Epilepsy Program: Nutritional therapies
Dietary modifications are the oldest known treatment for epilepsy. Today, many patients experience freedom from seizures through medications or surgery. However, dietary changes are often recommended when other therapies do not work.
The specialists of the UCI Health Comprehensive Epilepsy Program have significant experience in prescribing nutritional therapies for epilepsy control.
Certain types of epilepsy syndromes are more responsive to nutritional therapy, such as seizures occurring in children that are caused by Rett syndrome or tuberous sclerosis complex.
Some patients benefit from a combination of medications and nutritional treatments.
The ketogenic diet
The ketogenic diet has been used for more than a century to help control seizures. This diet is high in fat intake and low in carbohydrates. Fatty foods include butter, whole milk, bacon and cheese. A typical ketogenic diet would consist of:
- 90% fat
- 2% to 4% carbohydrates
- 6% to 8% protein
It’s not completely clear how or why this type of diet can reduce seizures. Fat metabolism produces ketosis — a state of starvation, although the body is not deprived of the calories needed to sustain growth, development and daily function.
It is thought that ketosis may suppress chemicals in the brain, called neurotransmitters, that trigger seizures.
How it works
Patients on the ketogenic diet begin with a 24-hour fast followed by the gradual introduction of the diet over a period of days. Fluids and calories are strictly calculated by weighing and measuring foods.
Ketone bodies (substances that indicate the body is in a state of ketosis) can be measured in the blood or urine. The goal is to achieve a urinary ketosis level of 80 mg/dL to 160 mg/dL.
This type of diet requires close monitoring and guidance by your physician and a nutritionist. Patients are typically prescribed vitamin and mineral supplements to provide a balance of necessary nutrients.
The ketogenic diet can be highly successful in certain patients. About 50% to 60% of children will experience a reduction in seizure activity by about 50%. One in three children will experience nearly total cessation of seizures.
Among teenagers and adults, about half will experience a 50% reduction in seizures and 13% will be seizure-free.
Both children and adults can remain on this diet for several years. The advantages of the ketogenic diet are:
- Faster efficacy (improvements can be seen in two weeks)
- Potential weight loss
- Reduction in several cardiovascular risk factors and diabetes risk factors
Side effects include:
- High cholesterol
- Acidosis or hyperketosis (high acidity in blood and/or dangerous levels of ketones in the blood)
- Kidney stones
- Weight loss
- Hair loss
Other dietary therapies
Other nutritional therapies to treat epilepsy are not as extreme as the ketogenic diet. They include a low-glycemic diet and a modified Adkins diet.
The glycemic index of a food defines how much the food raises blood glucose levels after consumption. A low-glycemic diet features about 60% of calories from fat, which is much less than the fat content of the ketogenic diet.
The low-glycemic diet also limits the amount of carbohydrates — foods such as bread, rice, beans and fruits — and focuses on consumption of carbohydrates with a low-glycemic index.
People on a low-glycemic diet can consume about 40 to 60 grams of carbohydrates a day — more than is permitted in the ketogenic diet. Studies show this diet can be effective in reducing seizure activity.
A modified Adkins diet is a variation of the ketogenic diet and also is less restrictive. The diet relies on a high intake of fats, although patients do not weigh or measure their intake. This diet has no restrictions on protein intake but patients limit their intake of carbohydrates. Studies show this diet can reduce seizures in about half of people who try it.
The healthcare team at the UCI Health Comprehensive Epilepsy Program has significant experience in prescribing nutritional therapies for epilepsy control.
For more information or to make an appointment, call 714-456-6203 or request an appointment online.