NOTE: Research on the Ketogenic Diet is included below with research on Feingold-type diets. For more information on the Ketogenic Diet, see the Charlie Foundation website or call them at (310) 395-6751. Unlike the Feingold Diet, this is not a do-it-yourself diet and requires careful monitoring and care to minimize side effects.
Murphy 2006 The ketogenic diet causes a reversible decrease in activity level in Long-Evans rats. Kielb 2000 Nephrolithiasis associated with the ketogenic diet. Najbauer 2000 The aspirin metabolite sodium salicylate causes focal cerebral hemorrhage and cell death in rats with kainic acid-induced seizures. Panico 2000 No Title - article about Ketogenic Diet, in Spanish. Mak 1999 Clinical experience of ketogenic diet on children with refractory epilepsy. Freeman 1998 The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Schiff 1998 Ketogenic diet--an alternative therapy for epilepsy in adults. Egger 1989 Oligoantigenic diet treatment of children with epilepsy and migraine. Ikonomidou 1988 Differential effects of non-steroidal anti-inflammatory drugs on seizures produced by pilocarpine in rats. Maher 1987 Possible neurologic effects of aspartame, a widely used food additive. Egger 1985 Controlled Trial of Oligoantigenic Treatment in the Hyperkinetic Syndrome. Egger 1983 Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Inoue 1983 Folate supplements and phenytoin-salicylate interaction. Chen 1980 Potentiation of noise-induced audiogenic seizure risk by salicylate in mice as a function of salicylate-noise exposure interval. Chen 1980 Potentiation of acoustic-trauma-induced audiogenic seizure susceptibility by salicylates in mice. Haavik 1979 Effects of the Feingold diet on seizures and hyperactivity: a single-subject analysis.
Note: A word of caution is needed here. Every dietary manipulation which involves removing all or most "processed" foods approaches the Feingold diet by inadvertently eliminating all the many additives used in such products. We are therefore not surprised to see that removal of "only" milk, wheat, sugar, or protein/fats from the diet will "work," at least somewhat, in relieving hyperactive behavior.
Note: People with epilepsy may be well served by remaining on Stage One of the Feingold Program, thus avoiding exposure to aspirin, sodium salicylate, and other forms of salicylate.
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Audiogenic seizure risk can be induced in genetically seizure-resistant BALB/c mice by exposure to an intense noise. . . . the greatest potentiation effect was obtained when animals were exposed to the noise 6 hr after the intake of salicylate. The findings were taken as indirect evidence suggesting that the ototoxic action of sodium salicylate could potentiate vulnerability of the mouse cochlea to noise damage."
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Combined exposure to noise and salicylates was found to produce greater acoustic trauma induced audiogenic seizure risk than exposure to the noise alone. The result suggests that salicylates could make the mouse cochlea more vulnerable to the traumatic action of noise."
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"93% of 88 children with severe frequent migraine recovered on oligoantigenic diets; ... the role of the foods provoking migraine was
established by a double-blind controlled trial in 40 of the children. ... Associated symptoms which improved in addition to headache included abdominal pain, behaviour disorder, fits, asthma, and eczema. In most of the patients in whom migraine was provoked by non-specific factors, such as blows to the head, exercise, and flashing lights, this provocation no longer occurred while they were on the diet."
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62 of 76 selected overactive children (81.6%) improved;
other symptoms such as headaches, abdominal pain, and fits, also improved.
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Of 45 children with epilepsy and recurrent headaches, abdominal symptoms, or hyperkinetic behavior, 36 [80%] improved on an oligoantigenic diet; 25 [55%] ceased to have seizures and 11 had fewer seizures during diet therapy. "Headaches, abdominal pains, and hyperkinetic behavior ceased in all those whose seizures ceased, and in some of those whose seizures did not cease." ..."Of 24 children with generalized epilepsy, 18 [75%] recovered or improved (including 4 of 7 with myoclonic seizures and all with petit mal), as did 18 of 21 [85%] children with partial epilepsy. In double-blind, placebo-controlled provocation studies, symptoms recurred in 15 of 16 children, including seizures in eight; none recurred when placebo was given. Eighteen other children, who had epilepsy alone, were similarly treated with an oligoantigenic diet; none improved."
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. . .One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant
medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. . . . Three months after diet initiation, 83% of those starting remained on the diet and 34% had >90% decrease in seizures. . . . At 1 year, 55% remained on the diet and 27% had a >90% decrease in seizure frequency. . . . It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective."
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The effects of a dietary manipulation on seizure frequency and activity level of a 3 1/2-year-old male with tuberous sclerosis, mental retardation, and uncontrolled seizures were assessed. . . . Every application of the K-P diet resulted in substantial reductions in seizure frequency. During a 21-week follow-up, seizure frequency remained low despite the phasing out of one drug, and seizures were reportedly eliminated 1 year later. Brief
objective measures of hyperactivity failed to show any effect due to the diet changes."
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. . . Pretreatment of rats with sodium salicylate, ED50 103 mg/kg (60-174), and phenylbutazone, 59 mg/kg (50-70) converted the non-convulsant dose of pilocarpine, 200 mg/kg, to a convulsant one.
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We found biphasic fluctuations of serum phenytoin level when aspirin was added to chronic phenytoin therapy for an epileptic patient. The total serum phenytoin level was lowered initially by addition of aspirin. However, after 4 months on phenytoin-aspirin combination therapy, he showed elevated serum phenytoin levels, mild nystagmus, and serum folate deficiency."
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The ketogenic diet induces several metabolic abnormalities that increase the propensity for stone formation. Urologists should be aware of this potential complication. Fluid liberalization and bicitrate are recommended as prophylaxis."
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"... Since phenylalanine can be neurotoxic and can affect the synthesis of inhibitory monoamine neurotransmitters, the phenylalanine in aspartame could conceiveably mediate neurologic effects. If mice are given aspartame in doses that elevate plasma phenylalanine levels more than those of tyrosine . . . the frequency of seizures . . . is enhanced. ... Perhaps regulations concerning the sale of food additives should be modified to require the reporting of adverse reactions and the continuing conduct of mandated safety research."
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Thirteen children with refractory epilepsy received a ketogenic diet. . . Clinical observation one month after the diet revealed that 53.8% of the patients had a > 75% reduction in seizure frequency and 76.9% of the patients had a > 50% reduction in seizure frequency. Six patients had some degrees of improvement in cognitive function and/ or school performances. The most common side effects were body weight loss (n = 6) and diarrhea (n = 5). Others included bad temper (n = 1), abdominal cramps (n = 2), nausea (n = 2), bad body smell (n = 1), and renal stones (n = 1). . . . We concluded that the ketogenic diet deserves a trial in children with refractory epilepsy."
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Individuals with epilepsy also often exhibit symptoms of attention deficit hyperactivity disorder (ADHD). The ketogenic diet, which is a high fat, low protein, and low carbohydrate diet used in the treatment of intractable epilepsy, also appears to improve symptoms of ADHD in individuals with both disorders. Previous research suggests that the diet decreases the activity level of rats. ... adult male Long-Evans rats were placed on either a ketogenic diet or a control diet. The results of the first experiment show that the ketogenic diet can cause a decrease in activity level within 24 h and that the results are reversible. The results of Experiment 2 show that the decrease in activity level is not linked to a change in anxiety level. The ketogenic diet may be of use in the treatment of ADHD."
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Aspirin (acetylsalicylic acid), and its main metabolite sodium salicylate, have been shown to protect neurons from excitotoxic cell death in vitro. . . . We report that sodium salicylate did not
protect neurons from seizure-induced cell death, and to the contrary, it caused focal hemorrhage
and cell death in the hippocampal formation and the entorhinal/piriform cortex of rats with kainic
acid-induced seizures. . . .These initial
observations may have important clinical implications for patients with epilepsy who take aspirin
while affected by these conditions, and should promote further investigation of this relationship."
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... 13 patients aged between 1 and 19 . . . evaluated for an average period of 22 months. . . . There was over 50% reduction in the number of crises of 84.5% of the children. Complete control was attained in 30.8%. The electroencephalographic recordings showed improvement in 100% of the children. The families involved reported a 58.8% reduction in the side effects observed. . . . CONCLUSION: The clinical and electroencephalographic improvement and minimal side-effects seen confirm that KD is beneficial in refractory epilepsy in children."
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. . .We present a 20-year-old man with intractable epilepsy
since early childhood who is being treated with great success by a medium-chain triglyceride
ketogenic diet. It has not only controlled the seizures but has also improved quality of life. We
recommend a therapeutic trial of the ketogenic diet in intractable epilepsy for all ages."