The Ketogenic Diet Revisited: Enhancing Epileptic Patient Quality of Life

摘要

The ketogenic diet is a high-fat, low-protein, low-carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. After the diet's renewed popularity several years ago, long-term and multicenter clinical trials are now available. These studies, along with recent animal models, provide evidence supporting the diet's efficacy when treating various types of epilepsy in both children and adults. Further evidence suggests that the classic 4:1 diet (fats to carbohydrates and protein) should be modified to an increased ratio, such as 6:1. Few serious complications are associated with the diet, and the side effects are considered tolerable as most patients remain on the diet at one year follow-up. The ketogenic diet may lead to a significant decrease in antiepileptic drug use and an accompanying decrease in daily medication costs. Although the mechanism of action is still uncertain, recent studies suggest that ketone bodies do not directly alter hippocampal synaptic transmission, however, they may increase glucose transport activity and provide an alternative energy source. Other research supports the inhibition of NMDA-type glutamate receptors in the presence of ketone bodies. The ketogenic diet has the potential to improve an epileptic patient's quality of life by decreasing seizure frequency, reducing the number of prescribed medications as well as daily medication costs, and by reducing the frequency of diet-medication interactions.