Physical Activity, Ketogenic Diet, and Epilepsy: A Mini-Review

Abstract

One-third of patients with epilepsy do not respond to antiepileptic drugs and may seek complementary and alternative treatment modalities. Dietary therapies, such as the ketogenic diet (KD), the modified Atkins diet, as well as the medium-chain triglyceride and the low glycaemic index diets, have been successfully implemented with some forms of epilepsy and are growing in utilization. The KD is a high-fat, low-protein, low-carbohydrate diet that has been used for various conditions for over a century. Insights into the mechanism of action of these diets may provide more targeted interventions for patients with epilepsy. Knowledge of these mechanisms is growing and includes neuroprotective effects on oxidative stress, neuroinflammation, potassium channels in the brain, and mitochondrial function. In this review, we explain the role of physical exercise and the ketogenic diet on epilepsy.

Effect of a Ketogenic Diet on the Nutritional Parameters of Obese Patients: A Systematic Review and Meta-Analysis

“…Similar to balanced diets consisting mainly of bland fresh foods or meal replacement diet programs, it is important to highlight people's low tolerance for KD due to the limited palatability of high lipid foods [44]; it is clearly not applicable as a long-term strategy. Moreover, the literature reports increases in uric acid, creatinine, and aspartate aminotransferase [8,45], as well as the short-term symptoms described in the results of this SR. Indeed, if the safety and effectiveness of following a KD cannot be assured [9], it must be recommended with extreme precaution.…”

“…However, the public often looks to take advantage of diets without understanding their primary objective or potential risks. One popular diet is the ketogenic diet (KD), developed in 1924 by Russell Wilder for the treatment of motor neuron diseases [6,7]; it has also been successfully used for some types of epilepsy [8]. Specifically, a very low carbohydrate ketogenic diet (VLCKD) intervention consists of an increased proportion of fat (44%) and protein (43%) and minimal glycemic intake (<30 g/day, equivalent to approximately 13%) while restricting caloric intake to less than 800 cal/day [9].…”