Dietary Therapies for Epilepsy and Other Neurological Disorders: Highlights of the 3rd International Symposium

Abstract

The 3 rd International Symposium on Dietary Therapies for Epilepsy was held in Chicago from September 19-21, 2012. The symposium was primarily sponsored and coordinated by The Charlie Foundation to Help Cure Pediatric Epilepsy with major support from Nutricia. The conference, which drew 420 attendees from 30 countries, generated broad appeal among physicians, scientists, dietitians, nurses, pharmacists, and other allied health professionals, as well as interested families. This article briefly reviews some of the scientific advances highlighted at the meeting in the field of dietary therapy for epilepsy since the prior international symposium in 2010. A more comprehensive review of the proceedings will appear in a special issue of the Journal of Child Neurology in 2013, edited by Eric Kossoff, Liu Lin Thio, and Elizabeth Thiele. The keynote address was given by Gary Taubes, science writer and author of Good Calories, Bad Calories. Taubes traced the correlation between dietary practices and disease incidence across cultures and historical eras. The overall conclusion: Societies that eat fewer carbohydrates are healthier, exhibit less obesity, and develop fewer diseases; in essence, "a calorie is not just a calorie" but depends upon its source (1). The findings that a diet high in fat and low in carbohydrates not only can be tolerated but is also healthier supports the use of the ketogenic diet as an epilepsy therapy with beneficial overall health implications, rather than a bizarre, unhealthy alternative, as previously thought. Subsequent symposium sessions dealt with specific dietary formulations and practices, clinical updates on dietary therapies for epilepsy and other disorders, and scientific advances in understanding the mechanisms of dietary therapies. Clinical Advances The effectiveness of the high-fat, low-carbohydrate ketogenic diet for medically refractory childhood epilepsy has been recognized throughout its 90-year history, and now evidencebased efficacy is established by a randomized clinical trial (2). More than 38% of patients who started on a ketogenic diet experienced a 50% or greater reduction in seizures at 3 months, a response largely maintained at 1 year. As reviewed by Helen Cross, four randomized clinical trials have now been published, with an updated Cochrane review concluding that compared to a prior review in 2003, the ketogenic diet results in shortto medium-term benefits in seizure control, comparable to modern antiepileptic drugs (3). This exciting evidence validates observations of clinicians who have been using the diet for decades; this evidence-based data infuses the field with tremendous energy as we move forward to optimize the ketogenic diet and establish its place in the treatment of epilepsy and other disorders. From this conference, it is clear that the ketogenic diet is now considered an essentially mainstream treatment for children with refractory epilepsy-a remarkable change compared to 1994 when The Charlie Foundation was founded. A related clinical advance is the recen...

High-Lights of Epilepsy 2015

“…The indication of ketogenic diet (KD) have been broadened [1,2]: Its indications have been in refractory infantile spasms [3], Lennox-Gastaut syndrome [4]. Now it has been recommended as therapy in Dravet syndrome [5], Rett syndrome [6] and Glut-1 deficiency [7,8].…”