October 6, 2008

Ketogenic Diet - A History

By Kirk

The Ketogenic diet is not by all means a new treatment. Claims for a dietary treatment of epilepsy are very old, (even before any anticonvulsants were available). Earlier attempts to a diet for epilepsy include: salt restriction, protein restriction, acid-ash diets, water restriction (to provoke dehydration), etc. There is even a reference to fasting as a “cure” for seizures in the Bible.

The first scientific report on fasting as a treatment of epilepsy was in France by Guelpa and Marie in 1910 who reported that seizures stopped during absolute fasting. Later on, other investigators observed cessation of seizures and improvement in mental activity during starvation . These results prompted the reproduction of ketosis and acidosis by means of a high fat -low carbohydrate diet in 1921 by Wilder at the Mayo Clinic who was trying to prolong the state of ketosis in diabetics.

Dr John M. Freeman reports that almost concurrently at the Johns Hopkins Department of Paediatrics, Howland and Gamble observed that “prayer and a water diet which involved starvation for three to four weeks” improved the seizures of the nephew of a professor of paediatrics. They decided to use the diet because prayer alone was ineffective. And so the ketogenic diet was born. Other investigators like Drs Lennox and Cobb In Harvard University started investigating the ketogenic diet concurrently.

The Johns Hopkins version of the diet was found to be best tolerated in a study that compared it with the use of medium-chain triglyceride (MCT) oil in 1989.

By the 1960’s with the introduction of other anticonvulsants, the ketogenic diet became gradually more of a curiosity. The general feeling amongst neurologists was that it was ineffective.

By the end of the 80’s and beginning of the 90’s the interest for the diet was revived by the studies of Dr Freeman who found by 1992 that the diet was followed by complete seizure control in 30 percent of children with uncontrollable seizures, and that an additional 38 percent showed marked improvement

One of the children treated successfully with the diet by the Johns Hopkins team was Charlie Abrahams. His parents in response have created the Charlie Foundation which has given widespread national publicity to the diet.

Topics: Thoughts on Epilepsy |

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