Low Glycemic Index Treatment

The LGIT for epilepsy was developed in 2002 as an alternative to the ketogenic diet (KD) for treatment of intractable epilepsy. The LGIT monitors not only the total amount of carbohydrates consumed daily, but focuses on carbohydrates that have a low Glycemic Index.

  • The Glycemic Index of a food refers to how high that food raises your blood glucose after eating, compared to a reference food such as sugar.
  • There are different features of foods that affect glycemic index. For example, dietary fiber reduces glycemic index. The rate at which a food is digested and absorbed also affects its glycemic index – so buttering a piece of bread can actually reduce its glycemic index.
  • The LGIT allows for an increased intake of carbohydrates, with a typical goal of 40-60 grams per day.
  • Food quantities are not weighed out to the gram, but are based on portion sizes. Because it is based on portion instead of exact measurement, patients are able to live a more flexible lifestyle that includes eating at restaurants.
  • Foods that are the basis for the ketogenic diet and are high in fat, such as heavy cream and high fat meats (bacon, sausage, hot dogs and eggs) are also included in the LGIT. However, on the LGIT the percentage of calories from fat is approximately 60%, compared with up to 90% on the ketogenic diet.

The LGIT is initiated as an outpatient following education from a registered dietitian. Individualized diet goals are provided based on a person’s current diet intake and growth history.

  • Initial findings indicate that it is an effective treatment for individuals with either generalized or partial onset seizures.
  • Seizures were reduced in a majority of patients using the LGIT. Some of these individuals achieved seizure freedom, and many were able to reduce their use of antiseizure medications.
  • The LGIT is flexible as long as carbohydrate intake is restricted to target levels and the overall diet meets caloric needs.
  • We recommend that all carbohydrates be consumed together with fats and protein to further reduce glycemic index.
  • Due to the dietary changes, multivitamin and mineral supplementation as well as calcium supplementation is required to reduce the risk of deficiencies.
  • Hear a personal experience with the use of the LGIT.
  • Some children have demonstrated positive weight reduction while on the LGIT.
  • There has also been an increase in risk of acidosis while initiating the LGIT. Acidosis is a blood condition in which the bicarbonate concentration is below normal; symptoms include lethargy, nausea, vomiting and headache. Acidosis is diagnosed with a simple blood test. This can be treated with supplementation of a bicarbonate solution without affecting treatment efficacy of the LGIT.
  • Follow up visits are scheduled one month after starting the diet and then every three months.
  • During these visits, height and weight as well as blood tests are obtained to carefully monitor each individual.
  • A registered dietitian with experience in treating patients with intractable epilepsy assesses individuals to make sure all nutrition requirements are met while on the treatment.
  • Similarly to the ketogenic diet, the mechanism of action of the LGIT remains unknown.
  • It is thought that metabolic changes that occur with the diet (such as the decrease in blood glucose levels and production of ketones) may have a therapeutic effect on the brain.

Like with any antiseizure treatment, if seizure freedom is achieved, physicians and patients can discuss the pros and cons of weaning off of the treatment.

Authored By:

Heidi H. Pfeifer RD, LDN

on Friday, February 04, 2022

Reviewed By:

Joseph I. Sirven MD
Steven C. Schachter, MD

on Thursday, August 22, 2013

Resources

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