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Lower in carbohydrate than Atkins and up to 90% fat, ketogenic diets have been used for over 30 years to treat seizure disorders. Modified ketogenic diets, however, are also being used for weight loss, for controlling migraines, and for diseases of aging.

In the treatment of epilepsy, the ketogenic diet is often described as a "big fat miracle." Over 100 hospitals in the United States and Canada offer a mostly-fat ketogenic diet as a treatment for intractable, drug-resistant seizure disorders, often with dramatic results. The story of 11-year-old Sam is a good example of how the diet works.

At the age of four, doctors believe, Sam had a mild case of meningitis. Shortly after he recovered from the infection, he began to have epileptic seizures. First he had just one or two seizures a day, but eventually he suffered as many as 150 a day, and was in constant danger of status epilepticus, a condition of non-stop seizures that often ends in death.

Nothing the doctors could prescribe for Sam worked for his epilepsy. A neurosurgeon even suggested that Sam's parents consider the surgical removal of half of his brain, when a diet-oriented neurologist suggested that they try ketogenic diet first.

The Anti-Epilepsy Fat-Added Diet

Ketogenic diets are eating plans that force the body to generate and burn ketones rather than glucose. The body can turn both carbohydrates and proteins (when eaten in excess) in the sugar glucose. When the diet is nearly 100% fat, however, it "burns" fatty acids by converting them into acetone (the same chemical found in nail polish remover), which is exhaled through the breath and excreted in the urine, and beta-hydroxybutyrate (which is, stricly speaking, not a ketone but a ketone derivative). 

When the brain is forced to use beta-hydroxybutyrate "ketone bodies" for fuel, for reasons investigators do not entirely understand, seizures become much less severe and much less frequent, even without medication.

Sam's diet is a conventional nutritionist's nightmare:

  • For breakfast, Sam eats scrambled eggs made with egg yolks and cream and cooked in olive oil, along with five slices of bacon.
  • For lunch, Sam has whole-milk Greek yogurt, with no fruit flavoring and no sugar of any kind, mixed with coconut oil to add enough calories.
  • For dinner, Sam has sausages (with no carbohydrate in the filler), hot dogs (without a bun), macadamia nuts, and hard cheese. He can also have bacon.

The food Sam eats contains twice as much fat as a Big Mac and 25% more fat than the low-carb phase of an Atkins diet. Sam consumes almost no carbohydrate. Cookies, candy, pies, cake, and macaroni and cheese are strictly forbidden. On special occasions, Sam is allowed to trade cookies or cake for a present instead. And managing Sam's health on the ketogenic diet is not easy.

Complications of Ketogenic Eating

Ketogenic diets are constipating. Kids and adults who eat high-fat have to take stool softeners--never fiber supplements, because they contain sugar and bacteria in the gut can release sugar from the fiber--to stay regular. If Sam does not drink enough water, he can easily develop kidney stones. And because Sam's diet is deficient in most minerals and most vitamins, taking a daily nutritional supplement is an absolute must. For treating conditions other than epilepsy, however, a little leeway in the ketogenic diet is possible.

Continue reading after recommendations

  • Di Lorenzo C, Currà A, Siriani G, Coppola G, Bracaglia M, Cardillo A, De Nardis L, Pierelli F. Diet transiently improves migraine in two twin sisters: possible role of ketogenesis? Funct Neurol. 2013 Dec 3:1-4.
  • Klement RJ. Calorie or carbohydrate restriction? The ketogenic diet as another option for supportive cancer treatment. Oncologist. 2013. 18(9):1056. doi: 10.1634/theoncologist.2013-0032. PMID: 24062422.
  • Photo courtesy of rpavich by Flickr :
  • Photo courtesy of John Verive by Wikimedia Commons :,_egg_and_cheese_sandwich.jpg

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