Evidence a High-Fat Diet Works to Treat Epilepsy

A idea of a hig fat diet to treat epilepsy has been around since the 1920s and has often been dismissed by the medical community. A new British study shows good evidence that it works. I wonder how well essential fatty acids from fish oils and other quality fats like avocado, coconut, and flax would work compared to the highly saturated animal fats that were tested.

From The New York Times:

May 6, 2008

By ALIYAH BARUCHIN
A formerly controversial high-fat diet has proved highly effective in reducing seizures in children whose epilepsy does not respond to medication, British researchers are reporting.
As the first randomized trial of the diet, the new study lends legitimacy to a treatment that has been used since the 1920s but has until recently been dismissed by many doctors as a marginal alternative therapy.
“This is the first time that we’ve really got Class 1 evidence that this diet works for treatment of epilepsy,” said Dr. J. Helen Cross, professor of pediatric neurology at University College London and Great Ormond Street Hospital. She is a principal investigator on the study, which will appear in the June issue of The Lancet Neurology.
Though its exact mechanism is uncertain, the diet appears to work by throwing the body into ketosis, forcing it to burn fat rather than sugar for energy. Breakfast on the diet might consist of bacon, eggs with cheese, and a cup of heavy cream diluted with water; some children drink oil to obtain the fats that they need. Every gram of food is weighed, and carbohydrates are almost entirely restricted. Breaking the diet with so much as a few cookies can cause seizures to flare up.
For the British trial, the researchers enrolled 145 children ages 2 to 16 who had never tried the diet, who were having at least seven seizures a week and who had failed to respond to at least two anticonvulsant drugs.
One group began the ketogenic diet immediately. The control group waited three months before starting it. In the first group, 38 percent of the children had seizure rates reduced by half, compared with 6 percent in the control group. Five children in the diet group had reductions exceeding 90 percent.
Perceptions of the diet have changed sharply in the last decade. In 1993, a Hollywood producer, Jim Abrahams, took his 1-year-old son, Charlie, to Dr. John M. Freeman at the Pediatric Epilepsy Center at Johns Hopkins, which was one of the few centers championing the diet. Within three days of starting the diet, Charlie’s incapacitating seizures, which had resisted multiple medications and surgery, stopped entirely.
With his wife, Nancy, Mr. Abrahams founded the Charlie Foundation to Help Cure Pediatric Epilepsy to promote education about the diet. He produced an instructional video for parents and a made-for-television movie, “First Do No Harm,” starring Meryl Streep as a mother who seeks out the diet for her child.
As a result of the Johns Hopkins work, research on the diet blossomed and it became a standard treatment at hospitals and epilepsy centers in the United States and abroad.
Dr. Shlomo Shinnar, director of the Comprehensive Epilepsy Management Center at the Montefiore Medical Center in the Bronx, called the new study “an important trial that lays to rest the issue of ‘Does it really work or not?’ ”
Although the diet has to be medically supervised, Dr. Shinnar said, it is a mistake to believe that it requires extensive hospital resources and a staff’s constant attention. “Here they don’t have this,” he said of the British trial. “This study makes it clear that this actually can be made to work in a community setting.”