Are ‘Seizure Diets’ Really Effective?

Epilepsy is a long-term disease that causes regular seizures along with changes in awareness, muscle control, emotions, and behavior. Epilepsy happens due to the abnormal electrical signals that are produced by certain damaged brain cells, leading to an uncontrolled burst of electrical activity in the brain, which causes a seizure. Most people living with epilepsy have to take medications to prevent these seizures. However, in some cases, prescription medications do not help much. Many people with epilepsy have been found to benefit from making dietary changes to prevent or reduce seizures. Such types of diets are usually referred to as ‘seizure diets.’ Seizure diets comprise of food that is used to prevent seizure activity. There are many types of seizure diets, with the most common one being the well-known ketogenic diet. Let us take a look to see whether seizure diets are really effective or not.

Epilepsy, also known as seizure disorder, is a disorder of the brain caused by abnormal electrical activity in the brain. Seizures are the main symptom of epilepsy and are believed to be caused by a disruption in the nerve cell activity in the brain. Epilepsy may occur due to a genetic disorder, or it can be caused by an acquired brain injury, such as a stroke or trauma. During a seizure, a person can experience various types of abnormal behavior, sensations, and even loss of consciousness.^{(1, 2, 3, 4, 5)} As mentioned above, most people having epilepsy and suffering from seizures have to take medication to prevent seizures. However, according to estimates by the Centers for Disease Control and Prevention, medications only work in two out of three people in helping reduce or prevent epileptic seizures.⁽⁶⁾

In people who do not benefit from prescription medicines, dietary changes have been found to help reduce or prevent seizures. These diets are known as seizure diets, and they include foods that can help prevent seizure activity. One of the most popular seizure diets is the ketogenic diet, which comprises of high-fat, low-carbohydrate, and controlled plant proteins that help alter the manner in which the body uses energy.

When you shift to a ketogenic diet (popularly known only as the keto diet), it causes the body to manufacture a substance known as decanoic acid. Recent studies have found that decanoic acid can help reduce convulsive activity, thus reducing the frequency of seizures over a period of time.^{(7, 8, 9)}

Although seizure diets may lower the frequency of seizures, they might lead to some other side effects. This is why, to avoid this, it is necessary that you follow an eating plan only under the supervision of a registered dietician or doctor.

As mentioned above, there are many types of seizure diets, with the ketogenic diet being one of the most well-known ones. Most people who want to take the dietary approach to reduce their seizures tend to follow the keto diet or the modified Atkins diet. Both these diets focus on providing the body with fats while restricting the amount of protein and carbohydrates.

There are two different approaches that can be taken with the keto diet. While the classic keto plan revolves around consuming a certain measured ratio between carbohydrates, protein, and fats. This is again carefully monitored by a dietitian or doctor. The second approach to the keto diet is known as the medium-chain triglyceride (MCT) plan. The MCT keto plan revolves around consuming a certain percentage of calories from each of the three categories. This approach allows you to ingest more carbohydrates and may also include fat from a supplement of MCT oil.^{(10, 11)}

On the other hand, the modified Atkins diet is a much less restrictive form of the keto diet. There is no particular ratio or formula to determine how much protein, fats, and carbohydrates you need to consume in this diet. It only focuses on eating high-fat, low-carbohydrate meals.

Another type of seizure diet is the low glycemic index treatment (LGIT), which also aims at having a low intake of carbohydrates. However, this diet is also easier to follow than some of the other seizure diets because there are fewer restrictions.^{(12, 13)}

Any seizure diet, especially the keto diet, causes the body to start using up fat instead of carbohydrates for energy. When the body starts to do this, it starts producing ketones, which is where you get your energy from. People who do not limit their carbohydrate intake take their energy from glucose, which is derived from carbohydrates.^{(14, 15)}

Another impact of the ketogenic diet is the production of decanoic acid, which some studies have found to have anti-seizure activity. A 2016 study published in the journal Brain showed how decanoic acid lowers seizure activity in laboratory animals.⁽⁹⁾

The keto diet is known to work for many types of seizures and epilepsy, and it can also be easily adapted to different cuisine types.

In recent years, a lot of research has been done on seizure diets, and studies have shown promising results. The conventional ketogenic diet has been found to reduce seizures in most children. Around 10 to 15 percent of children who were on the keto diet were found to be seizure-free.⁽¹⁶⁾

Another study done in 2016 and published in the journal Epilepsy and Behavior was carried out on 168 participants who were enrolled in the diet therapy for epilepsy between 2010 and 2015. Amongst the study participants who followed the modified Atkins diet for the entire five years, 39 percent went on to become seizure-free or experienced a 50 percent reduction in the frequency of their seizures.⁽¹⁷⁾

Another study carried out by the Tehran University of Medical Sciences in 2017 on 22 participants found that six participants who followed the modified Atkins diet had a 50 percent and higher reduction in seizure activity after just one month. Meanwhile, 12 participants also had a greater than 50 percent reduction in seizure activity, but after two months.⁽¹⁸⁾

At the same time, the low glycemic index treatment (LGIT) diet was also found to show promising results. A study carried out in 2017 on a small group of children established that more than half of the participants had a greater than 50 percent reduction in seizure activity after being on the diet for three months.⁽¹⁹⁾

The keto diet and the other related variations, including the modified Atkins diet, are known to have some side effects. Following this dietary plan can cause high cholesterol and some gastrointestinal symptoms. It can also have an adverse impact on bone health and may lead to the formation of kidney stones. Children who follow the keto diet can also experience growth issues and acidosis.

Since these diets are so restrictive in nature, they are usually quite challenging for people to follow, especially for a longer time. Even if they are effective in preventing and reducing seizure activity, many people find it quite challenging to stick with the plan for long enough to see if it makes a difference.

Most people who have epilepsy and suffer from seizures are known to respond well to anti-epileptic medications. However, for those who do not benefit from prescription medication, dietary changes may help reduce the frequency of seizures. Seizure diets may not work for everyone, and they are highly restrictive, making it difficult to stick with the plan. It is always best to work with a qualified dietician or medical professional if you want to try the seizure diet. This will also help you identify any symptom improvement you experience during the sustained course of the dietary program while managing any side effects as well if they were to occur.

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