Epilepsy is the most common neurological disorder, with the World Health Organisation estimating prevalence at around 1% of the global population.1 For almost a century, the ketogenic diet has been used for the management of difficult-to-treat epilepsy. Although the diet was a preferred option in the management of epilepsy until the 1920s, its use declined after the introduction of anti-epileptic drugs. The recognition that the ketogenic diet is a valid option for difficult-to-treat epilepsy, has led to a refocus since the 1990s.
1. The global Campaign against Epilepsy. Geneva. World health organization 2000. (Information pack for the launch of the Global Campain's Second Phase. 12-15 February2001).
The role of nutrition
Most patients with epilepsy respond well to anti-epileptic medication2. For the 20-30% of patients who do not respond3, the ketogenic diet may be recommended. Although its' mechanism is not yet fully understood, the ketogenic diet can offer an effective way to achieve seizure reduction or seizure freedom4-8.
The ketogenic diet is a high fat, low-carbohydrate diet, which ensures adequate protein for growth. By simulating the metabolism of fasting, a patient on the ketogenic diet will start to derive their energy principally by burning the fat in the diet, rather than the more common energy source, glucose9.
There are several types of ketogenic diet, for example the frequently prescribed 'Classical Ketogenic Diet' and also the 'Medium-Chain-Triglyceride Diet'; the efficacy in seizure reduction of both have been well proven in clinical trials5.
In the recent years, more relaxed alternatives of the ketogenic diet have become available next to the classical version of the diet, as well as doctors considering the diet as an earlier option in the management of difficult-to-treat epilepsy8.
2. Stafstrom C et al. Epilepsy and the ketogenic diet. 2004. Humana Press. Totawa. 3. Kwan P et al. Early identification of refractory epilepsy. N Engl J Med 2000:342;314-319 4. Freeman J et al. The ketogenic diet: a treatment for epilepsy in children and others. 2007. 4th ed. Demos, New York. 5. Neal EG et al. Lancet Neurol 2008;7:500-506. 6. Keene DL. Ped Neurol. 2006;35(1):1-3. 7. Henderson GB et al. J Child Neurol 2006;21 (3):193-198. 8. Kossoff EH et al. Epilepsia 2009:febr50(2)304-317. 9. Levy R, Cooper P. Update in Cochrane Database Syst Rev. 2012;3:CD001903.
Future based research
Today, research on the ketogenic diet is being published at a rate never seen before. There is a significant amount of evidence that shows seizure improvement in approximately half of children on the ketogenic diet. Our researchers are currently investigating new and innovative products to improve the quality of life for many patients with epilepsy, and their families.
We continually strive to develop further breakthrough ideas that help us live up to our vision, designing a comprehensive porpolio of products to be used in the classical ketogenic diet for both infants and children as a sole source of nutrition, e.g. in tube-fed children or bottle-fed babies. Alongside that, the Nutricia porpolio provides several nutrition options to support the oral ketogenic diet with the powdered and ready-to-feed liquid variants as well as specific modules.
All the products are classified as Food for Special Medical Purposes and Medical Food and are intended for patients who are medically diagnosed, for use under medical supervision.