Epilepsy and the Keto Diet
Published November 2020
Fewer Seizures, Better Quality of Life
The ketogenic (or keto) diet — a high-fat, low-carbohydrate diet — has a range of health benefits covered in mainstream media, from weight loss to elevated energy levels and decreased acne.
Yet, the keto diet is not just another fad diet; it is an evidence-based dietary therapy that can help patients with epilepsy by reducing seizures. After three months on the keto diet, research indicates that 87% of patients with epilepsy report an improved quality of life.
“It’s really remarkable seeing how patients can succeed with the keto diet and regain a sense of control over their lives,” states Yara Mikhaeil-Demo, MD, at Northwestern Medicine Comprehensive Epilepsy Center.
Health Benefits of a Keto Diet for Patients With Epilepsy
Since it was first introduced in the 1920s, the keto diet has become an evidence-based dietary therapy for specific conditions like epilepsy. First tested among pediatric patients, it is now prescribed to adult patients with epilepsy, alongside medication or surgical treatment. These patients report:
- Decreased frequency of seizures
- Decreased severity of seizures
- Improved seizure recovery
- Decreased blood sugar levels
- Increased energy
- Reduction in medication dosages
- Improved quality of life
- Weight loss
How It Works
On the keto diet, patients are encouraged to reduce consumption of foods high in carbohydrates, such as grains, legumes and sugars. The goal is to replace carbohydrate intake with fat in order to induce ketosis: a metabolic state whereby ketone bodies (chemicals produced in the liver from fatty acids) provide fuel for the body.
The reason why this diet produces health benefits specifically for patients with epilepsy requires more data. However, it has been theorized that when the brain sources its nourishment from ketone bodies instead of glucose, there is an improvement of mitochondrial density, meaning the body has a higher capacity to convert food into energy. Ketone bodies are also believed to increase the production of gamma-Aminobutyric acid (GABA), which is the major inhibitory neurotransmitter in the brain. This could help keep seizures from occurring.
Risks of a Keto Diet
There are pros and cons to the keto diet, including potential risks and side effects. The most well-known side effect is often referred to as the keto flu, or flu-like symptoms experienced during the body’s initial withdrawal from carbs. The keto flu typically subsides in a few days.
Risks associated with the keto diet concern heart health, kidney stones and high cholesterol levels. To minimize such risks, consult your physician before implementing a keto diet. Each patient with epilepsy shifting to a keto diet should be carefully monitored by an epilepsy specialist and registered dietitian or nutritionist.
How to Sustain a Keto Diet
A few types of keto diets have been designed, which cater to different lifestyles. Ilana Nurko, MS, RD, LDN, CNSC, advanced dietitian at Northwestern Memorial Hospital, explains that patients begin the Keto Program at Northwestern Medicine with an educational class about the keto diet to build an understanding of its benefits. Then, they meet individually with clinical staff to establish a customized plan that meets specific goals and helps them achieve success.
Effective keto regimens can be modified to help patients stick to the diet. Although it may be tempting to cook repetitive meals or purchase processed items marketed as keto, it also is vital for long-term health to include a variety of whole foods in your diet.
Remember, It’s a Mindset
“The most important thing about this diet is mindset,” advises Dr. Mikhaeil-Demo. “Think about all of the positives it can create in your life and realize that it can be a very versatile diet if you want it to be.” Start the diet with optimism, log progress and commit to at least three months for optimal results.
If you and your physician determine that the keto diet is right for you, here are a few delicious sample recipes you can enjoy when committing to a keto diet.