Low-carb, high-fat diets may reduce epilepsy seizures

By Hannah Nichols / Published Thursday 30 October 2014

Approximately 60-65% of patients with epilepsy become seizure free with antiepileptic drug treatment. The remaining 35% are resistant to medications. However, a review of current research published in Neurology presents a promising alternative treatment for epileptic seizure reduction - diets high in fats and low in carbohydrates.
Researchers aimed to review the high-fat, low-carbohydrate ketogenic and modified Atkinsdiets for the treatment of refractory epilepsy(drug-resistant epilepsy) in adults. Both diets have proved successful in children, yet they are studied in adults insufficiently.

The modified Atkins diet and the ketogenic diet include high-fat foods such as bacon, eggs, mayonnaise, butter, hamburgers and heavy cream, with certain fruits, vegetables, nuts, avocados, cheeses and fish.

The ketogenic diet is restrictive, not very palatable and logistically difficult to execute. The Atkins diet has been modified for use in patients with tough-to-treat epilepsy as an easier-to-execute variety of the ketogenic diet.

The ratios of fat to carbohydrate and protein are as follows:

Ketogenic diet: 3:1 or 4:1 [fat]:[carbohydrate 1 protein] ratio by weight, with 87-90% of caloriesderived from fat
Modified Atkins diet: 0.9:1 [fat]:[carbohydrate 1 protein] weight ratio, with approximately 50% of calories derived from fat.
By contrast, the typical American diet derives about 50% of calories from carbohydrate, 35% from fat and 15% from protein. US governmental guidelines for adults recommend 45-65% calories from carbohydrates, 10-20% from fat and 10-35% from protein.

Study author Pavel Klein, MB BChir, of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, MD, and a member of the American Academy of Neurology, says:

"We need new treatments for the 35% of people with epilepsy whose seizures are not stopped by medications. The ketogenic diet is often used in children, but little research has been done on how effective it is in adults."

The scientists examined five studies of ketogenic diet treatment in 47 adults and five studies of modified Atkins diet treatment in 85 adults with refractory epilepsy.

Some patients achieved 50% or greater seizure reduction
Across all studies, 32% of ketogenic diet-treated patients and 29% of modified Atkins diet-treated patients achieved 50% or greater seizure reduction. Also, 9% of the ketogenic diet and 5% of the modified Atkins diet-treated patients achieved greater than 90% seizure reduction.