The Effects Of A Ketogenic Diet On Children With Epilepsy

The Effects Of A Ketogenic Diet On Children With Epilepsy

What is Epilepsy?

Epilepsy is a chronic disorder characterized by recurrent, unprovoked seizures. Most people with epilepsy have more than one type of seizure and may have other symptoms of neurological problems as well. Although the symptoms of a seizure may affect any part of the body, the electrical events that produce the symptoms occur in the brain. The location of that event, how it spreads, how much of the brain is affected, and how long it lasts all have profound effects. These factors determine the character of a seizure and its impact on the individual.

How to treat Epilepsy?

The majority of epileptic seizures are controlled by medication, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors, including the person’s age, frequency and severity of the seizures, overall health and medical history.

What are the benefits of the ketogenic diet?

The ketogenic diet has antiepileptogenic properties and can also have a role in treating other neurological condition, such as paralysis and mental retardation. The diet has been used generally in children with difficult-to- control, generalized epilepsies. It is mostly recommended for children aged between two and ten years, who have been diagnosed with a generalized type of epilepsy, and who have failed to respond to a variety of drugs.

What does the ketogenic diet entail?

The ketogenic diet is very high in fat and low in carbohydrates. When fat (from food sources such as avocado, nuts, bacon, cream etc.) is the primary source of energy consumed, ketones are formed. Ketones are formed when the body uses fat for its primary source of energy.

Usually carbohydrates (found in bread, beans, potatoes, rice, pasta, cereal, dairy, fruit, vegetables, sweets, biscuits and sugar) are the primary source of energy, but due to the fact that the diet is very low in carbohydrates, fats become the primary source of energy instead. The typical ketogenic diet provides 3 to 4 grams of fat for every 1 gram of carbohydrates and protein. (For example, breakfast will consist of: one whole egg, two teaspoons butter, two bacon rashers and 30 grams of avocado pear.)

The diet needs to be implemented under the supervision of a dietician and must be followed strictly, it requires a significant commitment to work effectively.

Therefore, the diet is typically started with a period of fasting that lasts until the body produces moderate to large amount of ketones (ketone bodies are produced by the liver from fatty-acids during periods of low food intake, carbohydrate restrictive diets, starvation, prolonged intensive exercise or untreated diabetes). This initiation period usually takes place in the hospital, for the child to be monitored for potential side effects like vomiting, low blood glucose, dehydration and seizures. A two-month trial is usually suggested for deciding whether the diet is effective. If the diet is effective, it is typically continued for about two years.

During this period, children are often able to lessen the amount of medication they take for seizures. Most of the children on the diet seems to be more alert, even before medication is significantly lessened. It is crucial for a child to be monitored closely by a doctor and dietician to monitor growth while being on the ketogenic diet.

Example of Ketogenic diet for a child (1500ckal)

Breakfast

  • 1 Whole Eggs
  • 2 tsp Butter
  • 2 Rashers of bacon
  • 30g Avocado

Snack

  • 30g Nuts

Lunch

  • 90g Grilled Chicken
  • 1 TBSP Olive oil
  • 1 TBSP regular Salad dressing
  • 2 cups Greens (Salad)
  • 30g Avocado

Snack

  • 1 cup Plain Double Cream Yogurt

Dinner

  • 90 Steak Strips
  • 1 TBSP Olive oil (to fry steak)
  • 2 tsp Butter (to fry mushrooms)
  • 1 cup Mushrooms
  • 1 cup Broccoli

What are the limitations and side effects and limitations of the ketogenic diet?

The diet may cause some mild side effects in some children, including constipation, dehydration, vomiting, high cholesterol and kidney stones (due to uric acid build up in the blood).

More severe side effects include loss of bone density, alteration in the blood electrolytes and poor growth. Infections may also be more severe in a child treated with the ketogenic diet. It is very important for a child to take a carbohydrate-free vitamin and mineral supplement i.e. OmniVite.

Please refer to your dietician for more information on the different carbohydrate-free supplements that can be used.

What do you need to know before you start the ketogenic diet?

– The diet is very restrictive, especially for a child. Some children might find it difficult to follow the diet strictly, as thy might feel isolated at school for not eating “normal”.

– The diet won’t be effective if it is not followed carefully.

– Preparing the meals might be very time-consuming, especially for the first few weeks.

– It is not a healthy balanced diet for the long term

– It isn’t safe for children with certain metabolic disorders, i.e. fatty acid oxidation defects.

– The diet might not work for some children, no matter how closely they follow the diet.

– The diet might have some potentially serious side effects. Children must be monitored closely by a doctor and dietician while following the ketogenic diet.

For more information on how to implement the ketogenic diet safely and effectively contact your local dietician.

AUTHOR: Joani Britz (RD) SA 

About the author:

Tanya has been providing dietary guidance since 2009 as a registered dietician licensed in South Africa. Her goal is to help patients understand the connection between diet and diagnosis for improved nutritional well being.

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