Johns Hopkins neurologists report that a rigorously high-fat, low-carbohydrate diet not only reduces the number of seizures in children with severe seizure disorders but also keeps the frequency of attacks lower years after the diet is stopped.
A paper published in October's Pediatrics by pediatric neurologist John Freeman and his colleagues shows that more than half the children in a study of the so-called ketogenic diet continued to experience at least a 50 percent reduction in seizures three to six years after going back on a normal diet.
"Also notable," Freeman says, "is that many of the children who had success after ending the diet were free of both anticonvulsant drugs and seizures."
The authors, who also include Cheryl Hemingway, Diana Pillas and Paula Pyzik, say the ketogenic diet is "an excellent alternative" for children whose seizures cannot be easily controlled. "What we're seeing is long-lasting effect for many children who used the diet," Freeman adds.
Freeman notes that those in the study represent seizure-prone children who do not respond to at least two different anticonvulsant drugs. In addition, children in the study had an average minimum of two seizures per week and were between the ages of 1 and 16 years. Children were not excluded from the study on the basis of what kinds of seizures they had.
Of the study's 150 children started on the ketogenic diet, 83 remained on the diet for at least one year. Three years after the last child was enrolled in the study, questionnaires were sent to all participating families; 107 questionnaires were completed. Families of 35 children were interviewed by phone. Parents were asked about the current frequency of seizures as well as whether they had removed their child from the diet and, if so, when and why.
One-third of the original 150 children were either seizure-free or had greater than a 90 percent reduction in seizures, and 44 percent of those were free from medication.
Freeman says that while the reason the ketogenic diet works continues to puzzle neurologists and nutritionists, a "flurry of activity" is now under way to reveal the biochemical reasons for the treatment's success. Many experts believe the suppression of seizures is related to the buildup and breakdown of ketones, natural metabolites that accumulate in cells programmed to conserve energy.
The study was funded by grants from the Charlie Foundation to Cure Pediatric Epilepsy, Jim and Nancy Abrahams, and the Roxanne Fund.