Whathow much, and when we eat all affect the way our brains work even. For people with epilepsy, diet can reduce the likelihood of seizures. Mackenzie Cervenkaa director and neurologist of the Adult Epilepsy Diet Center at Johns Hopkins Hospital, explains what the ketogenic diet is and how it can benefit people with epilepsy.
What is a ketogenic diet? A ketogenic diet is a very high-fat low-carbohydrate diet that is designed to induce fat metabolism. When the physical body is depleted of glucose stores, it shifts to metabolizing fatty and fat acids, which produces compounds called ketones. The classic ketogenic diet used as far back as the s is a four to one ratio in grams of fat to carbohydrates plus protein. We typically teach our patients a modified Atkins dietwhich limits the net carbohydrate intake to 20 grams per day with no limitations on the amount of protein and fat they eat.
Typically, about 60 to 70 percent of their daily calorie intake comes from fat. Why do doctors recommend this type or kind of diet for individuals with epilepsy?
The ketogenic diet can reduce the frequency of seizures. How does the diet reduce seizures? During a seizure, networks of neurons fire when they are not supposed to. This can happen since the brain cells are more excitable and are releasing lots of excitatory neurotransmitters, like glutamate.
The ketogenic diet reduces the amount of glutamate in the brain and enhances the synthesis of GABA, which makes it less likely for a seizure to occur. The diet can reduce inflammation in the brain also, and inflammation due to infections like meningitis, encephalitis, or autoimmune disorders can trigger seizures.
There have also been a couple of really interesting studies recently that examined how the ketogenic diet can alter the gut microbiome, the trillions of microorganisms inhabiting the digestive tract.
These studies found the ketogenic diet can increase certain bacteria species that promote an increased proportion of GABA to glutamate in the brain. Why do you think lifestyle modifications like the ketogenic diet can be important for individuals with epilepsy?
For patients with treatment-resistant epilepsy, the dose of a drug or mixture of drugs necessary to stop seizures can sometimes cause significant sedation. In talking with my patients, a major part of epilepsy they struggle with most is the lack of control.
A diet is something in their environment they can control. They can be in control of their seizures and treatment, and I think that empowers them. She graduated from the University of Pittsburgh in with degrees in English and neuroscience.
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