Dietary Therapies for Epilepsy & Seizure Disorders

The ketogenic diet consists primarily of foods high in fat, with most of the remaining calories supplied by protein. The diet includes very few carbohydrates and is intended to induce a metabolic state called ketosis. Ketosis causes the body’s cells to use for energy substances called ketones, which are broken down from fats, instead of glucose, which is broken down from carbohydrates.

Ketosis mimics a fasting state, and research shows that seizures often lessen or disappear during periods of fasting in some people with epilepsy. Some people may be able to stop the ketogenic diet after a few years and remain seizure-free.

The diet is used mostly in children with epilepsy, but adults may also use the diet. High fat foods include mayonnaise, butter, and heavy cream. Small portions of fruit, cheese, meat, fish, and poultry are allowed. Food must be carefully measured and weighed.

Even small amounts of sugar can reverse the effects of the diet and cause a seizure, so sugar is prohibited. As a result, people on this diet must be vigilant about ensuring that medications, vitamins, toothpaste, and other products don’t contain sugar.

The modified Atkins diet is an alternative to the ketogenic diet. Like the ketogenic diet, people eat foods high in fat, such as bacon, eggs, mayonnaise, butter, hamburger, heavy cream, and oil. But the modified Atkins diet has fewer restrictions and can include such foods as breads and cakes, as long as the total daily carbohydrate count remains below that prescribed by a nutritionist and neurologist. For example, the diet may require less than 20 to 25 grams of carbohydrates per day.

A low glycemic index diet focuses on foods with a low glycemic index, meaning they affect blood glucose levels slowly, if at all. Although it’s not understood why, low blood glucose levels control seizures in some people. Foods on this diet include meat, cheese, and most high-fiber vegetables.

This diet attempts to reproduce the positive effects of the ketogenic diet, although it allows a more generous intake of carbohydrates. Foods don’t have to be weighed, but it’s important to monitor portion sizes. You also have to balance your intake of carbohydrates with enough fat and protein.

If your doctor recommends any of these diets, you meet with an NYU Langone registered dietitian or nutritionist to learn how to measure carbohydrates and read food labels.