Ketogenic Dietfor Epilepsy

By :Kimberley Baudanza, Brooke Luckie, Markelle Rollins

Kimberley

BaudanzaThe most common serious neurological condition in the world with a commonness of one percent of the population is epilepsy. Epilepsy mostly occurs in children and the elderly, although there are many methods of management twenty-five percent of the children diagnosed still suffer from uncontrolled seizures. A treatment option that has been used since 1921 is the Ketogenic diet (KD). An analysis formed from nineteen studies, with over a thousand eighty-four pediatric patients tested was completed in 1998 by Blue Cross Blue Shield. Overall the end results of the diet in pediatric epileptic patients was, sixteen percent became seizure free, thirty two percent had a ninety percent reduction in seizures and fifty six percent had half as many seizures as before. The diet is high in fat, moderate in protein, and low in carbohydrates. In order for this diet to be affective, the person must have self-control and be obedient of the diet.

SummaryCitation “An Overview of the Ketogenic Diet for Pediatric Epilepsy”Author : Zupec-Kania BA, Spellman E. Children's Hospital of Wisconsin, Nutritional Services, Milwaukee, WI 53122, USA. bkania@chw.org

Breakfast

Daily Meal Plan

Lunch

Dinner

• Buda P, Wieteska-Klimczak A, Własienko A, Mazur A, Ziołkowski J, Jaworska J, Kościesza A, Dunin-Wąsowicz D, Książyk J.

• Source• Department of Pediatrics, The

Children's Memorial Health Institute, Warsaw, Poland. http://www.ncbi.nlm.nih.gov/pubmed/23996884

• Exogenous LP (ELP) is associated with the aspiration or inhalation of oil present in food, oil-based medications or radiographic contrast media. The clinical manifestations of LP range from asymptomatic cases to severe pulmonary involvement, with respiratory failure and death, according to the quantity and duration of the aspiration. The diagnosis of exogenous lipoid pneumonia is based on a history of exposure to oil and the presence of lipid-laden macrophages on sputum or bronchoalveolar lavage (BAL) analysis. High-resolution computed tomography (HRCT) is the imaging technique of choice for evaluation of patients with suspected LP. The best therapeutic strategy is to remove the oil as early as possible through bronchoscopy with multiple BALs and interruption in the use of mineral oil. Steroid therapy remains controversial, and should be reserved for severe cases. We describe a case of LP due to oil aspiration in 3-year-old girl with intractable epilepsy on ketogenic diet. Diagnostic problems were due to non-specific symptoms that were mimicing serious infectious pneumonia. A high index of suspicion and precise medical history is required in cases of refractory pneumonia and fever unresponsive to conventional therapy. Gastroesophageal reflux and a risk of aspiration may be regarded as relative contraindications to the ketogenic diet. Conservative treatment, based on the use of oral steroids, proved to be an efficient therapeutic approach in this case.

Citation

Summary

Ketogenic diet for epilepsy By: markelle Rollins

Personal Diet List

Food Item Number of Servings Serving Size Total grams

ASPARAGUS-CKD-BOILED-DRAINED-W/SALT 0.5 1 CUP 90 grams

FINFISH-TROUT-MIXED SPECIES-COOKED-DRY HEAT 1 1 FILLET 62 grams

WATER-BOTTLED-PERRIER 1 1 c 236.31 grams

YOGURT-PLAIN-WHOLE MILK-8 GRAMS PROTEIN PER 8 OZ 1 1 CNTR8 OZ NT

WT 227 grams

CHEESE FOOD-COLD PACK-AMERICAN 1 1 PKG NT WT 8

OZ 227 grams

TURKEY ROLL-LIGHT MEAT 2 1 SLICES 56.7 grams

BLACKBERRIES-RAW 1 1 c 144 grams

SOY MILK-FLUID 1 1 c 240 grams

EGGS-CHICKEN-WHOLE-CKD-SCRAMBLED 2 1 EGG 120 grams

Personal diet list

BREAKFAST Scrambled eggs, blackberries and vanilla soy milk

LUNCH Turkey roll , American cheese, water

SNACK Greek yogurt

DINNER Trout, asparagus

Ketogenic Diet for epilepsy diet analysis

Analysis results

Analysis Results

Nutrient Total Rec. %Rec

Calories 1465.87 2200 66.63%

Pro (g) 103.15 48 214.9%

Fat (g) 92.51 73.33 126.16%

Carb (g) 58.96

--

Fiber (g) 12.21 30 40.7%

Cal (mg) 1651.6 1000 165.16% Iron (mg) 8.34 10 83.4%

Na (mg) 3200.11 2400 133.34% Pot (mg) 2534.57

--

Phos (mg) 1822.53 700 260.36%

Ash (g) 17.63 330 5.34% vitA (IU) 3536.52 4000 88.41%

vitC (mg) 41.65 75 55.53% Thia (mg) 1.05 1.1 95.45% Ribo (mg) 2.58 1.1 234.55%

Nia (mg) 9.9 14 70.71% H2O % 78.91 Female 19-30 --

satF (g) 46.68 24.44 191% monoF (g) 28.83 24.44 117.96% polyF (g) 8.71 24.44 35.64%

Chol (mg) 667.45 300 222.48%

Literature View Brooke Luckie

Citation

Mark T. Mackay, et al. "Efficacy Of The Ketogenic Diet: Which Epilepsies Respond?." Epilepsia (Series 4) 53.3 (2012): e55-e59. Academic Search Complete. Web. 9 Oct. 2013.

Summary The ketogenic diet is a medically

supervised, high-fat, low-carbohydrate, and moderate-protein diet, which has been successful in patients with refractory epilepsy. Epilepsy is a disorder of abnormal brain activity and the major sign is recurrent seizures. This diet has helped significantly reduce and even removed seizures from the individuals. The studies involving the care of epilepsy using the ketogenic diet has been surprisingly responsive. The fat in the diet is not yet known exactly why this greatly reduces the seizures and abnormal brain activity among individuals.

Brooke LuckieDays Menu

Food Item Number of Servings Serving Size Total Grams

CHEESE FOOD-COLD PACK-AMERICAN

1 1oz 28.35 grams

EGGS-CHICKEN-WHOLE-CKD-FRIED

2 1 LRG EGG 92 grams

CREAM-FLUID-HEAVY WHIPPING 1 1 oz 28.35 grams

COFFEE-BREWED-PREPARED WITH TAP

WATER1 1 c 236.8 grams

SOY MILK-FLUID 1 1 c 240 grams

WATER-MUNICIPAL 1 1 c 682.67 grams

CHEESE-CREAM-PHILADELPHIA-SOFT

1 1 oz 28.35 grams

CELERY-RAW 1 1 STALK 40 grams

CHEESE-NATURAL-PARMESAN-GRATED

1 1 oz 28.35 grams

Brooke Luckie Days Menu Continued

Food Items Number of Servings Serving Size Total Grams

SQUASH-SUMMER-SCALLOP-RAW

1 1 c 130 grams

PORK PRODUCTS-CURED-HAM-WHOLE-FULLY COOKED-ROASTED

3 1 oz 85 grams

TEA-INSTANT-UNSWEETENED-LEMON FLAVORED-PREPARED

1 1 CUP WATER+1TSP POWDER 238 grams

SALAD DRESSING-BLUE+ROQUEFORT CHEESE-COMMER-REGULAR-WO/SALT

1 1oz 28.35 grams

MUSHROOMS-RAW 1 1 c 70 grams

GUAVAS-STRAWBERRY-RAW 1 1 oz 28.35 grams

SPINACH-RAW 1 1 c 56 grams

LETTUCE-COS OR ROMAINE-RAW

1 1 pt 112 grams

FISH OIL-SALMON 4 1 oz 113.4 grams

Menu AnalysisBrooke Luckie

Nutrient Total Rec. %RecCalories 2156.61 2200 98.03%

Pro (g) 67.03 48 139.65%

Fat (g) 197.46 73.33 269.28%

Carb (g) 34.03 --

Fiber (g) 8.84 30 29.47%

Cal (mg) 826.5 1000 82.65%

Iron (mg) 8.81 10 88.1%

Na (mg) 2419.87 2400 100.83%

Pot (mg) 2414.19 --

Phos (mg) 1116.35 700 159.48%

Ash (g) 13.59 330 4.12%

Nutrient Total Rec. %RecvitA (IU) 8918.15 4000 222.95%

vitC (mg) 82.5 75 110%

Thia (mg) 1.32 1.1 120%

Ribo (mg) 1.79 1.1 162.73%

Nia (mg) 9.91 14 70.79%

H2O % 67.58 Female 19-30

--

satF (g) 57.88 24.44 236.82%

monoF (g) 53.53 24.44 219.03%

polyF (g) 53.12 24.44 217.35%

Chol (mg) 1137.52 300 379.17%

ADEQUACY: The Ketogenic Diet for Epilepsy requires people on a ketogenic diet have to eat mostly fatty foods, such as butter, cream, and peanut butter. BALANCE: This diet highly stresses a balance between Foods such as bread, pasta, fruits, and vegetables have to be severely limited. And the person's total calories and fluids are also restricted. At every meal, the food has to be measured carefully so that the right amounts of each food are given. Even a slight departure from the diet can cancel its effect.

Consensus

Consensus The ketogenic diet is a special high-fat, low-carbohydrate diet that helps to

control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is more strict, with calorie, fluid, and protein measurement and occasional restriction than the modified Atkins diet, which is also used today. Several studies have shown that the ketogenic diet does reduce or prevent seizures in many children whose seizures could not be controlled by medications. Over half of children who go on the diet have at least a 50% reduction in the number of their seizures. Some children, usually 10-15%, even become seizure-free. The name ketogenic means that it produces ketones in the body (keto = ketone, genic = producing). Ketones are formed when the body uses fat for its source of energy. Usually the body usually uses carbohydrates (such as sugar, bread, pasta) for its fuel, but because the ketogenic diet is very low in carbohydrates, fats become the primary fuel instead. Ketones are one of the more likely mechanisms of action of the diet; with higher ketone levels often leading to improved seizure control. However, there are many other theories for why the diet will work.