ET

ISSUE 2228 Sunday 1 July 2001

High-fat diet 'can control epilepsy among children' By Lorraine Fraser

A DIET laden with butter, cream and mayonnaise can play a key role in treating - and perhaps even curing - epilepsy in children, say leading specialists.

Paediatricians at three centres are to begin a study of high-fat diets in children whose seizures cannot be controlled by drugs. Doctors hope that the "alternative" treatment will eventually become widely available on the health service.

Researchers at Great Ormond Street Hospital for Children and the Central Middlesex Hospital, both in London, and the National Centre for Young People with Epilepsy, in Lingfield, Surrey, are to test the benefits on 120 children.

Instead of a mixed diet, where much of the energy intake comes from carbohydrates, the children will be prescribed a calorie-controlled eating plan, containing large amounts of fat. Vitamins and minerals are supplied through supplements.

A typical meal for a child in the study might be: 32g of roast chicken, 30g carrots, 39ml double cream and 23g butter. A slightly less-regulated diet - with fat given as a drink or medicine - will also be tested.

Research suggests that such diets can cut the number of seizures by 90 per cent or more in a third of children with severe epilepsy, while a further fifth of patients may see their seizure rate halved. These youngsters often suffer scores of fits every day, so the potential impact on their lives is huge. Many on the high-fat diet can also be weaned off drugs - reducing the risk of side-effects.

The idea stems from a discovery made almost a century ago when doctors found that epileptic children had fewer or, in some cases, no seizures, if they were starved - forcing them to live off their reserves of body fat. The idea developed that a diet based on ketones (the breakdown products of fat) could mimic the metabolic changes of starvation and produce the same effects.

Scientists are still not clear why a "ketogenic" diet can reduce the frequency of fits. However, Helen Cross, a consultant paediatrician at Great Ormond Street Hospital, and Ruby Schwartz, a specialist at the Central Middlesex Hospital, believe that the treatment has great potential. Dr Cross said: "Once the child becomes established on the ketogenic diet and their body adjusts, the effects can be dramatic."

Dr Schwartz said that youngsters on the diet did not become fat because their calorie intake was controlled, while their growth, development and well being often improved enormously. She said: "It's not for everyone, and parents have to be dedicated, but when it works, it's fantastic."

One of Dr Schwartz's patients is three-year-old Phoebe Robinson. Two years ago she was diagnosed with Lennox Gasteaux syndrome, a severe form of epilepsy. Initially, she suffered up to 80 seizures a day. Anti-epilepsy drugs had little impact on her condition, and Phoebe's parents, Robert and Emma, who run a farm at Milton Ernest, Bedfordshire, had to watch her deteriorate.

Fifteen months ago, however, Phoebe was put on a "ketogenic" diet, and since then has made remarkable progress. She has not had a fit for almost eight months, and her daily dose of medication is now a fraction of what it once was. Her mother said: "She is now a happy little girl - smiling and laughing."

-- Anonymous, June 30, 2001