What is the ketogenic diet?
The ketogenic diet is used in the management of epilepsy that doesn’t respond to medication. It is another way of trying to help improve your seizures or even possibly stop them altogether. It is the complete opposite to what you may think of as a healthy balanced diet. It is a special diet which is very high in fat, low in carbohydrate and with enough protein for growth and repair of body tissues.
How does the ketogenic diet work?
In the ketogenic diet, the aim is to change the way your body works by encouraging it to use fat instead of carbohydrate as its main source of energy. When carbohydrate is eaten, it is broken down (metabolised) by the body to produce glucose to fuel your brain and other body cells. When the body breaks down fat it produces ketone bodies instead of glucose as the main energy source. It is these ketones that seem to stop or reduce seizures although how or why this happens is not fully understood.
The ketogenic diet involves eating only very small amounts of carbohydrate foods (sugars & starches e.g. chocolate, sweets, bread, potato, pasta etc.) and a lot of fat (e.g. mayonnaise, butter, oil etc.) every day. It is very important you eat enough of the foods high in fat to enable your body use this for energy instead, by producing sufficient ketones.
The ketogenic diet is tailored to meet individual requirements. It may require some adjustment or ‘fine tuning’ to make it just right for you to achieve the best level of ketones to help with seizure reduction. If the ketogenic diet is effective after an initial 3-month trial period, people with drug resistant epilepsy usually stay on it for up to 2 years, then may be advised to return to a normal diet. However if necessary, you can stay on the diet for longer.
For those with the metabolic conditions Glucose Transporter type 1 (Glut-1 DS) and pyruvate dehydrogenase deficiency syndrome (PDHD), the ketogenic diet is used as first line management and you will be advised to continue with it long term.
It is very important that the ketogenic diet is undertaken alongside medical and nutritional supervision. For more detailed information about the ketogenic diet please refer to your ketogenic team.
Who is the ketogenic diet for?
The ketogenic diet is for the dietary management of epilepsy that doesn’t respond to medication in children and young people when two or more anti-epileptic drugs (AEDs) have failed. The diet has also worked for adults that do not respond to medication and there are developments for its use in other neurological disorders.
The ketogenic diet is not effective for everyone and there can be varying degrees of success. For some it may result in complete seizure control. For others, improved seizure control may be achieved, and possibly fewer side effects than other treatments, enabling a better quality of life. You should determine your own personal goals for the diet along with your dietitian and ketogenic team to ascertain whether the diet is working for you.
You will likely have to continue with your medication when starting the diet. However, if the diet is helpful in the management of your epilepsy, your ketogenic team may review the amount of medication that you need, and may recommend they be slowly withdrawn.
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