The ketogenic diet is a treatment for epilepsy

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The ketogenic diet is a treatment for epilepsy

For centuries, there have been virtually no effective treatments for epilepsy. The progress of medical science in our century has led to the emergence of drugs that can to some extent help most patients, but scientists are still looking for new anticonvulsants (so-called anticonvulsants) that would be safer than existing ones. Indeed, all antiepileptic drugs have side effects such as lethargy, drowsiness, intestinal disorders, and allergic reactions. In addition, drugs have relatively rare but severe side effects, such as damage to the liver and pancreas, the hematopoietic system with the development of anemia, and thrombocytopenia. It is also necessary to take into account the fact that more and more cases of epilepsy of resistance to drug treatment are observed, while doctors are forced to prescribe several drugs, which means that the likelihood of toxic side effects increases. Sometimes such patients can undergo surgical treatment. Meanwhile, there is a method for treating severe forms of epilepsy, which can give additional positive effect in some patients when most drugs are ineffective. This is the so-called ketogenic diet, which is widespread today in Europe and America.

What is the ketogenic diet?

A ketogenic diet is a diet high in fat and low in protein and carbohydrates, which is used to treat epileptic seizures. The use of a ketogenic diet allows you to reduce the dose of drugs taken, avoid their side effects, in rare cases, when using a ketogenic diet, drugs are even canceled completely.

Why do you need a ketogenic diet?

Typically, the ketogenic diet is used for severe, difficult to treat forms of epilepsy, including Lennox- Gastaut syndrome . The diet was invented in the 20 years of this century in the United States, when nutritionists and pediatricians have paid attention to the special biochemical processes occurring in the human body during starvation, leading ultimately to a reduction in the number of seizures.

It is known that with the help of fasting, they tried to treat epilepsy at the beginning of our era and in the Middle Ages (then it was called “treatment with prayer and fasting”), and sometimes this practice really led to an improvement in the condition of patients. Nowadays, scientists have found that with prolonged starvation, the body “rebuilds” metabolism in such a way that the brain begins to function with a large “margin of safety” and seizures in such conditions develop less frequently. However, a ketogenic diet does not require prolonged fasting, especially since it would be extremely difficult for a small child to abstain from food for at least a day (such experiments were carried out at the beginning of this century, but due to the severity and danger of epilepsy treatment by fasting did not find application). The main content of the new method of treatment is a specially calculated diet of the child, in which the amount of carbohydrates (sugar) is reduced and the bulk of the food is made up of fats. When food is digested, fats are converted into specific metabolic products, the so-called ketone bodies, which enter the brain and provide an anticonvulsant effect.

How it’s done?

When prescribing a ketogenic diet, the diet for each child is calculated only by the doctor strictly individually, taking into account the diagnosis, age and weight of the child, and his nutritional needs. The calculation of the diet is carried out in accordance with special programs developed in leading clinics in the world (Johns Hopkins University Hospital in the USA, a number of clinics of leading universities in Europe and America). The content of basic nutrients (proteins, fats, carbohydrates) in food is selected in a certain ratio, which is determined by the doctor. In the course of treatment, this ratio can change, therefore, it is necessary to constantly monitor the patient by the attending physician, who, if necessary, corrects the diet. The patient’s diet includes various types of fatty foods – bacon, heavy cream, vegetable oils, for example, flaxseed. In countries where the ketogenic diet is widely used, the food industry produces a variety of specialty foods that can provide a varied and complete menu. For beginners in the course of treatment, nutritionists have developed special milkshakes with a large amount of fat, which children can not only drink, but also eat frozen like ice cream. This helps the child get used to fatty foods and creates the necessary biochemical changes in the body that provide an antiepileptic effect. In the course of treatment, a great skill in compiling a menu is required from the doctor, otherwise the child will quickly get tired of a monotonous diet, and he may refuse to eat altogether. During various diseases, for example, colds, the metabolism always changes. This can reduce the effectiveness of the ketogenic diet. During such conditions, it is imperative to consult with your doctor so that he corrects the menu.

Who should be on the ketogenic diet?

Usually, the ketogenic diet is used in children from 1 to 10-12 years old, however, there is information about its effectiveness in adults, as well as in children from 4 months of age. But at an early age, i.e. before 1 year old, it is difficult to find the necessary products that would allow the child to grow and develop normally. Adults on a ketogenic diet are more difficult than children. This is due to the fact that the child’s body is more capable of adapting to new conditions, while the metabolic processes in adults and children are somewhat different. The exact mechanism of action of the ketogenic diet has not yet been found, however, numerous scientific studies show its high effectiveness in various, including severe forms of epilepsy, except for cases with organic brain damage (for example, the diet is ineffective for epileptic seizures that have arisen after a brain injury ).

When is the effect of the diet?

The effect of using a ketogenic diet occurs gradually over the first 3 months after its start. Usually, long-term treatment is required (for several years, more often 2-3 years), after which a persistent improvement is generally observed, which persists even with a normal diet. Thus, it is not necessary to follow a ketogenic diet for life. In many cases, the positive effect is noticeable as early as the first or second week of treatment. However, sometimes within one to two months of using the diet, no effect is noticeable – in this case, it is too early to draw conclusions about the ineffectiveness of the treatment, perhaps the doctor needs to more carefully calculate the biochemical parameters.

How effective is the ketogenic diet?

According to various sources, up to about 60-80% of cases, the use of a ketogenic diet reduces the number of seizures by more than 50%, of which 40% of patients showed a decrease in the number of seizures by more than 90%. As with all treatments, benefit cannot be expected in all patients. So, at least 20-30% of patients have a ketogenic diet ineffective. Some doctors compare the effectiveness of the diet with the effectiveness of many widely used antiepileptic drugs, but it should not be forgotten that the ketogenic diet is not an independent treatment for epilepsy, but rather an additional way to combat seizures, allowing you to try to reduce the dose of drugs and avoid serious side effects. that occur when taking some antiepileptic drugs used in the treatment of severe forms of epilepsy.

Side effects and problems with the ketogenic diet

The side effects of the ketogenic diet are extremely few, mainly temporary dysfunctions of the gastrointestinal tract (constipation) and a lack of certain vitamins, which can be easily corrected with the help of modern vitamin and mineral complexes. The need for daily monitoring of the child’s nutrition, the selection of special products and the exclusion of sugar from food can be considered as inconveniences, which causes a special protest from patients. But with appropriate training, the patient’s parents can learn to diversify the menu in such a way as not to cause a quick ” eating “, and the shortage of sweets is made up by the use of special sugar substitutes, which are now available in a large assortment. It is sometimes feared that eating high-fat foods increases the likelihood of atherosclerosis. Apparently, such phenomena can be observed in people with a hereditary predisposition, but the manifestations of atherosclerosis in children who received a ketogenic diet have not yet been found, especially since after the end of the diet, all biochemical processes quickly return to normal. In many countries, parents of children on a ketogenic diet come together to exchange literature, information and recipes.

What is the reason for the surge in interest in the ketogenic diet?

In the United States, until the 1980s, the diet was used only in some university hospitals, since most doctors did not have sufficient information about the principles of using the diet. The discovery of new antiepileptic drugs each time brought hope for an ever more complete cure of a wide variety of patients, but over time, scientists began to look for an additional remedy that could be effective in various forms of epilepsy and not cause severe side effects inherent in some drugs used in treatment severe forms of epilepsy. At this time, reports began to appear in the press about the effectiveness of a forgotten method of treatment, invented at the beginning of this century. New centers for the ketogenic diet began to be created, and a large number of scientific publications on this topic appeared in leading medical journals. Today, ketogenic diet centers are found all over the world, including in the former socialist countries – Poland, the Czech Republic, as well as in Latin America.

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