet is that it lowers glucose levels and improves insulin resistance. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the occurrence of epileptic seizures.

The Charlie Foundation is a global leader in promoting ketogenic therapies

In 2006, The Charlie Foundation commissioned a panel comprised of neurologists and dietitians with particular expertise in using the ketogenic diet to create a consensus statementin support of the clinical management of the ketogenic diet and when it should be considered. Children are especially good candidates for the diet owing to their reliance on adults for nourishment and to the nature of a young developing brain.

Comparison of diet therapies

There are five levels of diet which have been published in medical literture as effective treatments for epilepsy: the classic ketogenic diet, the modified ketogenic dietmedium-chain triglyceride (MCT) oil supplement dietmodified Atkins and low glycemic index treatment (LGIT)
Classic Ketogenic and Modified KetogenicMCT oil dietLow Glycemic Index TreatmentModified Atkins

Questions Ketogenic MCT Oil Low Glycemic Index Treatment Modified Atkins
Is medical supervision required? Yes Yes Yes Yes
Is diet high in fat? Yes Yes Yes Yes
Is diet low in carbohydrate? Yes Yes Yes Yes
What is the ratio of fat to carbohydrate & protein? 4:1, 3:1, 2:1, 1:1 Approximately 1:1 Approximately 1:1 Approximately 1:1
How much carbohydrate is allowed on a 1000 Calorie diet? 8gm carb on a 4:1
16gm carb on a 3:1
30gm carb on a 2:1
40-60gm carb on a 1:1
40-60gm 40-60gm 10gm for 1 month
20gm afterwardsAdjusted for children vs. adults
How are foods measured? Weighed Weighed or measured Measured or estimated Estimated
Are meal plans used? Yes Yes Yes optional
Where is the diet started? Hospital Hospital Home Home
Are calories controlled? Yes Yes Yes No
Are vitamin and mineral supplements required? Yes Yes Yes Yes
Are liquids (fluids) restricted? No No No No
Is a pre-diet laboratory evaluation required? Yes Yes Yes Yes
Can there be side-effects? Yes Yes Yes Yes
What is the overall difference in design of these diets? This is an individualized and structured diet that provides specific meal plans. Foods are weighed and meals should be consumed in their entirety for best results. The ratio of this diet can be adjusted to effect better seizure-control and also liberalized for better tolerance. This diet is also considered a low glycemic therapy and results in steady glucose levels. An individualized and structured diet containing Medium Chain Triglycerides (MCT) which are highly ketogenic. This allows more carbohydrate and protein than the classic ketogenic diet. A 2008 study showed that both diets are equal in eliminating seizures. A source of essential fatty acids must be included with this diet. This is individualized but less structured diet than the ketogenic diet. It uses exchange lists for planning meal and emphasizes complex carbohydrates. The balance of low glycemic carbohydrates in combination with fat result in steady glucose levels. It is Not intended to promote ketosis. This diet focuses on limiting the amount of carbohydrate while encouraging fat. Carbohydrate may be consumed at any time during the day as long as it is within limits and should be consumed with fat. Suggested meal plans are used as a guide. Protein is Not limited but too much is discouraged.


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