Epilepsy and the Ketogenic Diet: Clinical Implementation & the Scientific Basis (Nutrition and Health) [Hardcover]

Carl E. Stafstrom (Editor), Jong M. Rho (Editor)

Book Description

Publication Date: July 29, 2004

A benchmark synthesis of the current state of the science and clinical practice of the ketogenic diet. On the basic science side, the authors review what is known about the basic biochemical mechanisms of action of the KD at the molecular level, spelling out in detail its complex interactions with nutrient components, neurodevelopment, brain biochemistry, and physiology. They also examine the effects of the KD on the metabolism of fats, amino acids, and carbohydrates in the central nervous system at both the macro and cellular levels. On the clinical side, physicians, dietitians, and nurses provide a full range of information concerning the treatment of seizures with KD, including a detailed assessment of the indications for, and the contraindications and/or complications that arise from, its use, detailed equations that permit the caregiver to calculate the actual amounts of different types of foods that can be included in daily diet plans, and documented information on the carbohydrate and calorie content of hundreds of commonly used drugs.

Editorial Reviews

Review

Foreword by Philip A. Schwartzkroin, PhD "This book is a comprehensive summary of the use of the ketogenic diet for treatment of medically intractable epilepsy. This book should be read by all those caring for patients with medically intractable epilepsy, and should be on the shelves of all those involved in supervising the ketogenic diet."-The Lancet

From the Back Cover

Recent advances in our understanding of the ketogenic diet (KD)-a high-fat, low-carbohydrate, adequate-protein diet used for the treatment of medically intractable epilepsy-have produced a resurgence of interest in, and application of, this valuable treatment for the epileptic patient. In Epilepsy and the Ketogenic Diet, internationally recognized researchers and clinicians from around the world synthesize the current state of the science and clinical practice of the KD. On the basic science side, the authors review what is known about the basic biochemical mechanisms of action of the KD at the molecular level, spelling out in detail its complex interactions with nutrient components, neurodevelopment, brain biochemistry, and physiology. They also examine the effects of the KD on the metabolism of fats, amino acids, and carbohydrates in the central nervous system at both the macro and cellular levels. On the clinical side, physicians, dietitians, and nurses provide a full range of information concerning the treatment of seizures with KD, including a detailed assessment of the indications for, and the contraindications and/or complications that arise from its use, detailed equations that permit the caregiver to calculate the actual amounts of different types of foods that can be included in daily diet plans, and documented information on the carbohydrate and calorie content of hundreds of commonly used drugs. Numerous relevant tables, graphs, and figures, as well as up-to-date references, consistent use of terms across chapters, and a highly annotated index ensure easy access to needed information. Illuminating and highly practical, Epilepsy and the Ketogenic Diet constitutes a unique benchmark synthesis of up-to-date clinical and scientific information that explains the mechanisms behind the KD and how its maximum therapeutic benefits may be realized in the epileptic patient with minimal adverse effects.

Product Details

• Hardcover: 376 pages
• Publisher: Humana Press; 1 edition (July 29, 2004)
• Language: English
• ISBN-10: 1588292959
• ISBN-13: 978-1588292957
• Product Dimensions: 10.2 x 7.1 x 1.1 inches
• Shipping Weight: 2.2 pounds (View shipping rates and policies)
• Average Customer Review: 4.5 out of 5 stars  See all reviews (2 customer reviews)
• Amazon Best Sellers Rank: #794,551 in Books (See Top 100 in Books)
  • #88 in Books > Health, Fitness & Dieting > Disorders & Diseases > Epilepsy

Customer Reviews

Most Helpful Customer Reviews

10 of 10 people found the following review helpful:

5.0 out of 5 stars A Thought Provoking Scientific Treatise on Epilepsy, Seizures and the Ketogenic Diet, November 26, 2005

By 

Dr. T - See all my reviews

This review is from: Epilepsy and the Ketogenic Diet: Clinical Implementation & the Scientific Basis (Nutrition and Health) (Hardcover)

Of all of the books I have read on epilepsy, few are "unique." This book fits that category well. It is fun to see what people that "think outside of the box " are writing.

The book is organized into three sections. Part I includes an introductory scientific chapter about seizures. It provides the reader with the theoretical background needed to understand the material in Part III (Basic Science) and several of the earlier chapters. Part II is mostly a "how to do it" (the ketogenic diet) for health care professionals. It also includes chapters on indications and complications. Section II concludes with a particularly intriguing chapter on other dietary treatments (besides the ketogenic diet) for epilepsy.

For this reader the high point of the book started with the first chapter in Part III and continued right to the end of the book. Biochemical effects of the ketogenic diet are examined, citing scientific studies. Possible explanations for the anti-seizure/anti-epileptic effect of the ketogenic diet are set forth; cerebral energy metabolism, effects on amino acids, molecular regulation, neuronal excitability, effects of caloric restriction, the role of norepinephrine, galanin and neuropeptide Y, etc. Some surprising results are noted. For example, in the chapter on caloric restriction it is suggested that high glucose levels may exacerbate human epilepsies. On a superficial level this is just the opposite of what medical students are taught; i.e., hypoglycemia (not hyperglycemia) causes seizures, which it can.

The "Afterword", is by Jim Abrahams, father of Charlie Abrahams of Charlie Foundation fame. The piece he wrote or something like it should be given to every parent of a child newly diagnosed with epilepsy. Not that all the kids should go on the ketogenic diet, but rather that the parents should know that treating epilepsy is a complicated and even "artsy" endeavor. They should also know that there are many factors that may possibly affect their child's seizures and that there are many treatment options available. Another fact that he alludes to is that early control is important and that if that fact were known, parental complacency early on would be rare.

In all fairness to physicians, most parents whether they realize it or not are quite distraught when their children first develop seizures. Instantaneous assimilation of massive amounts of information is difficult if not impossible under those circumstances even for the medically sophisticated parent. Physicians may be reluctant to throw everything at parents all at once. However, the high degree of parental focus precipitated by the crisis of a child developing a chronic disease, can be the driving force for a parent to devote great energies toward learning about their child's illness. The act of learning can to a great degree allay the extreme anxiety the parents may feel. Physicians can help by suggesting non-technical publications for the parents to read as a starting point in their quest for knowledge. They can also acknowledge the potential benefits of other treatments that the parents may have discovered on the Internet for example. It would be nice if physicians know what does not work as well, and have enough knowledge and credibility with the parents to be able to explain why.

This is a great book for clinicians that want to understand the possible scientific basis for the efficacy of the ketogenic diet. It will greatly broaden one's view of the disease as well.

3 of 3 people found the following review helpful:

4.0 out of 5 stars summarises strong evidence for KD, April 25, 2006

By 

W Boudville (Terra, Sol 3) - See all my reviews
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This review is from: Epilepsy and the Ketogenic Diet: Clinical Implementation & the Scientific Basis (Nutrition and Health) (Hardcover)

The authors give a comprehensive explanation of how a ketogenic diet might be a treatment of epilepsy. The molecular basis of this model is covered. While not conclusive, when combined with the positive clinical data reported in the text, the implication is highly favourable. Even against intractable epilepsy, KD offers some remediation.

Many chapters have extensive references to the research literature on KD. Also, KD is investigated for possible efficacy against other disorders. Here, things are far more speculative. But maybe KD could be applied to obesity, diabetes and heart disease.