November is not only the month to raise awareness on men’s health and prostate cancer, it is also Epilepsy Awareness Month, during which people try to spread the word on epilepsy, why it happens, what to do if someone has a seizure, how epilepsy can be treated, etc…

In this blog article, we will be talking about the ketogenic diet and how it is used as a treatment option for people whose seizures could not be controlled with at least 2 anti-epileptic drugs. The diet can help reduce the severity of seizures as well as their occurrences.

Epilepsy is not just one condition, but a group of many different ‘epilepsies’ with one thing in common: a tendency to have seizures that start in the brain. Anyone can develop epilepsy at any time of life. It happens in people of all ages, races and social classes and it is most commonly diagnosed in children and in people over 65. You can learn more about epilepsy here.

What is the ketogenic diet?
It is a high fat, low carbohydrate, controlled protein diet that has been used since the 1920s for the treatment of epilepsy. With this diet, the body uses fat as a source of energy through a process called ketosis, and produces chemicals called ketones, as well as a fatty acid called decanoic acid which contributes to the control of seizures.

There are several types of ketogenic diets that are effective in controlling seizures such as the classical diet which includes very little carbs and protein, and most of the fat in it comes from butter, cream, oil and other natural fatty foods. Another diet is the medium-chain triglyceride (MCT) diet. This diet allows for more carbs, and the fat comes from naturally fatty foods and from a supplement of MCT oil which is only available by a doctor’s prescription.

It’s important for the patient to get nutritional guidance from an experienced dietitian to ensure the diet is nutritionally balanced. The dietitian can give customized recipes as well as which food to avoid, and if any vitamin supplements are needed.

Does the ketogenic diet really work for epilepsy?
A clinical trial at Great Ormond Street Hospital in 2008 showed that 38% of children who started the diet had the number of their seizures reduced by over half, and were able to reduce their medication. Although not all children had better seizure control, some had other benefits such as increased alertness, awareness and responsiveness.

Christelle Bedrossian
Dietitian-Nutritionist
Beirut, Lebanon