Ketogenic Diet

A ketogenic diet is mainly used as a diet for the treatment of all types of seizures in children. The diet is designed to create and maintain a state of ketosis. The beneficial effect of this diet in epilepsy is that the ketone body behaves as an inhibitory neurotransmitter, thus produces an anticonvulsant effect on the body. An increased level of free plasma polyunsaturated fats contributes to the beneficial effects of ketogenic diet in epilepsy by helping to sustain ketosis. Mild dehydration is important with this diet to prevent dilution of the level of ketones circulating at anytime.

Epilepsy is an intermittent derangement of the nervous system presumably caused by a sudden, excessive disorderly discharge of cerebral neurons. Most seizures begin early in life, but a cycle of epileptic events occurs after age of 60 years. Seizures before the age of 2yrs are mainly caused by developmental defects, birth injuries, or a metabolic disease.

The ketogenic diet is a high fat, adequate protein, low carbohydrate diet that is used in medicine primarily to treat epilepsy. The diet mimics aspects of starvation by forcing the body to burn fats rather than carbohydrates. Normally the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fuelling the brain function. If there is very little carbohydrate provided in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass to the brain and replace glucose as an energy source.  An elevated level of ketone bodies in blood is a state known as ketosis and it leads to a reduction in the frequency of epileptic seizures. This diet is a muscle sparing, fat loss diet that works by forcing the carbohydrate deprivation into ketosis.

A traditional ketogenic diet is based on long chain triglycerides. The patient is asked to fast for 24 – 72 hrs until a condition of ketonuria is produced .The diet usually works during initial fasting period. A medium chain triglyceride diet replaces the long chain fats of triglyceride with MCT. MCT oil is available as odourless, colourless, tasteless oil and is mainly used as a means of improving the palatability of the diet.

The calorie intake is in a 3:1 ratio of fat to protein and carbohydrate calories. 75% of calories are needed as fat. Protein is calculated to provide appropriate intake (about 1g/kg/day) for growth. Carbohydrates are added to make up the remaining portion of protein and the energy needs. Multiple vitamin and calcium supplementation is recommended to ensure that the diet is nutritionally complete. A greater amount of non-ketogenic foods such as fruits and vegetables, small amounts of bread and starches can also be allowed.

Post by Faiz Lahori