Most people living with epilepsy take medication to prevent seizures. Medications work in 2 out of 3 people, according to the Centers for Disease Control and Prevention. If prescription drugs do not work, dietary changes may also prevent or reduce seizures in some people.

“Seizure diets” are the use of food to prevent seizure activity. Some seizure diets, such as the ketogenic diet, are high-fat, low-carbohydrate, controlled protein plans that change the way your body uses energy. In the case of the ketogenic (keto) diet, this way of eating causes the body to produce a substance called decanoic acid. Recent studies have shown this substance to reduce convulsive activity.

Although these diets may reduce seizures, they may also have other side effects. For this reason, it’s important to follow this eating plan under the supervision of a doctor or registered dietician.

What are examples of “seizure diets”?

There are different dietary plans that may reduce seizures. Most people trying a dietary approach follow the keto diet or the modified Atkins diet. These diets focus on giving the body fats while reducing carbohydrates and protein.

The keto diet has two possible approaches. The classic plan involves a measured ratio between fats, carbohydrates, and protein. This type of diet is carefully monitored by a dietician.

The medium chain triglyceride (MCT) plan involves aiming to ingest a certain percentage of calories in each of those same three categories. This second approach allows for more carbohydrates. The MCT plan may include fat from a supplement of MCT oil.

The modified Atkins diet is a less restrictive form of the keto diet. There is no specific formula for fats, proteins, and carbohydrates. This diet focuses on high-fat, low-carbohydrate meals.

Another “seizure diet” is the low glycemic index treatment (LGIT). It also aims for a low intake of carbohydrates. But it’s easier to follow than other seizure diets because it has fewer restrictions.

Why do seizure diets work?

A seizure diet — and particularly the keto diet — causes the body to use fat instead of carbohydrates for energy. In this state, the body produces ketones, which is where the energy comes from. People who don’t restrict carbohydrates get their energy from glucose, which comes from carbohydrates.

Another effect of the keto diet is the production of decanoic acid. This substance has been shown in some studies to have antiseizure activity. For example, a 2016 study in the journal Brain showed that decanoic acid reduced seizure activity in laboratory animals.

The keto diet works for many different types of epilepsy and seizures. It can also be adapted to different kinds of dietary cuisines.

Is there evidence it works?

Research into seizure diets has shown promising results. The traditional ketogenic diet reduces seizures in most children. About 10 to 15 percent of children on the ketogenic diet are seizure-free.

A 2016 study published in Epilepsy and Behavior followed 168 people enrolled in diet therapy for epilepsy between 2010 and 2015. Among study participants who stayed on the modified Atkins diet the whole time, 39 percent either became seizure-free or had a 50 percent reduction in seizures.

In a 2017 study of 22 participants on the modified Atkins diet, six had a greater than 50 percent reduction in seizure activity after one month. Twelve had a greater than 50 percent reduction after two months.

The low glycemic index treatment (LGIT) is also promising. A 2017 study in a small group of children found more than half had a greater than 50 percent reduction in seizure activity after three months on LGIT.

Risks and side effects

The ketogenic diet and its variations, such as the modified Atkins diet, are not without side effects. Following this eating plan can result in high cholesterol and gastrointestinal symptoms. It can also negatively affect bone health and cause kidney stones. Children following the keto diet can also experience acidosis and growth issues.

Because these diets can be restrictive, they’re often difficult for many people to follow. Even if they may be effective, many people find it hard to stick with the plan long enough to see if it works.

The takeaway

Most people living with epilepsy respond well to anti-epileptic drugs. For those who do not, diet changes may reduce the frequency of seizures.

Seizure diets don’t work for everyone and may be highly restrictive. Working with a qualified medical professional, you may be able to experience symptom improvement over a sustained period on the program.