If you feel like you've tried everything when it comes to your epilepsy treatment but you’re still having seizures, you're not alone. For some people living with epilepsy, drugs don't completely keep seizures at bay. Plus, other treatment options, such as surgery or stimulation therapy, may not be right for you.
So what can you do to feel better and improve your quality of life?
You may have heard how the food you eat can help minimize your seizures. In general, diets specially tailored for people with epilepsy tend to be high in fat and low in carbohydrates. Scientists aren't quite sure why this type of diet helps cut down on seizures, but it is known that healthy fats are brain boosters for the average adult.
Could the keto diet help?
One common dietary approach for people with epilepsy is a strict regimen called the ketogenic diet, also known as the keto diet. It’s mostly prescribed for young children, but there’s some interest in seeing how a ketogenic diet may help epilepsy in adults, as well. The high-fat, low-carb diet appears to change the way the brain gets and uses energy. Although it’s not fully understood how it works, it has been used for decades with some success.
A 2021 study published in the journal Nutrients describes how the keto diet has been the standard of care since the 1920s for people who do not find relief from medications. One-third of all people with epilepsy fall into this group. It’s worth noting, though, that people on this diet for the long term may experience side effects like constipation and kidney stones. Given the side effects and its restrictiveness, adherence to this diet can be challenging and some people drop out after a while.
The Atkins option
There's another diet that could help cut down on seizures while allowing you to eat some of your favorite foods: the modified Atkins diet.
This diet isn’t quite as restrictive as the ketogenic diet. It can also be started at home, instead of during a hospital stay. And family members can do it with you for support, with the approval of a healthcare provider (HCP), of course.
A 2020 review paper in the Cochrane Database of Systematic Reviews showed that more adults (42.5 percent) achieved seizure reduction at one month with the modified Atkins diet (MAD) alone compared to those (32.5 percent) who followed the MAD while using a special dietary supplement designed to help manage epilepsy called the KetoCal supplement. By three months, however, only 10 percent of adults in both groups maintained seizure reduction. More research is needed, however, to confirm these results. (KetoCal products can be used as one’s sole source of nutrition, as a snack, or to create recipes.)
Although it’s considered easier to follow than the keto diet, the modified Atkins diet still comes with restrictions, particularly when it comes to reducing intake of carbohydrates. Many people in the studies ended up dropping out of this diet, too. Side effects may include constipation and headaches.
Depending on your health profile and tastes, there are some other eating plans that may help with epilepsy. These include:
The low-glycemic index treatment
The low-glycemic index treatment is a less restrictive diet with a high content of fat (60 percent), more protein (20 to 30 percent) than other epilepsy diets, and a low carbohydrate content (10 percent). The diet also has a low glycemic index, which means that it’s less likely to cause swings of blood sugar. Foods in this diet include meat, dairy products, some fruits, whole grains, and bread.
The medium-chain triglyceride diet
This is a relatively flexible diet with a high fat content (30 to 60 percent) and low protein (10 percent) and carbohydrates (15 to 19 percent). The high ketogenic potential of this eating plan allows people to reduce the intake of fatty acids in favor of more proteins and carbohydrates, making the diet more palatable to children, compared with the keto diet. Foods in this diet include avocados, coconut oil, butter, milk, yogurt, and cheese.
Adding foods to your plate
If you and your HCP determine that it makes sense for you to try a modified diet, you may regret missing out on some of the foods you used to enjoy. But instead of thinking about what you can't eat, it can help to anticipate and even look forward to savory foods that may be new to you. Some of the foods you can expect to eat if a high-fat, low-carb epilepsy diet treatment is right for you include the following:
- Avocados
- Butter
- Olive oil
- Mayonnaise
- Heavy whipping cream
- Bacon
- Eggs
Although changing what you eat may improve your epilepsy symptoms, there isn't a single miracle food that prevents seizures. You'll have regular HCP visits and health tests while working closely with a nutritionist on your diet overhaul. Chat with your HCP to see if following a special dietary approach could work to get you closer to living seizure-free.
Sources: Verrotti A, Iapadre G, Di Francesco L, Z... + 3
- Verrotti A, Iapadre G, Di Francesco L, Zagaroli L, Farello G. Diet in the Treatment of Epilepsy: What We Know So Far. Nutrients. 2020 Aug 30;12(9):2645.
- Cleveland Clinic. Ketogenic Diet (Keto Diet) for Epilepsy. Last reviewed on October 6, 2020.
- Martin-McGill KJ, Bresnahan R, Levy RG, Cooper PN. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev. 2020 Jun 24;6(6):CD001903.
- Mayo Clinic. Atkins Diet: What's behind the claims? May 12, 2022.
