Authored by Yubin Lee
Art by Daisy Meng
Keto: one of the hottest topics in diet culture.
In the ever-evolving landscape of media, where trends come and go like passing fads, one diet has persistently held the spotlight—the ketogenic diet. With its allure of rapid weight loss, heightened mental clarity, and increased energy levels, the ketogenic diet has become the darling of health enthusiasts and those seeking to transform their lives through nutrition. However, the ketogenic diet is not merely another fleeting trend. It is a dietary approach that carries the potential to revolutionize a neurological condition that’s puzzled medical experts for centuries: epilepsy.
The ketogenic diet, commonly consisting of low-carb, medium-protein, high-fat foods, is characterized by its drastic reduction of carbohydrate intake and increase in healthy fats [1]. This combination of foods trigger ketosis: a metabolic state during which the body starts relying on ketones for energy rather than glucose [2]. (For those unfamiliar, ketones are chemicals produced by your liver when it breaks down fats.) As a result, the ketogenic diet promises an array of potential benefits. Fueled by countless success stories, celebrity endorsements, and a growing collection of cookbooks, this dietary regimen has captivated the imaginations of those seeking a new path to health.
But what does this all have to do with epilepsy? Epilepsy is a neurological, chronic condition characterized by recurrent seizures—abrupt, uncontrolled bursts of electrical activity in the brain that can manifest in a wide range of physical and mental symptoms. These seizures, varying in intensity and duration, can profoundly impact an individual's quality of life, daily activities, employment, and social interactions. Unfortunately, epilepsy affects over 50 million people all over the world [3].
While many find relief through antiepileptic medications, a significant portion of those diagnosed have seizures that resist conventional treatments. This means that drugs, pills, and other medicines are ineffective in controlling their seizures [4]. Such forms of epilepsy have caused intense interest in alternative treatments— which is where the remarkable ketogenic diet comes in.
Though the ketogenic diet may be the latest trend, its application in epilepsy management is far from a passing fancy. It actually predates most modern dietary fads, and we can trace its origin back to the early 20th century. This was when Hugh Conklin, an osteopathic physician, first discovered keto as a non-pharmacological intervention for epilepsy [5]. Since then, the diet’s efficacy in reducing seizures has been demonstrated through various clinical studies, especially in drug-resistant cases.
However, it is important to emphasize that despite ketogenic diet’s long history and proven results, the precise mechanisms underlying its effectiveness remain elusive. This dietary approach challenges conventional wisdom about nutrition and neurological health, leaving scientists and medical professionals intrigued yet uncertain of its workings. Despite this, several prevailing theories have gained prominence within the scientific community which provide insight into why the diet may be an effective tool in the management of epilepsy:
1. Metabolic Shift:
One theory focuses on the fact that the ketogenic diet triggers a fundamental metabolic shift by altering where the brain gets its energy. By reducing carbs and producing ketones, the brain starts primarily using ketones instead of carbs as an alternative source of fuel. Ketones are believed to provide a more stable and consistent energy supply compared to the fluctuations associated with glucose metabolism. Thus, scientists believe that the keto diet may contribute to the stabilization of neuronal activity, which reduces the likelihood of seizures [6].
2. Neurotransmitter Modulation:
Another theory revolves around the ketogenic diet's influence on neurotransmitters, the chemical messengers facilitating communication between brain cells. It is predicted that the diet may impact the balance of neurotransmitters, such as glutamate and GABA, which play critical roles in regulating neuronal excitability. By altering this delicate equilibrium, the ketogenic diet may dampen excessive neuronal firing, thereby reducing the occurrence of seizures [7].
3. Anti-Inflammatory Effects:
Recent research has shed light on the potential anti-inflammatory effects of the ketogenic diet. Chronic inflammation is known to be associated with certain types of epilepsy, and by reducing carbohydrate intake, keto may mitigate inflammation in the brain and provide a protective effect against seizures [8].
Who would’ve thought that a diet culture sensation could become a beacon of hope for millions of people suffering from a neurological condition? As science delves deeper into keto’s enigmatic effectiveness, the promise of this dietary approach shines ever brighter— offering a lifeline to those whose lives are profoundly impacted by epilepsy. This mind-boggling connection leaves many of us wondering what new horizons await in the future of nutrition and neuroscience.
Works Cited
Person, et al. “Dietary Therapies for Epilepsy: 5 : V2: Handbook of Pediatric Epilep.” Taylor & Francis, Taylor & Francis, 1 June 2023, www.taylorfrancis.com/chapters/edit/10.1201/9781003296478-5/dietary-therapies-epilepsy-eric-kossoff.
D’Andrea Meira I;Romão TT;Pires do Prado HJ;Krüger LT;Pires MEP;da Conceição PO; “Ketogenic Diet and Epilepsy: What We Know so Far.” Frontiers in Neuroscience, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/30760973/. Accessed 30 Nov. 2023.
“Epilepsy.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/epilepsy. Accessed 30 Nov. 2023.
El-Rashidy, Omnia Fathy, et al. “Ketogenic Diet for Epilepsy Control and Enhancement in Adaptive Behavior.” Nature News, Nature Publishing Group, 6 Feb. 2023, www.nature.com/articles/s41598-023-27373-1.
Freeman, John M. “The Ketogenic Diet: One Decade Later .” Publications.Aap.Org, publications.aap.org/pediatrics/article/119/3/535/70431/The-Ketogenic-Diet-One-Decade-Later. Accessed 30 Nov. 2023.
Masino, Susan A, and Jong M Rho. “Metabolism and Epilepsy: Ketogenic Diets as a Homeostatic Link.” Brain Research, U.S. National Library of Medicine, 15 Jan. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6281876/.
Yudkoff, Marc. “Ketogenic Diet, Brain Glutamate Metabolism and Seizure Control.” Prostaglandins, Leukotrienes, and Essential Fatty Acids, U.S. National Library of Medicine, 2004, pubmed.ncbi.nlm.nih.gov/14769486/#:~:text=Relatively%20more%20glutamate%20then%20is,as%20a%20precursor%20to%20GABA.
Ruskin, David N, et al. “Ketogenic Diet Effects on Inflammatory Allodynia and Ongoing Pain in Rodents.” Nature News, Nature Publishing Group, 12 Jan. 2021, www.nature.com/articles/s41598-020-80727-x#:~:text=Ketogenic%20diets%20are%20very%20low,of%20action%20is%20reducing%20inflammation.
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