What is Epilepsy?
Epilepsy is a neurological disorder characterized by generally more than 2 unprovoked seizures, which are spontaneous, disordered electrical discharging of cerebral neurons1. The term epilepsy can be interchangeable with the term seizure disorders. During a seizure, periods of electrical discharges take place and can last from a few seconds to several minutes. Seizures can range from brief lapses of attention, to muscle jerks, to severe convulsions2. Different types of seizures include different parts of the brain; generalized seizures involve the entire brain, while partial seizures affect only part of the brain1.
It is crucial to differentiate between a single seizure and the diagnosis of epilepsy, as there can be many reasons a single seizure may occur such as fever, or hyperglycemia/hypoglycemia1.
Purple Day
About 50 million people are diagnosed with epilepsy worldwide, with the most prevalent rates in low- and middle-income countries2 . According to the CDC, 1.2% of the US population has active epilepsy, which equates to 3 million adults and 470,000 children3.
In 2008, Cassidy Megan founded Purple Day in an effort to bring her own struggles with this disorder to light; she recalls feeling scared, alone, and would often lose friends and be a victim of bullying. Cassidy states that her main goals in founding Purple Day are to dismantle the myths surrounding epilepsy and to inform those with seizures that they are not alone4.
Purple Day, celebrated on March 26th, is commemorated by people wearing the color purple, as well as hosting events to educate, increase awareness, and support those living with this condition. With the help of Grassroots International, a grantmaking and social action organization, this campaign has raised so much attention that people in over 85 countries, on all continents, participated in Purple Day last year4,5.
Nutrition Recommendations for Epilepsy
People with epilepsy may be at great nutritional risk. Infants, children, and adolescents are especially vulnerable for they are in a period of significant and rapid growth and development.
An impaired ability to consume adequate nutrients, limited food choices, and drug–nutrient interactions pose as the main contributors to nutritional risk1.
Ketogenic Diet
The now-popularized diet, known as the ketogenic diet, has gained much attention over the last few years. What many people may not be aware of is that this diet was created for children with epilepsy whose seizures have not responded to antiepileptic drugs (AEDs). The diet is characterized by high-fat, low-carbohydrate components with about 3 to 4 grams of fat for every 1 gram of carbohydrate6. The name ketogenic comes from the word “ketones”, which is the product made when the body is forced to use fat as the main fuel source in the absence of carbohydrates. Unfortunately, the exact mechanism for why following a low carbohydrate, high fat diet seems to help reduce seizure episodes is unknown. However, it has been theorized that the combination of low sugar and high fat components modifies the neuronal metabolism and ‘excitability’ of the brain, thereby reducing the tendency for seizures to occur7,8. With that said, there have been promising results for those who follow the ketogenic diet; over half of children have at least a 50% reduction in the number of their seizures, while about 10-15% children become seizure-free5.
This diet is usually not recommended for adults because the restriction of food choices proves to be extremely difficult to follow. The modified Atkins diet, however, does work well for epileptic adults as it is less restrictive; fats are not measured, and protein is not limited to a specific daily total calorie intake like in the ketogenic diet9. If an adult does decide to follow the ketogenic diet, it is recommended that they speak to their healthcare provider and take a supplement to avoid deficiencies, as the diet is low in carbohydrates, fiber, calcium, and other nutrients1.
General Recommendations:
- Let to know your medication.
Pharmacotherapy is the main seizure treatment used today10. However, many AEDs have major drug-nutrient interactions, so it is crucial to talk to your healthcare provider or an RDN about the potential nutritional risks1.
- Eliminate simple sugars, and include more natural, whole food options into your diet.
This can be a daunting process as simple sugars are found in just about everything– processed foods, candy, dairy or milk products, fruits, soft drinks, and more. However, eliminating simple sugars is the first step in controlling glycemic index and starting a healthy eating pattern. Registered Dietitian Nutritionists (RDNs) who work with epileptic clients noted that even simple, yet consistent diet changes have resulted in improvement in seizure control10.
- Increase your fluid intake.
Fluids are encouraged because of the risk of kidney stone development, as well as the diuretic effect of any low-carbohydrate diets used to treat epilepsy10.Any diet supplementation or recommendations should be firstly checked with, and then closely monitored by an experienced team of neurologists and dietitians/RDNs.
If you would like to learn more about epilepsy or Purple Day, please visit the https://www.purpleday.org/ or https://www.epilepsy.com/ website.
References
1. Nahikian-Nelms M. Nutrition Therapy and Pathophysiology. 4th ed. Cengage; 2020.
2. World health organization. Epilepsy. Who.int. Published June 20, 2019. https://www.who.int/news-room/fact-sheets/detail/epilepsy
3. “Epilepsy Data and Statistics | CDC.” Www.cdc.gov, 28 Jan. 2019, www.cdc.gov/epilepsy/data/index.html#:~:text=Epilepsy%20Prevalence%20in%20the%20United.
4. Purple Day – Supporting Epilepsy Around The World! https://www.purpleday.org/
5. Grassroots International | Funding Global Movements for Social Change. Grassroots International. https://grassrootsonline.org/
