How Does LC Diet Cure Epilepsy in Children?

[StLouisTom]

LC literature reminds us over and over that a low carb diet helps children with severe epilepsy, actually curing a good number of them. It's usually presented as a "proof" of the safety of the diet. In all my reading though, I don't recall anyone addressing WHY the diet works for these children. A thread on this forum mentioned that even some adult epileptics benefit from the diet.

I wonder what the mechanism of this diet cure is. And is there some brain benefit for those of us without epilepsy? Does anyone know how this works?

[Nancy LC]

Well, there's been some research into ketogenic diets to treat alzheimer's too. I don't think they really know WHY for sure ketogenic diets work on some epileptics.

I personally think there could be several things at work here, one is the brain prefers to run on ketones. Having too much glucose might be really bad on the brain. And my pet theory is that some people have food intolerances that actually attack the brain. In some people they have neurological issues with Gluten. It actually causes calcifications on the brain. There have been documented cases of gluten sensitivity causing seizures: http://www.aafp.org/afp/980301ap/pruessn.html

If you click the link on "The Gluten File" in my signature and on the right hand side, look for "Neurologic Manifestations" you'll see an amazing collection of work linking numerous brain disorders to gluten or celiac disease.

My suspicion is that gluten isn't the only thing we eat that can cause problems, but it is one we know about.

What's piqued your interest in this?

[dina1957]

LC literature reminds us over and over that a low carb diet helps children with severe epilepsy, actually curing a good number of them. It's usually presented as a "proof" of the safety of the diet. In all my reading though, I don't recall anyone addressing WHY the diet works for these children. A thread on this forum mentioned that even some adult epileptics benefit from the diet.

I wonder what the mechanism of this diet cure is. And is there some brain benefit for those of us without epilepsy? Does anyone know how this works?

What the Diet Does

Normally, our bodies run on energy from glucose, which we get from food. We can't store large amounts of glucose, however. We only have about a 24-hour supply.

When a child has no food for 24 hours -- which is the way the diet begins, usually in a hospital -- he or she uses up all the stored glucose. With no more glucose to provide energy, the child's body begins to burn stored fat.

The ketogenic diet keeps this process going.

It forces the child's body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting.

In fact, the diet gets most (80 percent) of its calories from fat. The rest comes from carbohydrates and protein.

Each meal has about four times as much fat as protein or carbohydrate. The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person.

Doctors don't know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others.






Side Effects

Like all the other treatments for epilepsy, the ketogenic diet has some side effects, which may or may not affect a particular child. Some side effects may go away if caught and managed early on. Knowing what to look for can make a big difference.

Reported side effects include dehydration, constipation, and, sometimes, complications from kidney stones or gall stones.

Adult women on the diet may have menstrual irregularities. Pancreatitis (inflammation of the pancreas), decreased bone density and certain eye problems have also been reported. Again, this is why the medical team closely follows children or adults who are on the diet.

The diet lacks several important vitamins which have to be added through supplements.

Sometimes high levels of fat build up in the blood, especially if a child has an inborn defect in his ability to process fat. This possibility can lead to serious effects, which is another reason for careful monitoring.

http://www.epilepsyfoundation.org/answerplace/Medical/treatment/diet/ketosidefx.cfm



HTH

[dina1957]

Well, there's been some research into ketogenic diets to treat alzheimer's too. I don't think they really know WHY for sure ketogenic diets work on some epileptics.

I personally think there could be several things at work here, one is the brain prefers to run on ketones. Having too much glucose might be really bad on the brain.
This is true that having too much glucose can be fatal ( at a very high levels) but if having slihgtly elevated BGs would lead to epilepsy and seizures, most of the T2 will become epileptics. Actually, to the contrary, seizures develop mostly in T1, who are known to suffer from hypoglycemic coma, when BG drops <40. Also, T2 on insulin fall into this cathegory but it is rather rare occurance. Low blood sugar not high is what causes seizures, which are rather a symptoms of epillepsy but not the cause. Epilepsy can be cause by brain trauma and/or infections.

Etiology of epilepsy

Epilepsy is often, but not always, the result of an underlying brain disease. Any type of brain disease can cause epilepsy, but not all people with the same brain disease will have epilepsy. In view of the fact that only a proportion of people who have a brain disease experience seizures as a symptom of that disease, it is suspected that those who do have such symptomatic seizures are more vulnerable due to biochemical/neurotransmitter reasons.


There are still many people for whom the cause of their epilepsy cannot, as yet, be identified. In such cases, the theory most commonly accepted is that this epilepsy is the result of an imbalance of certain chemicals in the brain (especially chemical messengers known as neurotransmitters) causing them to have a low convulsive threshold.


Children and adolescents are more likely to have epilepsy of unknown or genetic origin. The older the patient, the more likely it is that the cause is an underlying brain disease, such as a brain tumour or cerebrovascular disease, or is the result of head injury.


Trauma and brain infection can cause epilepsy at any age, and as mentioned previously may account for a higher incidence of epilepsy in developing countries. For example, a common cause in Latin America is neurocysticercosis cysts on the brain caused by tapeworm infection, while in Africa, malaria and meningitis are common causes, and in India neurocysticercosis and tuberculosis often lead to epilepsy.


Febrile illness of any kind can trigger seizures in young children. About 3% of children who have febrile convulsions go on to develop epilepsy in later life.
http://www.who.int/mediacentre/factsheets/fs165/en/

[StLouisTom]

What's piqued your interest in this?

I was reading a post (War Zone) I think where someone mentioned the topic, and it just got me wondering. My dad died of Alzheimer's last year, and I've heard some people say Alzheimer's may be "diabetes of the brain", so I'm interested in the effect of the diet on the brain.

[StLouisTom]

"Doctors don't know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others."

So I guess no one really knows why it works. Also interesting that they say the diet "mimics starvation". Critics of a LC diet (i.e. Dr. McDougall) use this as an argument against LC diets. They say you're "starving yourself" on the diet, and "making yourself sick", etc.

[Dodger]

"Doctors don't know precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some children and not for others."

So I guess no one really knows why it works. Also interesting that they say the diet "mimics starvation". Critics of a LC diet (i.e. Dr. McDougall) use this as an argument against LC diets. They say you're "starving yourself" on the diet, and "making yourself sick", etc.'Mimics starvation' just means that it allows the person to use ketones for energy.

[durhamgirl]

from http://pediatrics.aappublications.org/cgi/content/full/105/4/e46

Various theories have postulated that: 1) there is a direct "stabilizing effect of ketone bodies on the central nervous system; 2) resulting acidosis accompanying ketosis modifies the seizure threshold; 3) changes in fluid and electrolyte balance result in reduced seizures; and 4) change in lipid concentration induced by the diet has an antiseizure effect...."

One study showed that a byproduct of ketosis called beta-hydroxybutyrate (BHB) inhibits seizures in animals.

another good article, on ketosis as a treatment for brain cancer - below -- has more info on brain changes during ketosis...
http://www.nutritionandmetabolism.com/content/2/1/30
"Hence diet therapies, which lower glucose availability and elevate ketone bodies, can reduce brain tumor growth through integrated anti-inflammatory, anti-angiogenic and pro-apoptotic mechanisms."

[Nancy LC]

I was reading a post (War Zone) I think where someone mentioned the topic, and it just got me wondering. My dad died of Alzheimer's last year, and I've heard some people say Alzheimer's may be "diabetes of the brain", so I'm interested in the effect of the diet on the brain.
I'm so sorry. My own father was very afflicted at the end of his life too. He passed away last year too. Although the immediate cause of death was probably due to strokes, I think if you had to characterize what his actual illness was, it was insulin resistance. And I've got a ton of relatives (aunts, uncles) that also have it or died from it (alzheimer's).

There has been a lot about this posted in the Research area, I bet if you did a search you'd come up with the stuff.

[Nancy LC]

Hey, just ran across something: http://www.glutenfreeforum.com/index.php?showtopic=27453
Epilepsy and Celiac Disease: Favorable Outcome With a Gluten-Free Diet in a Patient Refractory to Antiepileptic Drugs. Neurologist. 2006 Nov;12(6):318-321

[cs_carver]

I'm thinking some of my diabetic friends used to carry glucagon for times when their blood sugar crashed--high sugars do slow long term damage; low sugars cause death pretty quickly. So what's with TypeI that would render one's own body incapable of kicking out enough glucagon to dump some sugar into the blood? Could be part of the problem.

+1 on the ketones but also insulin stabilization. Without doing any tangible research on this question, it simply appears that insulin runs roughshod over everything and it wouldn't be far-fetched to think that some people with epilepsy have a different sensitivity to the effects of that hormone. A LC diet would keep insulin out of the picture.

[kebaldwin]

Dina1957:

Be careful of the "dangerous side effect" studies done on low carb diets. Normally these studies only last 7, 10, 14 days when your body if freaking out. They usually don't look at the long (6+ months) effects.

For the first two weeks of a low carb diet - your body is freaking out - and anything someone tells me - I would believe. But studies need to wait at least eight weeks before they start analyzing "pros and cons".

BUt a lot of doctors / researchers / anti low carb people realize that if they waited that long -- their results would show overwhelming positives for low carbing.

[dina1957]

Dina1957:

Be careful of the "dangerous side effect" studies done on low carb diets. Normally these studies only last 7, 10, 14 days when your body if freaking out. They usually don't look at the long (6+ months) effects.

For the first two weeks of a low carb diet - your body is freaking out - and anything someone tells me - I would believe. But studies need to wait at least eight weeks before they start analyzing "pros and cons".

BUt a lot of doctors / researchers / anti low carb people realize that if they waited that long -- their results would show overwhelming positives for low carbing.
Iam not sure what do you mean by me being careful about posting "dangerous side effects", I just quoted information provided.
FYI, ketogenic diet used to treat seizures, is a bit different than just regular low carb diet and even Atkins Induction level. It is about 90% fat. The rest is protein and almost no carbs. The ketone levels should be very high, this is whole purpose since ketones suppress seizures, so it is suggested to reduce water intake initially (not like drinking about a gallon a day on Atkins). Heavy cream diluted with a bit water is given at every meal to assure high fat intake.
A child is placed in a hospital for at least few days (depending on severity of seizures) to establish correct ration and make sure child is OK. The side effects were reported, not a results of some sloppy anti-carb study conducted for a couple of weeks.;)

The ketogenic diet is not a do-it-yourself diet. It is a serious form of treatment that, like other therapies for epilepsy, has some side effects that have to be watched for.

Normally, if the diet works those children follow diet for a long time, at least, for a couple years, so the side effects are quite real.

[kebaldwin]

Iam not sure what do you mean by me being careful about posting "dangerous side effects", I just quoted information provided.

Sorry if it sounded like I was giving you a hard time - I did not mean to.

Some of the info you qouted talked about

Like all the other treatments for epilepsy, the ketogenic diet has some side effects, which may or may not affect a particular child. Some side effects may go away if caught and managed early on. Knowing what to look for can make a big difference ...

my point was ... many of these problems do not exist for properly trained people on a ketogenic diet. I was warned about most of these problems and more.

But if people with Epilepsy on a ketogenic diet is different than a type 2 diabetic - then I wish Dr Atkins was here to explain it.

[dina1957]

my point was ... many of these problems do not exist for properly trained people on a ketogenic diet. I was warned about most of these problems and more.

But if people with Epilepsy on a ketogenic diet is different than a type 2 diabetic - then I wish Dr Atkins was here to explain it.
The difference IMHO, is that ketogenic diet is a broad term to define fat burning mechanism, but a degree of ketosis is different. One can eat less than 100 g and still show some ketones, but it is not enough let's say to prevent seizures in epileptic child, they need a very high level of ketones. Diabetics not necessarily need to be in ketosis, they just need to reduce carbs intake per meal, and the number varies from one diabetic to another. No need for T2 to be in ketosis to obtain a good BGs control.:)