Epilepsy Diets: Foods for Thought

Since joining the NYU Comprehensive Epilepsy Center as its full-time Registered Dietician Coordinator in February, Courtney Schnabel, MS, RD, CDN —working in close coordination with the Center’s other experienced doctors—has helped many of its patients receive medical nutrition therapy as part of their epilepsy treatment.

In particular, Courtney offers extensive experience helping implement and monitor the Ketogenic Diet and other nutrition therapies for the Center’s patients. Generally speaking, individuals with Doose Syndrome, Dravet Syndrome, Tuberous Sclerosis, Lennox-Gastaut and GLUT-1 transporter deficiency have tended to respond particularly well to the Ketogenic diet, and it’s being used in treating patients experiencing Infantile Spasms as well.

“We are currently managing over 90 patients—both pediatric and adult—on one variety of the diet. Of those patients, most are pediatric and roughly 5% have Dravet Syndrome, which is one of the most difficult-to-control epilepsy syndromes,” Courtney notes. She adds, "The diet is considered to have a 50% success rate in the majority of patients who are treated. However, small-scale studies have shown higher success rate in children with Dravet Syndrome."

How Ketogenic diets work

In Ketogenic-style diets, carbohydrates (carbs) are restricted, and protein is provided only in amounts to meet the recommended dietary allowance to support growth and development. Fat is the main component of meals, providing roughly 90% of total calories. Meals are provided in exact portions with higher ratios of high-fat foods to encourage the breakdown of fat for energy. When the body has fewer calories from carbs and protein, it switches from burning glucose to burning fat for energy.

The breakdown of fat creates ketone bodies and a state of “ketosis”.  Although the exact mechanism of action is not confirmed, the sustained state of ketosis is believed to suppress neurotransmitter activity and improve seizure control.

Of course, a Ketogenic-style diet is not appropriate for treating every type of epilepsy and are not intended as an alternative to medical treatment. Rather, the diet is one of many tools used by the Center’s team to treat certain patients with epilepsy. Many factors must be considered, and the diet is not suitable for patients with certain metabolic conditions. The strict diet should be implemented under close supervision and monitoring by doctors experienced in this therapy, such as those with whom Courtney works at NYU.  Under no circumstances should the diet be administered on one’s own.

For more information

Read the following presentation Nutrition and Epilepsy: Healthy Lifestyle and Therapeutic Approaches, which Courtney delivered at the 2012 FACES Epilepsy Conference. To learn how the Center can help with nutrition therapy, call (646) 558-0846.