High-fat diet curbs childhood seizures

When medications fail, a fat laden diet with almost no carbohydrates can dramatically improve the condition of children who have seizures, a dietitian and a pediatric neurologist reported during a session titled “The Ketogenic Diet–New Successes for Ancient Therapy”, at the 79th Annual Meeting and Exhibition of the American Dietetic Association (October 20-24) in San Antonio, Texas.

This diet, known as a ketogenic diet, mimics the metabolic effects of fasting, known since ancient times to reduce seizures. To keep the body burning fat instead of stored carbohydrates, the diet is “very high in fat, low in protein, and has almost nonexistent sugar–lots of bacon, mayonnaise, peanut butter,” said David B. Sperry, M.D., clinical assistant professor of neurology and pediatrics at Southwestern Medical Center, Dallas, Texas.

Burning fat results in ketones, which “causes the brain to become less irritable, so there are fewer seizures,” explained Dr. Sperry.

“This diet has an astonishing success rate,” said Karen Amorde-Spalding, R.D., pediatric dietitian for the Ketogenic Diet Program at Children’s Hospital, Oakland, California. “In our program, nearly 70 percent of the children placed on the diet experienced significant improvement in seizure control while on reduced or no anti- epileptic drugs.”

Most children who need the ketogenic diet are brain damaged from accidents, disease, or congenital problems. “In a situation where you have brain damage from accident or meningitis, you will see lots of developmental delays,” explained Dr. Sperry.

Traditionally, medication was used to control the side effects and seizures. The negative effects of these medications include lethargy and sleeplessness, which are relieved by the diet.

Dr. Sperry said that this diet “really clears the air” about a child’s condition. “The brain becomes more susceptible to development as the number of seizures drops,” he said. “All these children become more alert, their personalities improve and a few are even totally seizure free. The child will still be brain damaged, but much more responsive and alert. Therefore, the children need less care, and face far fewer dangerous health-related problems.”

The ketogenic may sound attractive to the millions of Americans trying to eat less fat at the recommendation of health experts, but this is a therapeutic diet and NOT to be used by the general, healthy population, noted Dr. Sperry. “It’s even more rigorous than a diabetic diet,” he said. “Patients experience nausea and diarrhea. They cannot even take acetaminophen (Tylenol, etc) for a fever, because it contains sugar. These children cannot take any medication with sugar.”

But that’s no deterrent to the patients’ families. “This is a unique population. These families have been to hell and back,” Amorde-Spalding said bluntly. “Most of the children are very impaired and haven’t responded to any other therapy. Many are on multiple drugs, some of which have toxic effects.”

For these families, devising ways to encourage their child to eat lots of butter and mayonnaise is a minor challenge compared to the struggles they”ve faced over the years. “Toddlers and preschoolers are the majority of patients participating in out diet program, and they eat with their fingers and love to dip things,” she said. “So you give them a bit of broccoli or a bit of chicken and a mound of butter or mayonnaise. That’s not always successful with older children, but parents have become very clever at developing recipes for quiches or custards or omelets.

Seeing young patients improve on the ketogenic diet is a great reward. “Lots of kids are developmentally delayed,” Amorde-Spalding said, “but some of our patients are integrated into regular classrooms. Some can read–many can do the usual kid things. Our oldest success story is 11 years old and previously had horrible behavior problems. Now he is much, much better without the drugs. He’s attending school and his whole life has changed.”

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