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LYDIA
BECKET was only one year old when the seizures
started—racking convulsions that came in waves, often
several a day. For the next two years, her parents tried
one medication after another: Tegretol, phenobarbital
and Topamax. The same drugs that bring relief to many
children with epilepsy just made her sicker. Then
Lydia’s medical team put her on a ketogenic—or high-fat,
low-carbohydrate—diet. Within a week, she was
seizure-free. “I don’t know where we would be if it
wasn’t for that diet,” said her mother, Camilla Becket,
who has chronicled the stories of several families
coping with epilepsy in the film Childhood Epilepsy:
What You Need to Know (more on the film is online at
www.becketfilms.com/health/diagnosis epilepsy.php).
The
diet, which is more than 85 years old and has been
extensively studied, made headlines earlier this month
when British researchers presented the strongest
evidence to date of its efficacy. In a randomized
controlled study of 145 children ages 2 to 16 who had
more than seven seizures a week and were unresponsive to
medication, senior author Dr. J. Helen Cross of the
Institute of Child Health and Great Ormond Street
Hospital in London reported a 38-percent reduction in
mean seizure frequency among the 54 children assigned to
receive the ketogenic diet.
WHIP UP
In a ketogenic diet, fatty foods such as heavy whipping
cream are a necessity.
--PHOTO BY RICARDO
DEARATANHA
The
control group experienced an increase in seizures,
according to the report, which appeared in the online
edition of Lancet Neurology.
The
results come as researchers and physicians are seeking
ways to leverage the ketogenic diet to treat various
other neurological disorders, including ALS, brain
tumors, autism, Parkinson’s disease, Alzheimer’s
disease, narcolepsy and migraines. Many of these
conditions respond to anticonvulsant medications, said
Dr. Eric Kossoff, medical director of the Ketogenic Diet
Center at Johns Hopkins Hospital, and the ketogenic diet
seems to act as an anticonvulsant.
Using
diet to control disease is nothing new. “For many
conditions, we have come to accept special diets as
routine parts of medicine,” said Dr. George Christison,
professor of psychiatry at Loma Linda University in
Southern California.
Examples
include diets low in simple carbohydrates (starches,
sugars) for people with diabetes; low-fat diets high in
fruits, vegetables and nuts for people with
cardiovascular disease; phenylalanine-free diets for the
genetic disorder phenylketonuria; low-sodium diets for
hypertension; and low-fat diets for gallstones. Some
parents of children with autism spectrum disorders are
putting their children on diets that eliminate foods
with gluten and/or casein in the hopes that the diet may
help, although the jury is still out on whether this
diet is effective.
Most of
these diets have an obvious cause-and-effect
relationship to the disease, such as the lactose-free
diet for the treatment of lactose intolerance and the
gluten-free diet for celiac disease. But diets without
this clear connection to the causes of a disease are
gathering steam in mainstream medicine as well.
They
include the following:
Anti-inflammation diets. “Inflammation appears to be a
common thread of many chronic diseases of aging, like
Alzheimer’s, heart disease, diabetes and common forms of
cancer,” said Dr. David Heber, director of the
University of California, Los Angeles, Center for Human
Nutrition.
An
anti-inflammatory diet involves reducing total fat,
which by its nature reduces the amount of omega-6 fats,
which are believed to promote inflammation. One consumes
either fish three times a week or about 3 grams of fish
oil supplement a day. This boosts levels of omega-3s,
which have anti-inflammatory properties. Adherents also
eat lots of richly colored fruits and vegetables, which
are also anti-inflammatory.
The role
of inflammation in disease is the subject of a growing
body of research, including a study of 28,263 women
appearing in the March 2000 New England Journal of
Medicine, in which Harvard researchers found a strong
link between a blood chemical linked to inflammation and
cardiovascular health.
Alteration of diet may also be powerful in prevention
and treatment of eye disorders, said Allen Taylor,
director of the nutrition and vision research lab at the
USDA Human Nutrition Research Center on Aging at Tufts
University.
Taylor’s
group is studying the efficacy of a low-glycemic diet—a
diet low in simple carbohydrates—in the prevention and
treatment of macular degeneration and cataracts. The
group has found that controlling spikes in blood sugar
can result in diminished risk for age-related macular
degeneration and cataracts. This benefit is achieved
with dietary measures as simple as replacing white bread
and pasta with whole-grain breads and pastas, and by
limiting sweet foods or drinks.
****
Diet has
been shown to lower the risk of diabetes in people with
prediabetes, which can develop into Type 2 diabetes,
sometimes even returning their blood sugar levels to
normal. In a three-year trial known as the
diabetes-prevention program, a low-fat, weight-loss diet
(and exercise) reduced by 58 percent the chances that a
person with impaired glucose tolerance would go on to
develop diabetes. It did so more dramatically than the
diabetes drug metformin. The results, published in the
New England Journal of Medicine in 2002, were so
pronounced that the trial was halted a year early.
In
addition, a low-carb, ketogenic diet was found in a
16-week study of 28 overweight individuals with Type 2
diabetes to reduce the need for diabetes medications.
The study was published in 2005 in the journal Nutrition
and Metabolism.
“For
people who have a lot of trouble controlling their
diabetes, a low-carb diet can be helpful,” said Dr.
Christine Gerbstadt, a Florida-based physician and
registered dietitian in private practice. “But the
ketogenic component, the more severe carb restriction,
may or may not have extra benefits.” Such a diet might
be worth a try under medical supervision, she said—with
the understanding that a diet rich in animal fats could
present a health trade-off.
n Mood
disorders, such as attention-deficit disorder,
depression, anxiety and aggression, can be helped by
diet, either when medications fail or as an adjunct to
medications, said Dr. Bill Sears, an associate clinical
professor of pediatrics at the
University of
California,
Irvine, School of Medicine.
“There’s
a lot of good science on food and the brain,
particularly in the area of omega-3 fatty acids,” Sears
said. “In fact, the first so-called medicine I prescribe
for a child with any type of learning, behavior or mood
disorder is high doses of omega-3.”
A 1998
study by Dr. Joseph Hibbeln of the National Institutes
of Health reported that countries with the highest rates
of depression ate the least fish, whereas those with the
lowest ate the most. Hibbeln has also reported that
women who have higher levels of DHA, one of the omega-3
fatty acids found in fish, in their breast milk have
lower incidence of postpartum depression than women with
lower levels. And in a January review of complementary
and alternative medicine treatments appearing in Current
Opinion in Psychiatry, researchers at the University of
Western Australia in Perth concluded that data on the
effectiveness of omega-3 in managing depression is
promising.
Not all
studies, however, have reported a beneficial effect of
omega-3s on mood disorders. |
