Keto Diet May Help Some Teens And Adults With Epilepsy

What was studied

This study was a systematic review and meta-analysis. The researchers gathered and combined results from earlier studies to evaluate the efficacy, safety, and tolerability of ketogenic diet therapy (KDT) for adolescents and adults with drug-resistant epilepsy.

They screened 1,846 articles and included 33 studies, with a total of 1,019 people. The included studies were 3 randomized controlled trials, 17 prospective case series, and 13 retrospective case series. The review also examined epilepsy subtypes, KDT subtypes, side effects, attrition proportions and reasons for stopping KDT, and effects beyond seizure control such as mood and quality of life.

What they found

Overall, 42.82% of participants had seizure reduction greater than 50% with ketogenic diet therapy. In subgroup analyses, 53.4% of individuals with generalized drug-resistant epilepsy responded to KDT, compared with 14.4% of those with focal drug-resistant epilepsy.

The analysis did not find an association between efficacy and KDT type. The overall attrition proportion was 20.95%, and restrictiveness and compliance challenges were reported as reasons for stopping the diet. The findings suggested that KDTs were safe and generally well tolerated.

Limits of the evidence

This review combined studies of different designs, and only 3 of the 33 included studies were randomized controlled trials. Many were prospective or retrospective case series.

The subgroup results, especially for generalized versus focal epilepsy, may be uncertain because the confidence intervals were wide. The abstract also gives limited detail about side effects, mood, and quality of life findings. Uncertainty remains regarding the benefits of KDT in adolescents and adults.

For families and caregivers

For families, this review suggests that ketogenic diet therapy may help some adolescents and adults with drug-resistant epilepsy as an adjunctive treatment. The findings also suggest that these diets were generally well tolerated in the included studies.

At the same time, the diet can be restrictive, and some people stopped it because of compliance challenges. Families may want to discuss with their epilepsy care team whether this approach is appropriate and how it could be used safely.

What to watch next

More high-quality studies in adolescents and adults could help clarify safety, tolerability, effects on quality of life and mood, and whether some epilepsy subtypes are more likely to respond.

Terms in this summary

ketogenic diet therapy

A high-fat, low-carbohydrate diet used as a medical treatment to help reduce seizures.

drug-resistant epilepsy

Epilepsy in which seizures continue despite trying appropriate seizure medicines.

systematic review

A study that carefully collects and summarizes all relevant research on a question.

meta-analysis

A method that combines results from multiple studies to estimate an overall result.

randomized controlled trial

A study where people are assigned by chance to different treatments.

generalized epilepsy

A type of epilepsy in which seizures are generalized.

focal epilepsy

A type of epilepsy in which seizures are focal.

attrition

The proportion of people who stop a treatment or leave a study before it ends.