by Danielle Dunn
Unlike many dietary therapies, the ketogenic diet has a long history of use and has been well researched, having been formally recorded in medical literature 100 years ago.
The wisdom surrounding the mechanism of action of the ketogenic diet goes back even further than that though and is referenced to in the Bible at the time of Jesus and 400 years prior in Hippocratic recordings as a treatment for people with seizures.
The influence of the pharmaceutical industry in making increasingly diverse formulations of antiepileptic medications available from the 1930s onward resulted in the majority of medical practitioners prescribing drugs rather than the Ketogenic Diet. Taking a pill is far easier than carefully following a strict diet if the pill works. The problem with a bias towards a pharmaceutical approach however is that a third of patients with epilepsy do not gain seizure control with medications despite there being now around 20 different antiepileptic medications for doctors to choose from.
Very few clinics were still offering Ketogenic Therapy in the 1990s and the treatment was on the verge of extinction. A courageous family turned this situation around and the use of the ketogenic diet for epilepsy today is expanding very much because of the catalyst of a parents effort to do the best they could for their son with uncontrolled seizures.
In 1993 in the USA a little boy named Charlie Abrahams developed severe drug resistant epilepsy. He had numerous drug trials and even brain surgery but still his epilepsy continued in full force. Desperate, his parents Jim and Nancy Abrahams did their own research in a medical library and soon discovered about use of the Ketogenic Diet for childhood epilepsy. They transferred their son to one of the last Ketogenic Therapy centres worldwide at the Johns Hopkins Hospital under the care of huge advocates for the diet, dietitian Millicent Kelly and paediatric neurologist Dr John Freeman. Within a month of starting the diet Charlie was seizure free and his antiepileptic medications were then weaned.
Jim used his influence as a popular movie director and produced a film called 'First Do No Harm' telling their story and raising awareness for the diet.
You can watch the full movie for free on YouTube at:
He and Nancy also created the Charlie Foundation:
and helped to coordinate international conferences for Ketogenic Therapy to increase the areas of Ketogenic research and knowledge sharing among clinicians.
A similar organisation, Matthews Friends:
was set up in 2004 in the UK which has branches in Canada and New Zealand to provide a support network for parents and health professionals involved in ketogenic therapy.
Ketogenic therapy is a fast growing area of research with around one paper a week currently being published on the diet in worldwide medical journals. With increasing research and higher quality studies being published, the confidence for using the diet among doctors and healthcare funding for it gradually increases.
The first centre to offer some forms of Ketogenic Therapy in New Zealand was Starship Hospital which reinstated its Ketogenic clinic after years of closure in 2015.
A year later through an initiative of the Christchurch Hospital paediatric neurology team and dietitian Charlene Tan Smith and with the support of funding for training from the Brydie Lauder Charitable Trust and guidance from renowned Canadian Ketogenic dietitian Jennifer Fabe, a second centre was established in Christchurch, offering all forms of Ketogenic Therapy.
New Zealand is currently in a less than ideal situation where as of May 2019 only the small number of children who gain Starship referrals and those children living in the Canterbury District Health Board are eligible for publicly funded Ketogenic Therapy. Limited private therapy is available for adults and children with conditions where Ketogenic Therapy is an evidence based treatment.
The existence and growth of Ketogenic Therapy today is very much the result of a partnership between patients and health professionals.
With information being so readily available now, patients are becoming more informed about their epilepsy management options and thus more proactive in advocating for best practice treatment.
Likewise with the failure of modern pharmaceuticals to improve the seizure control rate for those with drug resistant epilepsy medical practitioners are looking beyond traditional medications and further into the potential for dietary intervention to improve the quality of life for those with severe epilepsy.
With fresh research on the horizon suggesting Ketogenic Therapy could help as and adjunctive treatment for other neurological diseases like Parkinsons, specific brain cancers, dementia and autism this field of treatment has a promising future ahead of it and will continue to expand in the face of a dominant pharmaceutical climate. Watch this space!