Classic Ketogenic Diet (keto diet) and Epilepsy

We all know that the food we eat, affects our health. So, it is no wonder that both our ancient systems as well as modern medicine have explored the use of various diets for maintaining good health and for the treatment of disease.

The ketogenic diet (keto diet) is one of the best examples of a diet used to treat a specific medical condition viz. epilepsy (commonly known as fits or akadi or mirgi). It was originally devised in the US nearly a century ago for those who do not respond to anti-epileptic drugs. 

The keto diet mimics fasting. In recent years, it has also gained popularity among the masses as a diet for weight reduction. In this blog post, we’ll explore the ketogenic diet for epilepsy and in a subsequent post, we will discuss its various types and potential usefulness in other medical conditions.

What is the ketogenic diet?

The human body needs energy. This comes from the food we eat. Generally, the body uses carbohydrates (carbs) and fats for energy, in that order. In a keto diet, carb intake is restricted, so that the body starts “burning” fats for energy. This leads to the production of chemicals called ketone bodies in the blood, resulting in an acidic state called ketosis. Ketosis has profound effects on various parts of body which can bring some health benefits. Because ketones have a calming effect on brain, they reduce the number and severity of fits. Additionally, they improve alertness and reduce associated symptoms like hyperactivity. If calories are also limited, then this burning of stored fats can help in weight loss. However, this diet can potentially result in some complications and therefore should be conducted only under strict medical guidance.

The classic ketogenic diet 
In the classic ketogenic diet, the ratio of fats to carbs + proteins are strictly calculated (ratios such as 4:1, 3:1 and so on) For example in a 4:1 ratio, there are 4 parts of fat to one part of combined carbs + proteins. Higher the ratio better the ketosis. Direct sugars such as glucose, table sugar, jaggery and honey are completely stopped. Anti-epileptic medicines are continued in tablet or sugar free forms. With optimal ketosis, good seizure control is achieved as also an improvement in cognition. In such patients, the anti-epileptic medicines can be gradually reduced or even completely stopped under the guidance of a neurologist.

Every meal is calculated and prescribed to provide an exact amount of fats, proteins and carbs as per ratio decided for the child depending on his age, weight etc. It involves actual weighing of food ingredients while preparing meals. Therefore, it is easier to implement in younger children where parents have full control of the feeding or in admitted patients on tube feeds.

There are other diets like MCT, Modified Atkin’s and Low glycemic index diets to treat epilepsy which use the same principle but are easier to follow. We will discuss more about these and their uses in non-epileptic persons in the next post.

Dr. Purnima Prabhu, Paediatric Nutrition Therapist is an expert in ketogenic diet for different health conditions. For more queries and guidance, you may book an appointment or call on 022 6766 8181 / 022 4510 8181.