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Brain magic

MagazineJanuary 2013 (Vol. 23 Issue 10)Brain magic

Alow-glycaemic diet may stop your child's seizures naturally

A low-glycaemic diet may stop your child's seizures naturally.

race was three and a half years old when she was diagnosed with epilepsy. Although she'd begun talking at two, 18 months of grand mal seizures and antiseizure medication had left her unable to talk. Her parents took her to the renowned Johns Hopkins Hospital medical centre in Baltimore, Maryland, where a specialist wanted her to try a special diet.

The challenge was to persuade a three-year-old to follow a low-carbohydrate low-protein regime that would eliminate sugar and virtually every favourite nursery food, so her sisters and cousins began calling it 'Grace's Magic Diet', telling her that it would make the 'boo-boos' in her head disappear. They even drew a picture book so she'd feel special when eating her 'magic' food.

To her doctor's delight, the diet worked its magic; Grace turned out to be a 'super-responder' and her seizures vanished within a few days.

Grace stayed on her Magic Diet for 18 months and then was slowly weaned off it. The seizures never returned, and Grace now speaks normally and is in every other way a healthy seven-year-old.

Grace is an American but like her, some 60,000 UK children are diagnosed with epilepsy (and 300,000 US children) before they're 18. The most common serious neurological disorder worldwide, according to the World Health Organization, epilepsy occurs when the brain's electrical activity misfires, causing recurrent seizures-from momentary 'blank-ing out' (absence or petit mal) to full-fledged convulsions (tonic-clonic or grand mal). Although epilepsy can strike at any age, children under 18 make up at least half of all new cases.

Doctors don't understand why brain electrical activity goes out of kilter and tend to treat the symptoms with a raft of anticonvulsant drugs, which alter electrical transmissions in the brain or change the brain's chemicals.

There's no doubt that they work: around two-thirds of the patients with newly diagnosed epilepsy who take them become seizure-free (Epilepsy Curr, 2008; 8: 90-1).

But antiepileptic drugs don't address the actual cause of why your child is having fits and they come with a high price to pay in terms of side-effects-everything from mental and visual disturbances to suicidal behaviour.

The good news is that drugs are not the only way to manage epilepsy. As the Johns Hopkins doctors and many others have discovered, many (though not all) cases of epilepsy are caused or exacerbated by certain foods or nutritional deficiencies.

If this is so and you can locate the culprit, just a few changes in the diet may help your child's seizures to lessen or even disappear. The same goes for adults if you or a loved one has the condition.

As your child's detective, a first place to look is at something he or she is getting too much of (a food he's allergic to) or something he isn't getting enough of (certain nutrients). Removing the offending food or adding certain supple-ments can do wonders to sort out the seizures and ultimately get your child off the drugs.

Remember, though, that with a potentially serious condition like epilepsy, you should never embark on any drug-free switch without the guidance or supervision of a qualified health practitioner. And feel free to share with your healthcare provider WDDTY's diet and supplement programme for a drug-free approach and work together to determine if you can get your child off drugs.

Allergies

Believe it or not, as nutritionists increasingly recognize, food sensitivities and allergies can lie at the root of many cases of common fits or even full-scale epilepsy. When food is the problem, simply avoiding the offending foods can reduce the frequency of seizures or eliminate them altogether (Altern Med Rev, 2007; 12: 9-24).

Suspect that allergy or food sensitivity is to blame if your child also has asthma or hay fever. Although any food can be the source of the problem, it may be best to get your child tested. WDDTY panellist Harald Gaier has found the Food Allergen Cellular Test (FACT) offered by Genova Diagnostics in New Malden, Surrey (www.gdx.net/uk/product/10; tel: 020 8336 7750), to be the most reliable, or contact the Biolab Medical Unit in Central London (www.biolab. co.uk; tel: 020 7636 5959/5905).

In the meantime, investigate these two most common culprits.

Wheat. Epilepsy and coeliac disease (allergy to gluten) often go hand in hand and if that's the case, seizures will improve or end by eliminating all foods containing gluten (wheat, rye, barley and sometimes oats) so long as you work out the connection early-soon after the onset of seizures (Altern Med Rev, 2007; 12: 9-24). If you suspect a food as a possible cause, check this one out first.

Cow's milk. Kids with epilepsy often suffer from sensitivity to cow's milk, particularly if they also have asthma, another condition brought on by diet (Acta Neurol Scand, 2001; 104: 349-52).

Many kids often eat a diet almost entirely made up of wheat and cow's milk, so if your child's a picky eater and mostly filling up on bread and milk, suspect this as a cause.

Low-carb diets

If food sensitivities don't turn out to be the problem, you could try Grace's Magic Diet, officially known as the 'ketogenic diet', or some variation of it. This high-fat low-protein low-carbohydrate diet from the 1920s, now well accepted by the medical profession, turns out to be as effective for children as most of the newer epilepsy drugs (Pediatrics, 2007; 119: 535-43).

Following this diet leads to 'ketosis'-high blood levels of 'ketones' in the body. These chemicals appear in the blood and urine when the body burns fat rather than the usual carbs (from, say, bread, pasta or sugar) for energy. And because the ketogenic diet is very low in carbs, fat becomes the body's primary fuel-as it does in the first stages of the Atkins diet. Although we don't understand how ketosis controls seizures, higher levels of ketones in the body appear to improve control of seizures.

In one study, more than a third of the children following this diet for three months cut their seizures by more than half and, in 7 per cent of the children, by more than 90 per cent (Lancet Neurol, 2008; 7: 500-6).

Other research shows that between 10 and 33 per cent of patients on this diet become seizure-free, and 40-70 per cent cut their seizure frequency in half. Like Grace, many are able to reduce or stop their medication (Altern Med Rev, 2007; 12: 9-24).

This diet works particularly well in children aged between 2 and 5, although older patients can benefit too and all types of seizures seem to respond to the diet.

Because the diet is so high in fat and low in carbs and protein, it can cause gastrointestinal upset, dehydration, high blood levels of fat and acidity, tiredness and even kidney stones (Pediatrics, 2007; 119: 535-43). If you do want to try this diet with your child, it's vital that you supplement with vitamins and minerals to prevent nutritional deficiencies (Altern Med Rev, 2007; 12: 9-24).

But the main problem with the diet is administering it, if you're the parents, and sticking to it, if you're the child. If you're planning to embark on it, make sure to get the guidance and supervision of an experienced healthcare team that includes a doctor, a dietitian and often a nurse as well.

A slightly kinder and gentler version of the ketogenic diet is the high-fat, low-carb modified Atkins diet. This Atkins approach also leads to ketosis, but with fewer restrictions on calories and protein so it's easier to follow.

It's also just as effective as the ketogenic diet for epilepsy. When both diets were pitted against each other, both worked equally well at reducing seizures after six months (Seizure, 2009; 18: 359-64). According to a review of eight studies of the modified Atkins diet, more than a quarter of patients reduced their seizures by more than 90 per cent and nearly half by 50-90 per cent-results that are remarkably similar to those with the classic ketogenic diet (Epilepsia, 2008; 49: 37-41).

In fact, the latest evidence shows that even a low-carb diet on its own may be beneficial for epilepsy. Carbs differ in their capacity to raise blood-sugar levels in the body and are now classified according to that potential in a system called the glycaemic index (GI). This diet, which relaxes the very tough restrictions of the ketogenic and modified Atkins diet, restricts carbs to those producing only small changes in blood glucose levels-this means it includes all but the starchy vegetables and certain fruits, and even some grains and legumes.

When the GI diet was put to the test recently in 76 children, 89 per cent with drug-resistant epilepsy, two-thirds cut their seizures by more than half after a year on the diet and almost half saw dramatic results after just one month.

The success of the GI diet, which is almost as effective as the other two, suggests that the mechanism behind all three could have to do with lowering glucose levels in the blood and not just changing ketone levels in the body (Epilepsia, 2009; 50: 1118-26). And this, of course, suggests that one possible cause of epilepsy is the highly processed, high GI-carb diet usually fed to children.

As with Grace, these diets are most successful when followed for a year or more, but you can achieve long-term benefits even after only a few months, which could mean the diets may result in some sort of permanent protective effects in the brain (Neurotherapeutics, 2009; 6: 406-14).

Supplements

Patients with epilepsy often have one or more nutritional deficiencies, often in vitamins B1 and B6, vitamin E, magnesium or manganese. Doctors have even coined the term 'vitamin B6-dependent epilepsy' to describe cases where they can completely control a patient's seizures just by giving large doses of vitamin B6.

The same goes for supple-menting with other nutrients. In one study where children taking anticonvulsants (and still having seizures) were given 400 IU a day of vitamin E with their usual medication for three months, more than 80 per cent of those in the vitamin E group reduced their seizure frequency by more than 60 per cent, and half of them virtually eliminated all of their seizures (Epilepsia, 1989; 30: 84-9).

Other research shows that supplementing with magnesium, manganese and omega-3 fatty acids can help to control your child's seizures. But this needs to be done with professional help, as certain supplements like folic acid and vitamin B6 can actually make things worse (Altern Med Rev, 2007; 12: 9-24).

Lynne McTaggart and Joanna Evans



vol 23 no 9 December 2012


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