A diet high in fat—extremely high in fat, that is—has just been shown in a clinical trial to cut seizure frequency in children with severe, drug-resistant epilepsy. It's not a cure, and it's not an easy treatment to stomach, but it works, British researchers reported Friday in the journal Lancet Neurology.
Dr. Atkins himself might have gagged on the therapeutic regimen, which is called the ketogenic diet. It's so fatty that carbohydrates and protein combined aren't permitted to account for more than 25 percent of total calories. Each patient needs to have his or her diet specially designed by a dietitian, who calculates how many calories of fat, carbs, and protein need to be eaten each day. By comparison, fat can constitute "only" 50 percent of the caloric energy in the Atkins diet.
Doctors have occasionally used the ketogenic diet to treat epilepsy for decades; the first report of its success against seizures was published in 1921. But they don't fully understand why it works. Subsisting primarily on fat changes the metabolism of the brain. Instead of being fueled by sugar, as it usually is, it begins to metabolize fat-derived molecules called ketone bodies, hence the term ketogenic diet. Somehow, certain neurological problems seem to lessen when ketones rather than glucose molecules are feeding the organ.
When anticonvulsive drugs became popular, the draconian diet waned in influence. But in recent years, researchers in the United States and elsewhere have revived its use in certain cases in which drugs have failed to stop kids from suffering extremely frequent seizures. But until now, no rigorous clinical study had been conducted to show whether the diet works better than a "placebo" diet.
The researchers tested the ketogenic diet in 73 children ages 16 and younger who had seizures once or more per day. They asked 72 other children to continue eating a normal diet. After three months, the researchers found that seizure frequency fell by at least half in 38 percent of the kids assigned to guzzle fat, while only 6 percent had such a dramatic improvement in the other group.
However, 19 of the 73 kids assigned to follow the special diet either never started it or didn't last all three months on it. Some of them developed constipation, vomiting, and other side effects, and 22 percent complained that they were hungry at the three-month mark. It's not easy subsisting largely on oil, butter, and other fat-rich substances.
Past research has also found that following the ketogenic diet raises some patients' cholesterol levels. And some people who try it lose weight because they can't stand to swallow enough fat-laden calories to offset the calories they're burning. Adult patients have tested the ketogenic diet for a variety of disorders other than epilepsy, and one of them told me that it was too "soft and slimy" for her taste—although she nevertheless stuck with it for a time.
Although it hasn't been proven to treat other health problems, some researchers suspect that the ketogenic diet could be effective against Parkinson's disease, Lou Gehrig's disease, and other primarily neurological conditions. There's even some evidence to suggest that it could help control brain tumors. More on that intriguing possibility in a future post.