BBC News Online
London, UK
3 May, 2008


Diet treatment call for epilepsy


A special high-fat diet helps to control fits in children with epilepsy, a UK trial suggests.

The number of seizures fell by a third in children on the "ketogenic" diet, where previously they had suffered fits every day despite medication.

The diet alters the body's metabolism by mimicking the effects of starvation, the researchers reported in the Lancet Neurology.

The researchers called for the diet to be more widely available on the NHS.

It is the first trial comparing the diet with routine care, even though it has been around since the 1920s.

Children are given a tailored diet very high in fat, low in carbohydrate and with controlled amounts of protein.

It is not exactly clear how it works but it seems that ketones, produced from the breakdown of fat, help to alleviate seizures.

A total of 145 children aged between two and 16 who had failed to respond to treatment with at least two anti-epileptic drugs took part in the study.

Half started the diet immediately and half waited for three months.

The number of seizures in the children on the diet fell to two-thirds of what they had been, but remained unchanged in those who had not yet started the diet, the researchers reported.

Five children in the diet group saw a seizure reduction of more than 90%.

However, there were some side-effects including constipation, vomiting, lack of energy and hunger.

Availability

Professor Helen Cross, study leader and consultant in neurology at Great Ormond Street Hospital in London, said the diet had been around for a long time but had fallen out of favour because it was thought to be too difficult to stick to.

"The parents say the first two weeks are quite difficult, but then it becomes much easier because you can make foods in bulk and it especially helps if you can see the benefits from it," she said.

"We have to be sensible about it, in this study we had children who had complex epilepsy.

"If your epilepsy is easily controlled on one medication then I wouldn't advocate the diet, but if at least two drugs have failed then it should be considered."

She said national guidelines recommend the diet as a treatment option, but a shortage of dieticians meant it was often unavailable.

A spokesperson for Epilepsy Action said: "The results of this trial add valuable information to what is already known about the diet, presenting evidence that it works for some children with drug-resistant epilepsy.

"In addition to this, however, we also recognise that the ketogenic diet is not without its side-effects, and that the risks and benefits should be considered before prescribing, as with drug treatment."

She said the results would hopefully encourage wider inclusion of the diet in the management of children with drug-resistant epilepsy.






http://news.bbc.co.uk/1/hi/health/7378178.stm

BBC News Online
London, UK
3 May, 2008


'Within days she seemed calmer'

A UK trial has for the first time shown a ketogenic diet can reduce fits in children with epilepsy, compared with standard treatment.

The results prompted the researchers to call for wider availability of the diet on the NHS.

Rachel Farrand, 38, from Redhill in Surrey, says she feels incredibly lucky to have been able to get her six-year old daughter, Ella, on to the diet.

Ella was a healthy baby until the week before her first birthday, when she was

admitted to hospital with pneumococcal meningitis.

The infection left her profoundly deaf and, although she was fitted with a cochlear implant to restore her hearing, it became obvious she also had learning difficulties.

She also started to have seizures - where her arms would extend and stiffen - and just over a year after her meningitis she was diagnosed with epilepsy.

The seizures seemed to happen after the sudden appearance of people and objects - literally when Ella was startled - and she would quite often fall to the ground.

She would be dazed afterwards and if a few fits happened close together she would need to have a sleep.

An EEG of the brain showed her brain waves were "very abnormal", Rachel explained.

Anti-epileptic drugs did nothing to control her symptoms and turned her into a "zombie".

'Different child'

Shortly after her fourth birthday, the seizures stopped and Ella was able to concentrate and was much more interested in what was going on around her, as well as responding to sounds.

But after a few months the seizures came back and, having seen the difference in her when she was seizure-free, her parents decided to try the ketogenic diet.

Ella has to eat three-and-a-half parts fat to every one part protein and carbohydrate.

She has three strictly-controlled meals and two snacks a day, which all have to be measured to be the correct ratio and the correct number of calories.

"Within days she seemed calmer and began sleeping better," says Rachel.

"Her concentration and focus improved and once again she was like a different child."

After six weeks on the diet her seizures stopped and tests showed her brain activity was much calmer.

"It's tricky at first but once you get in the swing of things it's fine.

"I can now make up a ketogenic meal quite quickly, it's just become a way of life."

The family make sure they do not snack in front of Ella, and her younger brother Alfie is adept at having "sneaky snacks" out of view of his sister.

Ella's parents were able to wean her off her remaining anti-epileptic drugs with no adverse effects.

"She continues to be hard work, and her progress will always be slow and erratic, but losing the seizures means we have one less thing to contend with," Rachel says.

Recently Ella was diagnosed with premature puberty - another result of the meningitis - and as a result her seizures started to come back, although they are much less severe.

Rachel hopes they will be able to get back on track soon.

"We're still seeing such improvements and when we took her off the drugs we saw the little girl underneath - she's much brighter and sparkier.

"We were so lucky - people fight for years to get their children on the diet. Hopefully with this research the NHS will put more money in."


A TYPICAL DAY'S FOOD

Breakfast - mushroom omelette, small bowl of raspberries and clementines, and a hot chocolate
Lunch - thai stir fry with quorn, courgette, onion and peppers and a strawberry milkshake
Dinner - roast chicken with cabbage, broccoli and carrots, small bowl of strawberries and vanilla ice cream
Snacks - ketogenic coconut cookie (with ground almonds instead of flour), ketogenic chocolate (plain chocolate mixed with creamed coconut)


http://news.bbc.co.uk/1/hi/health/7380655.stm

The Independent
London, UK
3 May, 2008


'Extreme Atkins' diet can treat epilepsy in children

Doctors have confirmed that a special high-fat diet can help children seriously afflicted with epilepsy.


Among children given the diet, seizures dropped by more than a third over a three-month period.

At the same time, children not given the diet experienced a more than 33 per cent rise in seizures.

The ketogenic diet has been successfully used to treat children with drug-resistant epilepsy since the 1920s. However, this was the first time it had been tested in a randomised trial.

The diet consists of large amounts of fat, little carbohydrate and controlled amounts of protein.

It is thought to mimic the biochemical response to starvation, when ketone bodies fuel the brain rather than sugar.

Ketone bodies, used as an energy source for the heart and brain, are compounds produced when fatty acids are broken down in the liver and kidneys. They provide a vital energy lifeline when fasting.

The trial, based at the Institute of Child Health at Great Ormond Street Hospital in London, involved 145 children aged two to 16, who suffered epilepsy fits at least one a day or more than seven times a week.

Around half the children were assigned a ketogenic diet immediately. The other half were given the diet after a delay of three months.

In the diet group, the number of seizures dropped by more than a third. Children who had to wait before having a ketogenic diet saw the number of seizures they suffered rise by about the same amount.

A total of 28 children in the diet group saw a more than 50% seizure reduction. Five children on the ketogenic diet had their seizures cut by more than 90% compared with none in the comparison group.

The findings are reported in the journal The Lancet Neurology.

Study authors Professor Helen Cross from the Institute of Child Health, and research dietician Dr Liz Neal wrote: "The ketogenic diet has not had the same kudos as medication, because it has been claimed there is no evidence base, and it is thought to be difficult to adhere to. In fact, this trial shows it is as effective as any new anti-convulsant drug. If this was a new drug we had tried, regulators would be making it freely available.

"In view of this we believe that the diet should be more widely available as a treatment on the NHS, for children with epilepsy who have failed to respond to anti-convulsant medication. We stress this is a diet which should only be undertaken on medical advice and under medical and dietetic supervision." The most frequent side effects associated with the diet were constipation, vomiting, lack of energy and hunger.

In an accompanying commentary, Dr Max Wiznitzer, from the Rainbow Children's Hospital in Cleveland, Ohio, US, said more information was needed about the long-term effects of the ketogenic diet.

He added: "Better identification of epilepsies that benefit from starting early on the ketogenic diet and comparisons between the choices of ketogenic diet are needed."


http://www.independent.co.uk/life-s...ren-820466.html

Thanks Demi, seems this diet has been around since 1920s. One of the side effects is constipation...hope they are feeding some fruit and veg to these children. I'd rather be a bit bunged up than suffer a seizure

Nicol

You beat me to it Demi. I just heard this on the radio and got all excited!

Remember the movie "First Do no Harm?" It was based on a true story, about a family who discovers the diet is the ONLY way to help their son.

"The researchers called for the diet to be more widely available on the NHS."

If epileptics and their carers wait for that to happen they'll wait a very long time. But why wait? The researchers and the writers of the articles are obviously unaware of the work done by Dr Eric Kossoff and others in using the Atkins Diet (or a modified version of it) in epilepsy. The 'ketogenic diet' as used traditionally in epilepsy is more restrictive than the Atkins Diet, but Dr Kossoff has found it doesn't need to be. He's also found that epileptic kids don't need to be hospitalized for an initial fast - their carers can more or less just get the Atkins book and follow it (under the epilepsy consultant's supervision).

Here are summaries of Dr Kossoff's studies which I put together on this topic on my website recently:

'A modified Atkins Diet is an effective and well-tolerated therapy for intractable pediatric epilepsy.'
Kossoff, E.H., McGrogan, J.R., Bluml, R.M., Pillas, D.J., Ruberstein, J.E., Vining, E.P., 'A modified Atkins Diet is an effective and well-tolerated therapy for intractable pediatric epilepsy', Epilepsia, 2006, 47(2):421-424.

'The ketogenic diet is effective for treating seizures in children with epilepsy. The Atkins Diet can also induce a ketotic state, but has fewer protein and caloric restrictions, and has been used safely by millions of people worldwide for weight reduction. ... This provides preliminary evidence that the Atkins Diet may have a role as therapy for patients with medically resistant epilepsy.'
Kossoff, E.H., Krauss, G.L., McGrogan, J.R., Freeman, J.M., 'Efficacy of the Atkins diet as therapy for intractable epilepsy', NEUROLOGY, 2003;61:1789-1791.

'The ketogenic diet is effective for treating seizures in children with epilepsy. The Atkins Diet can also induce a ketotic state, but has fewer protein and caloric restrictions, and has been used safely by millions of people worldwide for weight reduction. ... This provides preliminary evidence that the Atkins Diet may have a role as therapy for patients with medically resistant epilepsy.'
Kossoff, E.H., Krauss, G.L., McGrogan, J.R., Freeman, J.M., 'Efficacy of the Atkins diet as therapy for intractable epilepsy', NEUROLOGY, 2003;61:1789-1791.

'Only a decade ago the ketogenic diet was seen as a last resort; however, it has become more commonly used in academic centres throughout the world even early in the course of epilepsy. The Atkins diet is a recently used, less restrictive, therapy that also creates ketosis and can lower the number of seizures.'
Kossoff, E.H., 'More fat and fewer seizures: dietary therapies for epilepsy, THE LANCET Neurology, 2004, 3:415-20

Jackie

This is creating a buzz in UK. Of course nobody calls it LC diet, the sample menu in very interesting and I am sure very familiar to folks on this forum.
********
A UK trial has for the first time shown a ketogenic diet can reduce fits in children with epilepsy, compared with standard treatment.

The results prompted the researchers to call for wider availability of the diet on the NHS.

Rachel Farrand, 38, from Redhill in Surrey, says she feels incredibly lucky to have been able to get her six-year old daughter, Ella, on to the diet.

Ella was a healthy baby until the week before her first birthday, when she was

admitted to hospital with pneumococcal meningitis.

The infection left her profoundly deaf and, although she was fitted with a cochlear implant to restore her hearing, it became obvious she also had learning difficulties.

She also started to have seizures - where her arms would extend and stiffen - and just over a year after her meningitis she was diagnosed with epilepsy.

I can now make up a ketogenic meal quite quickly, it's just become a way of life

Ella's mother, Rachel Farrand

The seizures seemed to happen after the sudden appearance of people and objects - literally when Ella was startled - and she would quite often fall to the ground.

She would be dazed afterwards and if a few fits happened close together she would need to have a sleep.

An EEG of the brain showed her brain waves were "very abnormal", Rachel explained.

Anti-epileptic drugs did nothing to control her symptoms and turned her into a "zombie".

'Different child'

Shortly after her fourth birthday, the seizures stopped and Ella was able to concentrate and was much more interested in what was going on around her, as well as responding to sounds.

But after a few months the seizures came back and, having seen the difference in her when she was seizure-free, her parents decided to try the ketogenic diet.

Ella has to eat three-and-a-half parts fat to every one part protein and carbohydrate.

She has three strictly-controlled meals and two snacks a day, which all have to be measured to be the correct ratio and the correct number of calories.

"Within days she seemed calmer and began sleeping better," says Rachel.

"Her concentration and focus improved and once again she was like a different child."

A TYPICAL DAY'S FOOD
Breakfast - mushroom omelette, small bowl of raspberries and clementines, and a hot chocolate
Lunch - thai stir fry with quorn, courgette, onion and peppers and a strawberry milkshake
Dinner - roast chicken with cabbage, broccoli and carrots, small bowl of strawberries and vanilla ice cream
Snacks - ketogenic coconut cookie (with ground almonds instead of flour), ketogenic chocolate (plain chocolate mixed with creamed coconut)
After six weeks on the diet her seizures stopped and tests showed her brain activity was much calmer.

"It's tricky at first but once you get in the swing of things it's fine.

"I can now make up a ketogenic meal quite quickly, it's just become a way of life."

The family make sure they do not snack in front of Ella, and her younger brother Alfie is adept at having "sneaky snacks" out of view of his sister.

Ella's parents were able to wean her off her remaining anti-epileptic drugs with no adverse effects.

"She continues to be hard work, and her progress will always be slow and erratic, but losing the seizures means we have one less thing to contend with," Rachel says.

Recently Ella was diagnosed with premature puberty - another result of the meningitis - and as a result her seizures started to come back, although they are much less severe.

Rachel hopes they will be able to get back on track soon.

"We're still seeing such improvements and when we took her off the drugs we saw the little girl underneath - she's much brighter and sparkier.

"We were so lucky - people fight for years to get their children on the diet. Hopefully with this research the NHS will put more money in."
http://news.bbc.co.uk/2/hi/health/7380655.stm

A special high-fat diet helps to control fits in children with epilepsy, a UK trial suggests.

The number of seizures fell by a third in children on the "ketogenic" diet, where previously they had suffered fits every day despite medication.

The diet alters the body's metabolism by mimicking the effects of starvation, the researchers reported in the Lancet Neurology.

The researchers called for the diet to be more widely available on the NHS.

It is the first trial comparing the diet with routine care, even though it has been around since the 1920s.

Children are given a tailored diet very high in fat, low in carbohydrate and with controlled amounts of protein.

The parents say the first two weeks are quite difficult but then it becomes much easier because you can make foods in bulk and it especially helps if you can see the benefits from it

Professor Helen Cross


'My daughter seems calmer'

It is not exactly clear how it works but it seems that ketones, produced from the breakdown of fat, help to alleviate seizures.

A total of 145 children aged between two and 16 who had failed to respond to treatment with at least two anti-epileptic drugs took part in the study.

Half started the diet immediately and half waited for three months.

The number of seizures in the children on the diet fell to two-thirds of what they had been, but remained unchanged in those who had not yet started the diet, the researchers reported.

Five children in the diet group saw a seizure reduction of more than 90%.

However, there were some side-effects including constipation, vomiting, lack of energy and hunger.

Availability

Professor Helen Cross, study leader and consultant in neurology at Great Ormond Street Hospital in London, said the diet had been around for a long time but had fallen out of favour because it was thought to be too difficult to stick to.

"The parents say the first two weeks are quite difficult, but then it becomes much easier because you can make foods in bulk and it especially helps if you can see the benefits from it," she said.

"We have to be sensible about it, in this study we had children who had complex epilepsy.

"If your epilepsy is easily controlled on one medication then I wouldn't advocate the diet, but if at least two drugs have failed then it should be considered."

She said national guidelines recommend the diet as a treatment option, but a shortage of dieticians meant it was often unavailable.

A spokesperson for Epilepsy Action said: "The results of this trial add valuable information to what is already known about the diet, presenting evidence that it works for some children with drug-resistant epilepsy.

"In addition to this, however, we also recognise that the ketogenic diet is not without its side-effects, and that the risks and benefits should be considered before prescribing, as with drug treatment."

She said the results would hopefully encourage wider inclusion of the diet in the management of children with drug-resistant epilepsy.

http://news.bbc.co.uk/2/hi/health/7378178.stm

Somebody out there is probably thinking that if we cut out carbs and increase fat intake as the solution, then maybe cutting out fat and increasing carbs actually causes the problem in the first place. I'm just saying.

If I was doing the recommending, I would start with the diet and if that didn't work, then try a drug. A drug should not be the first recommendation when there is another option.

http://www.news-medical.net/?id=38024

According to experts in Britain a high-fat diet for children with severe epilepsy can dramatically reduce or prevent seizures; seizures are caused by bursts of electrical activity in the brain.
In new research by doctors at Great Ormond Street Children's Hospital it has been found that a high-fat, low-carbohydrate diet regime, known as a ketogenic diet, can reduce the number of fits suffered by children.

In the first randomised controlled trial to test the efficacy of the diet in children with drug-resistant forms of the condition, 145 children, aged between 2 and 16, who suffered daily seizures and had failed to respond to treatment with at least two anti-epileptic drugs, took part.

The diet has been around since the 1920s, it alters the body's metabolism by mimicking the effects of starvation - half of the group started the diet immediately while the others waited for three months.

The researchers say the number of seizures in the children on the diet fell to two-thirds of what they had been, but remained unchanged in those who had not yet started the diet; five children in the diet group saw a seizure reduction of more than 90%.

Some side-effects were experienced including constipation, vomiting, lack of energy and hunger.

While it remains unclear how the diet works it appears that ketones, produced from the breakdown of fat, helps to alleviate seizures.

Professor Helen Cross, a consultant in neurology at Great Ormond Street says the diet become unpopular because it was considered too difficult to sustain.

Parents involved say the first two weeks were difficult, but it helps if you can see the benefits from it.

Professor Cross says if the epilepsy is easily controlled on one medication she would not advocate the diet, but if at least two drugs have failed then it should be considered.

The researchers say that the diet should be recommended as an NHS treatment for children when drugs have failed to control their epilepsy.

The study is published in the Lancet Neurology journal.

From The Mail
London, UK
10 March, 2009


Health News: Atkins combats epilepsy, handwriting reveals heart disease and plaque-busting dental treatment


In our pick of top health stories this week, how the Atkins Diet could be used to fight epilepsy, doctors can detect heart disease in your handwriting, and a plaque-seeking dental probe.

Can Atkins help fight epilepsy?


The Atkins Diet, used by millions to lose weight, is being tested as a way to reduce epileptic seizures.
In previous studies, some patients were able to reduce their medication after being put on the diet.

The article continues here: http://www.dailymail.co.uk/health/a...-treatment.html

First: Why calcium supplements? I can understand the fear of Atkins may lead the researchers to give an unnecessary multivitamin, but calcium? Do they feel that kids on a whole-foods, natural diet need extra calcium?

Second: Definitely do not try a whole-foods, natural diet at home. Just keep eating processed grains if you have epilepsy.

This treatment has been available since 1928 when Millicent Kelly advocated it at John Hopkins but it has actually been around outside mainstream since 1919. How long a clinical trial do they need?