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It took a Hollywood producer, a made-for-TV movie with Meryl Streep, two decades of research, and the retraining of a cadre of dietitians and physicians to bring the ketogenic diet back into the mainstream. The hallmark feature of the diet is the production of ketones (beta-hydroxybutyrate, or BOHB), the residues left when fats are burned in the absence of sufficient glucose.
Although officially retired, Kelly continued to help me and my colleagues use the diet to treat six to eight children each year successfully.
Working with families whose children have epilepsy, we realized that there were no books written for parents to help them cope. Jim was outraged that in all his conversations with medical experts and other parents, he had never been told of the diet. The foundation also funded the production of several DVDs explaining the diet to parents, dietitians, and physicians.
The diet is rarely used as the initial treatment for epilepsy, but should be strongly considered when two anticonvulsants, properly used, have failed.
Modifications of the ketogenic diet, such as the modified Atkins diet, the medium-chain triglyceride (MCT) diet, and the low-glycemic diet (LGD), have been developed as alternatives to the rigidity of the classic version. Generally, children whose seizures are controlled by the diet are tapered off it after two years. The resurgence of interest in the ketogenic diet has led to some very preliminary studies of its use in conditions other than epilepsy.
Further information about the ketogenic diet may be obtained from the Charlie Foundation to Help Cure Pediatric Epilepsy. Baranano, KW and Hartman, AL The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illness, Treat Options Neurol. According to the National Society for Epilepsy, epilepsy affects at least 300,000 people in the UK - 60,000 of these people are children under the age of 16.
Seizures tend to develop in childhood or by late adolescence, but the likelihood of developing epilepsy rises again after the age of 65. The Daisyometer shows how much we have raised so far to keep our Daisy Garland Ketogenic Dietitian in place for the first year at The Royal Hospital for Sick Children in Glasgow.
We truly believe that the ketogenic diet prolonged Daisy's life, rescued us as a family, and as Daisy's mum, saved my sanity! Within days of starting the ketogenic diet Daisy's seizures reduced in both frequency and severity. The ketogenic diet is a rigid, mathematically calculated, doctor-supervised diet, which alters the body's chemistry by simulating the metabolism of a fasting body.
When a child starts the diet the ratio of fat to protein and carbohydrate combined are usually set at 4:1. Named after the ketone bodies excreted in the urine during ketosis, the ketogenic diet has been around since the 1920s. The diet is usually started in hospital, under the supervision of a neurologist, and is devised individually by a trained dietitian to fit the age, height, weight and metabolism of each child.

Your dietitian will draw up an individual menu plan for your child to follow and will prescribe any vitamins and minerals required whilst following the ketogenic diet. The ketogenic diet improves control of seizures in nearly three-quarters of the children who try it. If you would like to try the ketogenic diet you should approach your GP, neurologist or paediatritian. The incidence is greater in African-Americans and in socially disadvantaged populations, and about 200,000 new cases of epilepsy are diagnosed each year. One of the first and most successful therapies for epilepsy, the diet had fallen into obscurity with the introduction of anticonvulsant medications in the 1930s. The diet was far more effective than phenobarbital and bromides, then the only available anticonvulsant medications. Consequently, few physicians recommended the diet and not many dietitians knew of its benefits or were trained in its appropriate management. At the Third International Conference on Dietary Therapies for Epilepsy and Other Neurological Disorders, organized by the foundation in 2012, close to 500 physicians, dietitians, and parents from 30 countries around the world honored Streep for her role in reintroducing the diet. It is notable that 33 percent of the children with intractable seizures were seizure-free, or had only rare seizures, after being on the diet for one year, and 27 percent of the children whose seizures had previously been uncontrollable by medications had no seizures or only rare seizures three to six years after initiating the diet, although by that time most of the children were off the diet and all medications.
Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders Front Pharmacol. Medication failed to be effective for Daisy and the ketogenic diet was the miracle we had been praying for. It is a diet high in fat and low in protein and carbohydrate and is formulated to sustain the state of ketosis within the body. It was originally developed at the Mayo Clinic and Johns Hopkins University Hospital (Baltimore, USA) but unfortunately, as anticonvulsants drifted onto the market in the 1940s and 1950s, the ketogenic diet fell into disuse.
In 1922, Hugh Conklin, an osteopath and faith healer from Battle Creek, Michigan, erroneously theorized that epilepsy arose from the intestine and attempted a cure by fasting a number of children with epilepsy for up to 25 days, providing only limited liquids. With the discovery of phenytoin (Dilantin) in 1938 and the introduction of other anticonvulsant drugs soon afterward, the diet was gradually abandoned and largely forgotten.
Some with continued seizures remain on the diet because it has decreased the number of medications the children need to take as well as the consequent side effects.
A recent study9 suggests that episodic fasting, in addition to the diet, is even more effective than the diet alone in controlling seizures. Glioblastoma implanted in rodents rapidly regresses on a glucose-restricted ketogenic-like diet. On the 18th of January 2000, when Daisy was just 18 months old we were admitted to hospital to start the ketogenic diet. Even children with structural brain disorders such as microcephaly, hypoxic brain damage, prior strokes and developmental abnormalities have had success with the diet.

Once the diet is weaned many children's seizures fail to return or are limited to just a few. To date we have funded 11 Daisy Garland Ketogenic Dietitians all of whom work in NHS hospitals throughout the UK. Yet, even today, with many new medications, 30 percent of children with epilepsy continue to have difficult-to-control seizures. There the diet remained in vogue and was administered under the supervision of Millicent Kelly, his dietitian.
If that drug fails, too, then the likelihood of rendering someone with epilepsy seizure-free is poor.
Learning the mechanisms by which the diet controls epilepsy may give us a better understanding of epilepsy itself. Anecdotal reports and preliminary studies in humans have found tumor regression on ketogenic diets. There is no promise that the diet will be easy initially, but if it works - if it works - it becomes not only tolerable, but absolutely amazing. However, the ketogenic diet must never be undertaken without the correct medical and nutritional supervision. Thank you for supporting our work to improve the quality of life for children with difficult to control epilepsy. What seems to work just as well, if not better, especially in children, is a relatively unknown, high-fat diet.
More than 30 percent of patients with epilepsy will not have seizure control even with the best available medications.
Sensing a need for a separate book that focused solely on the diet, the dietitian Millicent Kelly and I collaborated with my daughter, Jennifer Freeman, a freelance writer, to write The Epilepsy Diet Treatment: An Introduction to the Ketogenic Diet, a shorter book specifically about the ketogenic diet. The risks of an unsupervised diet can result in malnutrition, chemical imbalances, vitamin deficiencies and may even result in death.
In 1990, I ceased directing the pediatric neurology division and focused my attention on pediatric epilepsy. This means that the child's diet will be made up of 4g of fat to every 1g of protein and carbohydrate combined. As the water content of a fasting body is lower than normal, the ketogenic diet may limit daily fluid intake.
Even children who are developmentally delayed or retarded can benefit from the diet; when their seizures cease or are reduced, they often make development progress.
Success of the diet requires strong determination, commitment and faith of the entire family.

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