Nutritional Therapy for Epilepsy – by Nutan Khimasiya

Epilepsy is a medical condition with which people have been fighting since childhood. It is important to be aware to manage this condition because apparently, there is no permanent cure for it. Nutan Khimasiya, shares her research-based facts in this article on epilepsy.

Nutritional Therapy for Epilepsy – by Nutan Khimasiya

Epilepsy is a chronic neurologic condition causing recurrent seizures, mostly seen in children younger than 2 years and adults older than 65 years of age. Nutritional therapy is being used in addition to other epileptic treatments, such as anticonvulsant medications, epilepsy surgery, and vagus nerve stimulation, but considering their complications. For example Carbamazepine (Tegretol) a widely-used anticonvulsant medication to treat focal seizures, have shown to increase the metabolism of vitamin D, calcium, folate, and biotin. Hence, patients on Carbamazepine medication should ensure adequate intake of foods rich in these nutrients, including green leafy vegetables for folate and biotin and fortified dairy products or its substitutes for calcium and vitamin D. Also dietary supplementation especially for calcium and vitamin D may be necessary for those who are on long-term medication of carbamazepine.

There are evidences that a ketogenic diet (with high fat, low carbohydrate and adequate protein) have shown to decrease the frequency of seizures; however, further research is necessary. Studies have shown that following a caloric restrictive diet enrich in polyunsaturated fatty acid (with omega 3 and 6) can be an ideal approach while treating epileptic patients. Further Atkins diet, which is high in fat and protein while low in carbohydrate, has also been used in treatment of epilepsy.

Ketogenic Diet (KD)

By now, the KD is well known to the epilepsy community. It was initially devised in 1921 to mimic the anticonvulsant effects of fasting, which were known to suppress seizures. (1) The success rate of the KD in controlling refractory seizures is at least as good as, and often better than that of the “new” anticonvulsant drugs (AEDs). (2)  The KD is effective in people of all ages, although it may be maximally effective in the toddler and school-age child (3,4,5).

Typically, a KD includes mostly saturated fats, usually in the form of heavy cream or butter. Fats in the classic KD consist of a mixture of animal- and plant-derived fats; fatty acids of various chain lengths are likely to be included, but no attempt is made to specify fat type or chain length in the diet formulation. An exception is the medium-chain triglyceride (MCT) diet, in which oils containing certain chain lengths are the main source of fat (6).

Atkins Diet

Atkins Diet has been widely used for weight loss benefits. Because Atkins diet consist of high fat and low in carbohydrate it is known to produce a state of ketosis, similar to that of Ketogenic Diet, hence theoretically it is possible that the Atkins diet may enable seizure control. A small case series appeared recently, attesting to the effectiveness of the Atkins diet on seizure control in six patients (three children, one adolescent, and two adults), ranging in age from 7 to 52 years, with diverse types of refractory epilepsy (7). With regard to seizure control, the results were remarkable: two children and the teenager had a greater than 90% seizure reduction. Although this is a small, uncontrolled trial, it raises the possibility that the Atkins diet may be beneficial for children with medically refractory epilepsy.  The Atkins diet seems to work better in children, as does the KD. The Atkins diet was less encouraging in adults with epilepsy, but larger-scale studies are necessary.

Calorie Restrictive Diet

The original idea for a KD was derived from the beneficial effect that fasting had on seizures, and this observation has been verified in the modern setting (8). The health benefits of modest calorie restriction are becoming increasingly clear and include an increased life span, reduced risk of cancer and cardiovascular disease, and amelioration of the degenerative effects of aging (9,10). Restriction of calorie intake also can be neuroprotective (11,12).

Polyunsaturated Fatty Acids (PUFA)

Fatty acids play a critical role in nervous system development. The essential fatty acids, especially the long-chain polyunsaturated fatty acids (PUFAs) of the ω-3 class (as found in certain fish oils), are necessary for the development of normal retinal and neuronal membranes, as well as for subsequent normal behavior and cognition (13,14). Deficiencies of PUFAs lead to cognitive, behavioral, and structural brain abnormalities. Consumption of omega-3 PUFAs may even counteract the degenerative effects of Alzheimer disease (15). Although clinical dietary trials demonstrating that PUFAs effectively reduce disorders of cardiac excitability were promising (16), few analogous attempts have been made to test PUFAs for seizures, in either patients or animal models. A single study has attempted a clinical trial of a PUFA-enriched diet in patients with epilepsy (17). Hence, the studies have shown that PUFAs play a primary role in brain development and in the modulation of neuronal excitability. However, exploration of their function in treatment of epilepsy is still at beginning stage. It is possible that a “PUFA diet,” parallel with the ketogenic diet, may become a possible mode of nutritional therapy for epilepsy in near future.


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About The Author

Nutan Khimasiya

Nutan Khimasiya certified Fitness and Nutrition expert. Nutan Khimasiya is internationally certified Fitness and Nutrition expert from ACSM-Clinical Nutrition, K11-Sports Nutrit.. Read More..


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