Brenda Khan
Changing your diet can be an important part of treating epilepsy and reducing seizures. While not everyone with epilepsy needs to go on a restrictive diet, a balanced and nutritious diet is important for overall health and can help reduce some seizure triggers. The ketogenic (keto) diet is a strict, high-fat and low-carbohydrate diet that has been used to reduce seizures since the 1920s. It is typically recommended for children and adolescents with epilepsy that has not responded to medication, but growing evidence supports its use in adults as well. The keto diet should be closely monitored by healthcare providers and is not without risks, including side effects such as low bone density, constipation, and high cholesterol. Other diets that have been studied for seizure management include the modified Atkins diet and the Low Glycemic Index treatment, which are less restrictive and eliminate sugar and sweets. In addition to these specialized diets, maintaining a well-balanced diet with essential nutrients, adequate sleep, and regular exercise can also help with seizure management.
| Characteristics | Values |
|---|---|
| Diet type | Ketogenic (keto) diet, Modified Atkins diet, Low Glycemic Index treatment |
| Diet composition | High in fat, low in protein and carbohydrates |
| Effectiveness | Up to 60% of children and 40% to 50% of adults on the keto diet experience a 50% or more reduction in seizure frequency |
| Side effects | Low bone density, constipation, high cholesterol, kidney stones, slower growth, sluggishness |
| Restrictions | No alcohol, caffeine, or recreational drugs |
| Supervision | Should be started under the supervision of a physician or dietician |
| Sleep | A balanced diet and regular sleep pattern may help reduce the risk of seizures |
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What You'll Learn
The ketogenic diet may help control seizures
The ketogenic diet has been used to reduce seizures since the 1920s. It is a high-fat, low-carbohydrate diet designed to mimic a fasting state, prompting the body to make ketones, which are evidence that the body is using fat for energy. The diet is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured.
The ketogenic diet is usually recommended for children whose seizures have not responded to several different seizure medications. The classic diet is not usually recommended for adults, as the restricted food choices make it hard to follow. However, the modified Atkins diet does work well for adults. This should also be done with a good team of adult neurologists and dietitians.
The ketogenic diet has proven effective over time to help epilepsy. About 40% to 50% of children who start the keto diet have 50% fewer seizures. And roughly 10% to 20% of children achieve more than a 90% reduction in seizures. In adults, the diet may be up to five times more likely to experience a 50% or greater reduction in seizure frequency.
The ketogenic diet can be effective in helping to control seizures. However, it is not risk-free. Side effects occurring with long-term diet use include low bone density and bone fractures, constipation, high cholesterol, kidney stones, slower growth than typical, and sluggishness (tiredness).
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The modified Atkins diet may reduce seizures
Dietary changes can be helpful in reducing epileptic seizures. The modified Atkins diet, in particular, has been associated with a significant reduction in seizures in people with epilepsy. This diet is a less restrictive version of the classic ketogenic diet, which has been used since the 1920s to control seizures.
The modified Atkins diet is a high-fat, low-carbohydrate diet that can be combined with standard drug therapy to reduce seizures. In a study by Manjari Tripathi, 26% of participants who followed the modified Atkins diet along with drug therapy had a greater than 50% reduction in seizures after six months, compared to less than 3% of participants who only used drug therapy. Another study found that 9% of participants in the ketogenic treatment group and 5% in the modified Atkins group had a greater than 90% reduction in seizures.
The modified Atkins diet is one of three "alternative diets" used to treat epilepsy, along with the MCT (medium-chain triglyceride) diet and the LGIT (low glycemic index treatment). It is important to note that the modified Atkins diet should be done under physician supervision and with periodic monitoring by a dietitian. This is because there can be adverse events associated with the diet, such as constipation, lethargy, and anorexia.
Additionally, it is worth noting that while a well-balanced diet is important for overall health and epilepsy management, there is no evidence that any type of food consistently triggers seizures in people with epilepsy, except in rare cases of reflex epilepsy. A balanced diet that provides essential nutrients and keeps blood sugar levels stable can contribute to overall health and help reduce some seizure triggers, such as maintaining healthy sleep habits.
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Lack of sleep may increase seizure likelihood
While changing your diet may help with seizure management, it is important to note that lack of sleep may also increase the likelihood of seizures. Sleep deprivation has been linked to an increased risk of seizures in people with epilepsy. This correlation has been observed in various studies, including questionnaire-based research, preclinical and clinical trials, and EEG examinations.
Sleep deprivation can disrupt the normal functioning of the brain, leading to an increase in abnormal electrical activity that may trigger seizures. This disruption can be attributed to the increase in cortical excitability and epileptiform discharges (EDs) observed in sleep-deprived individuals with epilepsy. Additionally, sleep deprivation has been used as a diagnostic tool for epilepsy by intentionally triggering epileptiform activity.
The relationship between sleep deprivation and seizures is further supported by the role of GABA receptors. Studies have found a decrease in GABAA receptor expression in both epilepsy and sleep deprivation. GABA agonists, which facilitate the action of GABA, can suppress seizures, while GABA antagonists can precipitate them. Therefore, the impairment of these receptors due to sleep deprivation may contribute to the increased risk of seizures.
Furthermore, certain sleep disorders, such as sleep apnea, have been linked to an increased risk of epilepsy. Sleep apnea causes interruptions in breathing during sleep, resulting in oxygen deprivation for the brain, which may increase the likelihood of seizures. Additionally, seizures that occur at night can disrupt sleep quality, leading to chronic sleep deprivation and potentially triggering more seizures during the day.
To mitigate the risk of seizure associated with sleep deprivation, it is crucial for individuals with epilepsy to prioritize obtaining adequate, high-quality sleep. While the specific number of hours of sleep needed varies from person to person, generally, 7-8 hours of sleep per night is considered a good guideline. However, it is essential to consider both the quantity and quality of sleep, as factors such as frequent awakenings or restless sleep can also impact overall sleep quality.
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Electrolyte imbalance may cause seizures
While changing your diet may not directly prevent seizures, certain diets have been proven to reduce their frequency. The ketogenic (keto) diet, for instance, is a strict food regimen that is high in fat and low in protein and carbohydrates. It is used to mimic fasting and to prompt the body to make ketones, which are evidence that the body is using fat for energy. The keto diet has proven effective over time to help epilepsy. About 40% to 50% of children who start the keto diet have 50% fewer seizures. And roughly 10% to 20% of children achieve more than a 90% reduction in seizures.
However, the keto diet needs to be closely monitored by healthcare providers due to its side effects. Some of these side effects include low bone density and bone fractures, constipation, high cholesterol, kidney stones, slower growth than typical, and sluggishness (tiredness).
The modified Atkins diet has also been found to be about as effective as the ketogenic diet for epilepsy in reducing seizure frequency in children and adolescents.
In addition to these specialised diets, eating a well-balanced diet can help provide the body with the nutrients it needs to function optimally, keep blood sugar levels stable, and keep energy levels steady. This may not directly affect seizures but it contributes to overall health and can help reduce some seizure triggers, such as supporting healthy sleep habits.
It is important to note that a diet high in salt may cause an electrolyte imbalance in the body by increasing sodium levels too high, which could disrupt electrical signalling in the brain and potentially lead to a seizure. Electrolyte imbalances can manifest with rapidly progressive neurologic symptoms or seizures, which may be the sole presenting symptom. Electrolyte disturbances that can induce seizures include hyponatremia, hypernatremia, hypocalcemia, and hypomagnesemia. These disturbances are secondary processes to other causes, and early diagnosis and correction of the causes are necessary to effectively treat and prevent brain damage.
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Omega-3 fish oil may reduce seizure frequency
While there is no evidence that any type of food consistently triggers seizures in people with epilepsy, certain dietary changes can help manage them. One such change is the ketogenic diet, a strict food regimen that is high in fat and low in protein and carbohydrates. The keto diet has proven effective over time to help epilepsy, with about 40% to 50% of children who start the diet experiencing 50% fewer seizures.
Another way to reduce seizure frequency is by consuming omega-3 fatty acids, which can be obtained through the consumption of oily fish such as trout, mackerel, tuna, herring, sardines, and salmon, as well as fish oil supplements. A 2014 study by researchers from UCLA School of Medicine found that consuming low doses of omega-3 fish oil every day for 10 weeks reduced seizure frequency by a third among patients with epilepsy. The study also found that omega-3 was linked to reduced brain cell excitability among epileptics, which may curb seizures.
However, it is important to note that the evidence on the association between omega-3 consumption and epileptic seizures is inconsistent. Some studies have found that while low doses of omega-3 may reduce seizure frequency, high doses may not have the same effect. Additionally, it is important to consult a healthcare provider before starting any new diet or supplement, as there may be side effects or interactions with other medications.
In addition to the keto diet and omega-3 supplementation, maintaining a well-balanced diet that provides essential nutrients and keeps blood sugar levels stable can also help with seizure management. Avoiding or limiting foods and beverages that are high in sugar, salt, and caffeine, as well as alcohol, may also be beneficial for reducing seizures.
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Frequently asked questions
The ketogenic diet, or keto diet, is a strict, high-fat, low-carbohydrate diet that is sometimes prescribed by doctors to treat epilepsy. The diet works by changing how the brain gets energy to function, which can help to reduce seizures.
Side effects occurring with long-term use of the ketogenic diet include low bone density, constipation, high cholesterol, kidney stones, slower growth, and sluggishness.
The ketogenic diet has been proven to be effective in helping to control seizures. Up to 60% of children and 40% to 50% of adults who follow a supervised ketogenic diet see a 50% or more reduction in seizure frequency.
The modified Atkins diet and the Low Glycemic Index treatment are two alternatives to the ketogenic diet that have been studied. The common feature of these diets is that they eliminate sugar and all sweets.
