“Yuck!” was once the common response to the ketogenic diet. It was the response of parents and, indeed, of many physicians who did not have experience with the diet. The concept of a mere diet being able to control otherwise uncontrollable seizures seemed far-fetched to many back in 1994, when we reintroduced the ketogenic diet with the initial publication of The Epilepsy Diet Treatment: An Introduction to the Ketogenic Diet. Eleven years later, with the help of the first three editions, the ketogenic diet has become a widely accepted therapy for children with difficult-to-control seizures. It has won over skeptics and gained acceptance among both physicians and the public. A growing number of medical centers around the world are developing the expertise needed to administer the treatment successfully.The limiting factor in its use seems to be the lack of adequately trained dietitians, who are the prime ingredient in the diet’s implementation and success.
Few new therapies in modern medicine have come to the fore in so short a time. Modern medicine treats epilepsy with pharmaceuticals, with anticonvulsant medications. Because it is based on food, the ketogenic diet is considered by many to be an “alternative therapy,” but it is one of the few “alternative therapies” that has, through careful studies and demonstrated success, become a part of the mainstream medical treatment for epilepsy.
Research to understand how the diet works is once again active but, as discussed elsewhere in the book, has not yet brought extensive understanding. Perhaps the biggest advance in the ketogenic diet is the general acceptance that the diet does work. Efforts to discover how it works remain in progress.
Since the first edition of this book was published, a huge amount of new information has been generated on the ketogenic diet:
- New data from clinical studies and laboratory research have expanded our knowledge about many aspects of the ketogenic diet, including growth on the diet, weight gain, effects on serum lipid levels, and effectiveness of the diet.
- Experience with hundreds of new patients has deepened our understanding of the best approaches to helping children and their families cope with the limitations and restrictions of the diet.
- Feedback from many sources has been received—from conferences, publications, and private communications with neurologists, dietitians, and parents.
- New and improved menus have been developed, including some created by professional chefs whose children went through the diet.The ketogenic diet now is available in many countries throughout the world and has incorporated many ethnic foods.
- The needs of modern dietitians have evolved, and to meet these needs, instructions for calculating and managing the diet on a day-to-day basis have been revised.
- Ongoing laboratory research points to potential future improvements in ketone measuring techniques, and potential new ways to administer ketogenic diets effectively in a less restrictive manner.
The debate now taking place is not whether the diet is useful, but what place the diet should hold in the management of difficult-to-control seizures in children. Should it be offered only after a child has failed all available medications? After she has failed two medications? Should it be limited to children over 1 year of age? Will it work in adults? While we know of no reason why an adult should not attempt the diet, its efficacy and side effects in adults have not been widely studied. Is its usefulness limited only to those with epilepsy?
Even today, with all the new anticonvulsant medications that come on the market, many children still are burdened with difficult-to-control seizures.The ketogenic diet, although difficult to follow, if properly done, remains more effective than any of these new anticonvulsant medications. It seems clear that, if the diet were a drug, companies would be promoting it as the treatment of choice for difficult-to-control epilepsy. Unfortunately, no companies are available to champion and promote the diet.
The ketogenic diet is not the answer for everyone. But for some, it may result in a better quality of life, with fewer side effects, than any other therapy. Many, many questions remain to be answered about the ketogenic diet. However, this new edition of Ketogenic Diets reflects the many advances in understanding that have taken place since the book was first published 11 years ago.
- Authors -
Contents
SECTION I: OVERVIEW OF THE TRADITIONAL KETOGENIC DIET
- 1. Epilepsy Today and the Place of the Ketogenic Diet 3
- 2 What Is the Ketogenic Diet? 19
- 3. History of the Ketogenic Diet 25
- 4. How Does the Ketogenic Diet Work? 37
- 5. Is My Child a Candidate for the Ketogenic Diet? 47
- 6. Twenty Questions About the Diet 53
SECTION II:THE ABC’s OF THE KETOGENIC DIET
- 7. Initiating the Ketogenic Diet: A Process 65
- 8 Fine-tuning the Diet:The Key to Success 85
- 9. Side Effects of the Ketogenic Diet 113
- 10. Making It Work at Home and on the Road 121
- 11. Going Off the Diet 137
SECTION III: CALCULATIONS
- 12. Calculating the Ketogenic Diet 147
- 13. Liquid Formulas and Tube Feedings 173
SECTION IV: MODIFIED KETOGENIC DIETS
- 14. The MCT Diet 185
- 15. Using the Atkins Diet for Epilepsy 189
SECTION V: KETOGENIC COOKING
- 16. Sample Meal Plans for the Ketogenic Diet 199
- 17. Atkins Diet Recipes 229
SECTION VI: SPECULATION
- 18. The Future Role of the Ketogenic Diet 243
SECTION VII:APPENDICES
- A. Medications 253
- B. Johns Hopkins Ketogenic Diet Admission Orders 261
- C. Food Database 263
- D. Atkins Carbohydrate Gram Counter 273
- E. Useful Websites 277
- F. Selected References 279
- G. International Centers 283
Index
About the Author
- Eric Kossoff, MD, is an Assistant Professor of Neurology and Pediatrics and a member of The John M. Freeman Pediatric Epilepsy Center, as well as the Division of Pediatric Neurology at Johns Hopkins Hospital. He is the Associate Director of the pediatric neurology training program and coauthor of The Ketogenic Diet, Fourth Edition. Dr. Kossoff is the editor of "Keto News" on www.epilepsy.com. He has dedicated his career to investigating and researching the impact of putting young children with epilepsy on a 95 per cent fat diet to control their seizures.
- John M. Freeman, MD, developed the ketogenic diet while working at Johns Hopkins University. The pediatric epilepsy center at Johns Hopkins was renamed The Johns Hopkins John M. Freeman Pediatric Epilepsy Center in his honor in 2002. The diet and the center were featured on Dateline in a 1994 edition as a therapy for childhood seizure disorders. "Dateline" reported that miraculous results were obtained in a large percentage of the patients who were placed on the high fat diet. A prolific author, he has written nearly 150 articles, 41 book chapters and seven books or editions of books including, the award winning The Ketogenic Diet: A Treatment for Children and Others with Epilepsy.
- Zahava Turner, RD, CSP, LDN, is the Ketogenic Dietitian for the John Freeman Epilepsy Center at The Johns Hopkins University responsible for all nutritional aspects for patients following the ketogenic diet, including education, follow up and menu planning.
- James Rubenstein, MD, is a neurodevelopmental pediatrician on the full-time staff at Kennedy Krieger Institute and The Johns Hopkins Hospital.
Product Details
- Paperback: 254 pages
- Publisher: Demos Health; 4th edition (October 4, 2006)
- Language: English
- ISBN-10: 1932603182
- ISBN-13: 978-1932603187
- Product Dimensions: 8.8 x 5.9 x 0.9 inches
List Price: $24.95