High-fat, low-carb diet helps kids with epilepsy

NEW YORK (Reuters Health) - The results of a study provide strong evidence that a diet high in fat and low in carbohydrates -- a so-called "ketogenic diet" -- can help control seizures in children with stubborn epilepsy that does not respond well to drug therapy.

Epilepsy is a common neurological disorder characterized by recurrent seizures when the normal working of the brain is interrupted. A ketogenic diet has been widely used since the 1920s to help control hard-to-treat seizures in children.

In their study, Dr. Elizabeth G. Neal, from University College London, and colleagues randomly assigned a group of children who were having at least seven epileptic fits per week despite anti-epileptic drug therapy, to a standard diet or a ketogenic one, which is typically high in fats and very low in carbohydrates.

After three months, children on the ketogenic diet had more than one third fewer seizures, while seizure frequency increased in children on the standard diet, the researchers report in the Lancet Neurology medical journal.

A greater than 50 percent drop off in seizure frequency was noted in 38 percent of children on the ketogenic diet compared with just 6 percent of children on the standard diet.

This study confirms that a ketogenic diet is safe and effective in children with drug-resistant epilepsy, the investigators conclude.

The most common side effects with the ketogenic diet were constipation, vomiting, lack of energy, and hunger, Neal and colleagues note.

In a written commentary, Dr. Max Wiznitzer, from the Rainbow Babies and Children's Hospital in Cleveland, notes that some questions still remain regarding ketogenic diets for childhood epilepsy. Among these are the long-term effects, the identification of epilepsies that benefit from early initiation of such a diet, and the mechanism by which the diet produces its anti-seizure effect.

SOURCE: Lancet Neurology, online May 3, 2008.