AIIMS 1st to show efficacy of new diet regime in drug resistant epilepsy
Researchers from AIIMS, New Delhi, have become the first in the world to show the efficacy of a new dietary regime – the low glycemic index diet therapy — in treating children with drug resistant epilepsy, who are normally administered the “high on fat” ketogenic diet, which is hard to follow and very restrictive.
While the glycemic index diet requires minor changes in diet schedules and can be given out patient, children have to be admitted to hospitals to be given the ketogenic diet whose compliance is therefore low.
In their path-breaking paper published in the Journal of the American Medical Association, child neurologists of AIIMS compared three available diet therapies for children suffering from drug-resistant epilepsy for the first time and proved the efficacy of low glycemic index diet which they showed posed the least risk of adverse events.
“Ours is the first-of-its-kind diet trial which compared three primary dietary therapies available for children with drug resistant epilepsy. Ketogenic diet is proven as efficacious, but is restrictive and hard to comply specially in an Indian setting where high fat diets are not the norm. We studied ketogenic, modified Atkins diet and low glycemic index diet in 158 children and found the seizure burden reduced by half in 67 per cent children on ketogenic diet, 52 per cent on modified Atkins diet and 59 per cent on low glycemic index therapy diet. Side effects were the least in children on low glycemic index therapy diet, which also showed high reduction in seizures. Our study shows that disease management guidelines should be modified to include low glycemic index diet,” says Dr Sheffali Gulati of the Centre of Excellence and Advanced Research on Childhood Neuro development Disorders, AIIMS, New Delhi.
In India 14 children in every 10,000 suffer from epilepsy. Experts say in 60 per cent patients, epilepsy will get controlled by two anti-seizure drugs, but the rest would need either surgery or dietary therapies.
“Surgery option cannot be exercised in all patients and can lead to permanent disabilities in some. Also epilepsy surgery is available only in select centres across the country. The other option is ketogenic diet therapies, which often require the patient to get admitted to the hospital to strictly adhere to protocols in which food has to be weighed. Modified Atkins diet is less severe than ketogenic diet and the third dietary protocol is the low glycemic index therapy diet, which requires very few diet modifications and is the least restrictive,” say researchers who nowshow that low glycemic index diet can deliver well in children with intractable epilepsy.