Latest Update on Ketogenic Diet (Dr. Kossof)

[KarenB]

This podcast interview was done with Dr. Sirven and Dr. Kossof

http://www.blogtalkradio.com/epilepsy/2013/01/30/latest-update-on-ketogenic-diet

Dr. Kossof said that the typical response rate of children to the Ketogenic diet is around 50% of children see improvement and about 10% become completely seizure free.

However, in the past 10 years, studies have shown that certain childhood seizures (he mentioned Glut-1 deficiency, infantile spasms, Dravet, Doose, and several others) have an incredibly high response to the Ketogenic diet -- as high as 90%.

He said that the perception of considering the diet as a last-ditch effort after a child has failed 5 or 6 medications is no longer the case -- that the diet is now being used as FIRST LINE treatment for a number of childhood epilepsies.

He also said that the diet is no longer restricted to children, and that the Modified Atkins Diet is now being successfully used with adults.

 

[Nakamova]

It makes so much sense to try the diet FIRST rather than last. Why treat the symptoms with a sledgehammer (meds), when you have a chance of preventing them in the first place with dietary changes? I know the ketogenic diet isn't easy, but it's great to hear that it's truly worth it, and that it's racking up a lot of successes along with the Modified Atkins Diet.

 

[KarenB]

Indeed. That 50% response rate is among children with intractible epilepsy that has not responded to medication (and usually by time they get to the diet, they've gone through 5 or 6 meds without relief).

Back when the diet was first being developed about 100 years ago, the response rate was much higher, in part because it wasn't just being used on kids who were considered "hopeless" -- but as a first line treatment because there were hardly any seizure meds out there at the time.

But then, when more seizure meds were developed, the diet fell by the wayside. AFter all, it's much easier to pop a pill that be on a restricted diet. However, as most of us have experienced, the side effects of these meds are often horrific. Cognitive decline, horrible mood swings, aggression, depression, loss of speech, liver damage -- and the list goes on and on. While the Ketogenic diet does have some side effects, it is so much gentler than ANY of the seizure meds currently on the market.

And, a number of children have had complete seizure control and eventually been able to wean off the diet and be med free, diet free and seizure free.

 

[CathyAnn31]

That's very interesting to read. I wonder if it would help
ADHD also.

Thanks for sharing.

 

[KarenB]

Maybe. Jon's first nutritionist said that she had a number of patients who had marked behavior improvement and better attention span after starting the diet. Many other medical professionals have indicated this is often the case with kids who have both epilepsy and ADHD (which commonly go together, although in our experience, it's often a bi-product of meds).
http://www.ncbi.nlm.nih.gov/pubmed/16750194

The question is, would it help a child who does not have epilepsy but does have ADHD? I wasn't able to find any studies to that end, although a lot of parents seem to be going that route. Also, for autism.

A literature review was recently published in Pediatrics journal regarding the diet factor in ADHD. Studies found about a 60% positive response rate in kids with ADHD who eliminated certain common allergens from their diet -- such as wheat, dairy, eggs, chocolate, nuts and citrus fruits.

A lot of these foods would be pretty much eliminated in the classic version of the Ketogenic diet anyway -- no wheat, dairy is pretty much restricted to cream, butter and cheese (and these types of dairy have very restricted levels of lactose, which is the allergen trigger in dairy), chocolate would be largely eliminated because of the sugar (although pure cocoa is allowed, as is sugar-free chocolate), citrus fruits have too many carbs for the diet. So, the only high allergen foods that remain are eggs and nuts.

The Ketogenic Diet would be helpful in maintaining a steady blood glucose level, avoiding the sugar spikes and then crashes associated with kids consuming high sugar foods (like soft drinks, candy, etc.).

 

[Bernard]

Good stuff Karen. Thanks for sharing. Wish there were more docs out there like Dr. Kossof. Now if we can only get a "unified diet theory". Hopefully Paolo's research is paying off in that repsect.

 

[KarenB]

Yes Bernard, I would especially like to see the diet get bumped up OVER aroma therapy in your chart of non-medical therapies for seizures.

There is a ton of studies out there indicating the high efficacy (just as high as any med, and sometimes better) of the Ketogenic diet for INTRACTIBLE seizures in children (50% response rate overall, and up to 90% with some types of epilepsy), and now a few studies for adult epilepsy.

I haven't really seen any studies on aroma therapy having such a stellar track record.

As far as a "unified diet theory" -- do you mean in regard to seizures?

My ideas on that (based on consultations with nutritionists and my own research) is that the strict Ketogenic diet may not be necessary for a lot of people. If I had epilepsy, I would follow a progression something like this, one thing at a time for about 2 to 4 weeks each, to see if it works:
1) Eliminate wheat
2) Reduce carbohydrate intake to about 150 carbs a day, and make sure carbs that are consumed are whole grains or beans or fruit or vegetables (to regulate blood sugar)
3) Give a 2 week trial in eliminating common food allergens (dairy, eggs, nightshade vegetables, peanuts, seafood). If no response, they can be added back in.
4) Try to take processed foods (esp. those with MSG and nitrates -- like sausage) out

If getting some relief from these steps, then consider Ketogenic diet (or Modified Atkins for adults)