Ketogenic Diet

One of Sarah’s favorite meals: bacon,
cucumber, tomato, butter and cream

Definition: A medically prescribed high fat, low protein and carbohydrate diet that creates a metabolic state similar to fasting.

Normal Metabolism

Carbohydrates from food are broken down into glucose during digestion
Extra glucose is stored in the liver and muscles in the form of glycogen for short-term use between meals
Fat provides long-term storage of excess calories
Insulin causes glucose in the blood to be taken into cells for use as energy
Glucose is the brain’s preferred source of energy

Fasting Metabolism

Caloric intake is greatly reduced and glycogen stores are depleted
Fat stores are burned for energy instead of glucose
The breakdown of fat produces “ketone bodies” which can enter cells and cross into the brain to be used as energy
Seizure activity has been shown to be reduced when high levels of ketone bodies are present in the brain

Sarah helps to weigh her meals

The earliest references to fasting as a treatment for epilepsy date back to the 5th century B. C. and the Bible mentions fasting after a seizure (Saint Mark 9:17-29). The ketogenic diet as we know it today was developed at the Mayo Clinic in 1924. In the decades that followed many new anti-epileptic drugs were discovered and the ketogenic diet fell out of favor. In the 1990’s the diet gained national attention when Jim Abrahams made a movie about his son, Charlie, who’s intractable seizures were virtually cured by the ketogenic diet.

On August 8, 2005, at the age of 2, Sarah was admitted to Children’s Memorial Hospital in Chicago to start the classic form of the ketogenic diet. A registered dietitian calculated the daily amount of calories and protein that Sarah needed to keep growing. 80% of the calories in her meals came from fat. The remaining 20% was made up of protein and carbohydrate. Everything Sarah ate was planned and weighed ahead of time to ensure that her body continued to produce ketones.

Sarah and her play-doh birthday cake

Before starting the ketogenic diet, Sarah suffered from about 100 absence and myoclonic seizures each day. In addition, she would suffer a generalized tonic-clonic seizure (grand-mal) lasting 30 minutes or longer every two weeks. Within five days of starting the ketogenic diet she stopped having the absence and myoclonic seizures altogether and the tonic-clonic seizures shortened to about 5 minutes duration. Although she still experiences 15-25 brief seizures per month, Sarah’s quality of life has improved and her brain is able to keep learning since starting her “magic diet””.

In the spring of 2008, Sarah was weaned to the less restrictive Modified Atkins Diet. Although her carbohydrate intake is still strictly limited (she is allowed approximately 7 grams of carbohydrate per meal, or the equivalent of 1/2 cup of broccoli) she is able to eat as much protein or fat as she wants. We no longer have to weigh her food and she can even have snacks. Her current favorite is pumpkin muffins made with coconut flour. She is doing very well on her new "magic diet" with no significant increase in seizure activity.

To learn more about the ketogenic diet, go to www.CharlieFoundation.org