Dietary Therapies for Adults – A Personal Perspective

Following a diet to control seizures can be difficult, especially for teenagers or adults who have already developed food preferences and eating habits. Yet for some people following a specific diet can be the key to obtaining seizure control.

Dr. Sirven highlighted findings from a recent article on the use of a Modified Atkins Diet (MAD) in a small group of adolescents/young adults with juvenile myoclonic epilepsy (also called JME). The study showed that this diet may be a promising treatment for people with difficult to control seizures from JME. However, the usefulness of dietary therapy is often dependent on how people can manage the practical aspects of following a special diet.

To gain a different perspective, I interviewed Heidi Pask, a woman who has successfully used MAD to control seizures for two years now.

What have been the major benefits to using dietary therapy as an adult with epilepsy?

Ms. Pask: Most importantly, the diet may help control seizures. Some people may even get complete control of their seizures. Most often diet therapy is used together with medicines, but if it works, over time a person may be able to lower the dose or number of medicines they take. A benefit of this is that people may feel better just by taking less medicine. I found that I have felt clearer mentally while on the Modified Atkins diet. I have not been able to come off of medicine, but I’ve found a combination of medicines that works better for me with fewer side effects as long as I stay on the diet.

Whether or not a diet treatment works doesn’t seem to depend on when it is tried, for example early in the course of treatment or the last thing you try. Its’ success is dependent on a person’s ability to stay on the diet.

What’s the hardest thing to learn when starting the modified Atkins diet?

Ms. Pask: For once in my life, I found that fat is better for me. This is a hard concept for people to understand as popular and scientific news stresses low fat diets for general health. But for epilepsy, the high fat concept works and is safe when done with the help of doctors, nurses and dieticians.

What are the hardest parts of using dietary therapy for seizures?

Ms. Pask: The first few weeks and months are the hardest. People need to get used to a different way of eating, which requires changes in lifestyle, food preferences and habits. It also means people need to learn all their nutrition facts! Here are a few examples and tips:

• Going out to eat at a restaurant or even at a friend’s house can be very difficult. People need to learn to ask questions about what is in dishes and use your nutrition facts to know whether you can have this.

• Learn to be fussy and ask for exactly what you want and how you want it prepared or else take food with you. This may be uncomfortable when you are visiting a friend, but it’s a lot easier if they understand why you are asking for special food or bringing your own.

• Never trust nutrition labels - always do your own math to know how much you can have.

• Learn to eat foods you never liked before. I never thought I'd see the day when I would actually eat a stick of butter or just drink grapeseed oil but I do now if I’m at too tired to cook, but need the fat.

Is following a special diet like the Modified Atkins expensive?

Ms. Pask: There are ways to get the nutrition you need without spending a lot of money. For example, different types of oils can be used to save money, but you need to know which ones to use. Buying some products online can help save money too. However be careful to learn everything you can about the foods you buy before eating them. If you are unsure, call the company directly. For example, not all foods that are labeled sugar free are zero calories. Small amounts of calories in sugar substitutes add up and you’ll need to watch these extra calories when the substitutes are used for baking or in other large quantities on a low carbohydrate diet.

What do you think about the pros and cons of diet therapy?

Ms. Pask: I think there may be an equal number of pros and cons, but for me, the pros outweigh the cons of using the Modified Atkins diet. If the diet works, it's an answer to seizure control.

How does someone find out more information about diet therapy for epilepsy?

Ms. Shafer: First of all, if a person is still having seizures after trying two or more medicines that are appropriate for their type of seizures, they should see an epilepsy specialist. At that time, people should ask questions about all types of therapies – what is possible for their type of seizures, how helpful would it be, what are the side effects, and who should they see to learn more about them?

Dietary therapy for seizures is just like medicine therapy- it should be prescribed by a health care provider who knows how to use diet therapy. There are differences between the various diets (for example, ketogenic, Modified Atkins, low glycemic). An epilepsy specialist and nutritionist with knowledge about dietary therapy can help people learn how to use the diets and recommend the best one for that person. Understanding a person’s ability to manage the practical aspects of staying on a diet is an important part of this therapy. People are more likely to stay on a diet if they receive support and help from others. Family and friends are important, but people should also keep regular follow-up with their epilepsy specialists, including doctors, nutritionists, and nurses to help them manage the diet successfully.

Hope this column helps learn about diet therapy and find some resources!. Share your experiences in the Community Forum at www.epilepsy.com or on our Facebook page!