Ketogenic diet in epilepsy

Dr. Shankar Prasad Saha, Ex Prof., and HOD of Neurology, NRS Medical College, RG Kar Medical College, Kolkata, Faculty in Bangur Institute of Neurology

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Published: Sep 29, 2020 01:09:00 PM IST

Updated: Sep 29, 2020 04:37:01 PM IST

Ketogenic diet is strictly therapeutic directed weight control plan that might be a treatment choice for epilepsy. It includes a high fat and low carbohydrate diet that guarantees the body will principally consume fat as opposed to carbohydrate and protein for vitality, consequently delivering ketones. The brain can utilize ketones as an elective wellspring of vitality. Somehow or another, the eating routine copies the body's metabolic state during fasting or sickness. This high ketone state (ketosis) diminishes seizure movement in certain conditions by components which are not completely perceived. The eating routine purposely keeps up this elevated level of ketones by a carefully determined, singular routine with inflexible dinner plans.

Mechanism of ketogenic diet

At the point when an individual is on the ketogenic diet, their body doesn't get enough carbohydrate to consume for vitality, so it must utilize fat. Consuming fat for fuel causes ketones to build up in the body. When this happens, the body is in ketosis. To accomplish this, an individual must stick to the eating regimen for a significant period. Ketosis likewise happens during times of fasting. As a 2013 study report , individuals have utilized fasting as a seizure treatment for quite a long time, and researchers archived the impacts of this methodology into the 1920s.

How likely the diet is effective?

It is essential to have practical assumptions regarding the probability of dietary treatment helping in epilepsy. The ketogenic diet doesn't control seizures in all patients. In fact, just a moderately little extent of patient advantage altogether from the ketogenic diet. In the event that a wide range of epilepsy are thought of, a little more than one of every three patients will have more than 50 % reduction in their seizure recurrence. Another in three will have less than 50 % reduction in seizure recurrence and the remaining one of every three will have no adjustment in seizure recurrence. Less than one in ten will have more than a 90% reduction in seizures and less than one in twenty will become seizure free. However, a few types of epilepsy may react better, for example, such as absence epilepsy, myoclonic-atonic epilepsy (Doose syndrome), Dravet syndrome and infantile spasms.

Composition Ketogenic diet

The classic ketogenic diet comprises of a 4:1 proportion of grams of fat to grams of protein in addition to carbohydrate consolidated; 90% of the calories in the eating regimen originate from fat. Lower proportions, for example, 3:1 might be utilized in children. Calories might be limited at first to 80%-90% of the everyday suggestions for age however is balanced after some time to accommodate development. Fluid limitation is not, at this point thought about vital, and sufficient liquid admission is significant for prevention of dehydration (especially in hot weather), constipation, and kidney stones, the last two may occur with ketonic diet.

Risks and benefits

An altered ketogenic diet may give benefits beyond epilepsy management. Adults on the eating regimen may encounter enhancements in:

Alertness
Concentration
Psychological function
Quality of life

Children and adults who follow ketogenic diet must see their primary care physician or dietitian every 3 months. These normal visits are significant for observing advancement and development and checking for any antagonistic impacts of the eating routine.

Risks of a ketogenic diet include:

Constipation
Weight loss
High cholesterol or triglyceride levels
Lethargy
Kidney stones

Since the diet allows for few fruits, vegetables, grains, and other nutritious foods, supplementation with a carbohydrate-free multivitamin is essential.

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