Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
A dietary approach to controlling epilepsy is a treatment choice when two or more medications in combination have failed to control seizures, and when surgery is not feasible.
We offer management of the ketogenic diet as a treatment to control epilepsy in children. The ketogenic diet is very high in fats with some protein and virtually no carbohydrates, which forces the brain to utilize fat for energy instead of glucose. With help from our nutrition staff, families on the diet must weigh foods and make sure that the balance between fat and other nutritional elements is maintained. The ketogenic diet eliminates seizures in approximately a third of the children who try it, and reduces the frequency of seizures in another third.
The low glycemic index treatment (LGIT) is a less restrictive alternative to the ketogenic diet, which may be very difficult for some patients to follow or tolerate. With LGIT, food quantities are not weighed out to the gram, but are based on portion sizes, allowing patients more flexibility.
LGIT allows for more carbohydrates in the patient's diet, but focuses on carbohydrates that have a low glycemic index, which means that they take longer to metabolize. The percentage of calories from fat is approximately 60 percent, compared with up to 90 percent on the ketogenic diet.
The modified Atkins diet is another effective diet that is less restrictive than the ketogenic diet.
Although the foods are very similar, with the Atkins diet there are no restrictions on fluids, calories or proteins. Carbohydrates are monitored, but foods are not weighed and measured.
In studies to date, approximately two-thirds of patients on the modified Atkins diet had a 50 percent reduction in seizures after six months.
It is not yet known why these diets prevent seizures, or why they work for some patients and not others. Research to learn more about the effects of diet on epilepsy is ongoing. With all dietary approaches to managing epilepsy, if the patient is seizure-free for a period of time, the physician may discuss whether to wean the patient off the diet.