The ketogenic diet is a high-fat, low carbohydrate diet therapy used to improve seizure control in patients with epilepsy whose seizures do not respond to traditional seizure medications alone. Ketogenic diets are designed to promote nutritional ketosis, a metabolic state in which the body switches to burning fat as an energy source rather than carbohydrate (sugar and starch).
The main types of diet therapies used to treat epilepsy are:
- Classic Ketogenic Diet
- Modified Atkins Diet (MAD)
- Low Glycemic Index Treatment (LGIT)
Ketogenic diet therapy can be considered a broad-spectrum treatment potentially improving almost any type of medication-resistant epilepsy. While complete seizure freedom may not be achieved, patients may experience one or more of the following:
- Lower number of seizures
- Less severity and intensity of seizures
- Shorter duration of seizures
- Lower dose and/or decrease in number of anti-seizure medications
Ketogenic diet therapies are considered safe and effective when initiated and supervised at a specialized epilepsy center with a skilled diet therapy team. Potential side effects from diet therapy include low blood sugar, excessive blood acidity, nausea, constipation, kidney stones and nutritional deficiencies.
The UCLA Diet Therapy Program includes an epileptologist, nurse practitioner and trained ketogenic dietitians. Each patient is closely monitored by the nurse practitioner and ketogenic dietitian to ensure that side effects are minimized, and food intake is appropriate to maintain growth.
Patients require a referral from their neurologist for an initial consultation in the UCLA Ketogenic Diet Therapy clinic. Prior to starting diet therapy, blood and urine laboratory tests must be performed to screen for any genetic conditions or nutritional deficiencies that may be worsened by diet therapy.
Historically, the ketogenic diet has mainly been considered a treatment for pediatric epilepsy, but it is now being used more often in adults. The UCLA Ketogenic Diet Therapy Program offers diet therapy for both children and adults with medically refractory epilepsy and is also exploring the use of diet therapy for other neurologic and medical conditions.