When children with epilepsy do not respond well to medications, doctors sometimes recommend special diets to help control seizures. These diets are usually used when medications are not effective enough or cause too many side effects. The goal of these diets is to adjust the body’s metabolism in a way that helps reduce abnormal brain activity. They typically involve reducing carbohydrates, increasing fats, and sometimes limiting proteins.
These diets should always be followed under a doctor’s supervision to avoid serious side effects. Alongside medication, these diets can play an important role in improving the quality of life for children with epilepsy. Below, we explore some of the most common dietary options for children with drug-resistant epilepsy.
Dietary Options for Children with Drug-Resistant Epilepsy
Drug-resistant epilepsy can seriously affect a child’s and their family’s daily life. When anti-seizure medications (ASMs) do not control seizures effectively, other treatments like surgery, vagus nerve stimulation, and special diets are considered. These diets usually aim to create a state called ketosis, where the body uses fat instead of carbohydrates for energy.
- Classic Ketogenic Diet (cKD)
The classic ketogenic diet has been used since the 1920s. In this diet, about 90% of calories come from fats, 6% from protein, and only 4% from carbohydrates, with a fat-to-protein+carbohydrate ratio of 3:1 to 4:1.
This high-fat diet produces ketones, which serve as an alternative energy source for the brain and help calm overactive neurons. Studies have shown that 55% of children had over a 50% reduction in seizures after one year on the ketogenic diet, and 27% had more than a 90% reduction.
Possible Side Effects: Constipation, vomiting, vitamin and mineral deficiencies, metabolic acidosis, high cholesterol, and kidney stones. Doctors usually recommend vitamin and mineral supplements to prevent these problems.
- Modified Atkins Diet (MAD)
The Modified Atkins Diet is a simpler and more flexible version of the ketogenic diet. In this plan, the fat-to-protein+carbohydrate ratio is about 1:1 to 2:1, and daily carbohydrate intake is limited to 10–30 grams.
Research shows that after three months on this diet, 52% of children experienced a 50% or greater reduction in seizures, and 30% had a 90% or greater reduction.
Pros: Easier to follow, more flexible, usually no need for hospitalization.
Cons: Requires careful monitoring and restrictions on some foods.
- Low Glycemic Index Treatment (LGIT)
Introduced in 2005, this diet focuses on eating carbohydrates with a glycemic index lower than 50. Daily carb intake is kept between 40 and 60 grams, without strict limits on fats and proteins.
Studies found that 66% of children had a 50% or greater seizure reduction after one year.
Pros: Easier to follow compared to the classic ketogenic diet.
Cons: May be slightly less effective in some patients compared to the ketogenic diet.
- Medium-Chain Triglyceride Diet (MCTKD)
In this diet, most fats come from medium-chain triglycerides (MCTs), which are quickly turned into ketones by the liver. This allows for more carbohydrates and proteins compared to the classic ketogenic diet.
Research shows that 64% of children had over a 50% reduction in seizures after three months, and 27% became seizure-free.
Pros: More flexible, allows higher carb intake.
Cons: May cause digestive issues like diarrhea and vomiting.
Choosing the right diet depends on each child’s condition, how well they adapt to the diet, and how they respond to treatment. The classic ketogenic diet remains the most proven option, but alternatives like the Modified Atkins Diet, Low Glycemic Index Treatment, and MCT diet are good options for children who struggle with stricter diets. It is essential to consult a doctor and a nutritionist to choose the right diet and avoid side effects.
Foods to Avoid for Children with Epilepsy
Just as following a proper diet is important, avoiding harmful foods is also necessary. Certain foods can cause sudden blood sugar spikes, overstimulate the brain, or interfere with ketosis, making seizures worse. According to reliable studies, children with epilepsy should avoid:
- High-Carbohydrate and Sugary Foods
- Candy, cakes, cookies, and sweet chocolates
- Sugary drinks like soda, packaged juices, and syrups
- Jam, honey, white sugar, and sweets
- Processed cereals and sweetened breakfast cereals
- White rice, pasta, white bread, and fried potatoes
These foods can quickly raise blood sugar levels and disturb the metabolic balance needed for seizure control.
- Fast Food and Processed Foods
- Chips, puffed snacks, and other processed junk food
- Fast foods like pizza, hamburgers, sausages, and deli meats
- Canned and packaged foods with preservatives
These foods often contain unhealthy fats, chemicals, and refined carbohydrates that negatively affect brain function.
- Stimulant and Caffeinated Drinks
- Coffee and instant coffee
- Strong tea and energy drinks
- Caffeinated soft drinks
Caffeine can overstimulate the brain, making seizures worse in some children.
- Foods That Can Cause Nutrient Deficiencies
- Carbonated drinks that reduce calcium and magnesium absorption
- Salty foods that disturb the body’s electrolyte balance
For better seizure control, children should follow a proper diet supervised by a doctor and nutritionist. Eating low-carbohydrate foods, healthy fats, and essential nutrients while avoiding harmful foods can greatly reduce the number and intensity of seizures.
Conclusion
Special diets like the ketogenic diet can help reduce seizures in children with drug-resistant epilepsy. High-fat, low-carb diets adjust brain activity and improve seizure control. However, every child needs a personalized plan, and careful monitoring of their diet, growth, and health is necessary. Doctors and nutritionists must work closely with families to prevent side effects and nutritional problems.
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