BENGALURU : The ketogenic diet is usually associated with fitness enthusiasts, who rave about its weight-loss benefits. However, doctors have revealed that the diet is also helpful for children with epilepsy.According to Dr Ravi Kumar CP, consultant paediatric neurology at Aster CMI Hospital, who has treated more than 10 children dealing with epilepsy through the ketogenic diet, “In epilepsy, an individual is prone to having recurrent seizures.
The highest risk of epilepsy can be for the first two years of life in children who undergo maximum spurt in neuro-cognitive development. Hence, the seizures need to be controlled at the earliest.” The ketogenic diet (KD) is a high fat, low carbohydrate and controlled protein diet that can be considered when the seizures have not responded to several different medicines. Though prescribed and decided by a physician, it is closely monitored by a dietician.
A ‘classic’ KD provides three to four grams of fat for every one gram of carbohydrate and protein. The planned diet involves special ingredients to be weighed and prepared according to the instruction and counselling provided by the dietician with minimal deviation expected from the patient. “Initially we start the diets at lower ratio from 2:1 (fat:protetin and carbohydrate ratio) and then slowly it is increased,” explained Dr Edwina Raj, senior dietician.
Some times, even babies who are around eight months experience seizures. In such cases, breast milk is allowed but in calculated proportions and other complementary feeding is also advised. “Porridge mixes or almond flour, coconut flour, almond milk and soya milk is advised,” said Aruna Devi, a senior dietician.
Recently, Aster CMI Hospital received a case where a 10-year-old girl was on antiepileptic drugs and suffered at least three episodes of seizures per day.
The child was started on a ketogenic diet in the ratio 2:1 for a week, which was well tolerated. The ratio was increased to 3:1. After one month the child’s father reported that the episode of seizures were reduced to one per week. The diet is still under process with regular follow ups and progression towards 4:1 ratio.
In another case, a six-year-old boy was dealing with almost-daily seizures from the age of one-and-a-half. His weight was 24.9 kg. He tried more than five different anti-epileptic drugs. The diet was initiated at the ratio of 2:1 and in about a week, the child’s seizures were under control.
Dr Bidisha Banerjee, Paediatric Neurologist at Manipal Hospital, has seen about 50 children who are dealing with epilepsy and were treated with ketogenic diet. She said, “The diet has to be customised for each child by a trained dietician. A minimum trial of three months may be needed in some. If beneficial, it may be used for years.”