Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.
Eating a healthy diet and staying active is important for everyone. For people with diabetes (both type 1 and type 2), prediabetes, and obesity, food and exercise plays an even greater role in managing day-to-day health. Despite all the popular articles and books, the research on nutrition, exercise, and obesity is very complex, and there is still a lot we don’t know.
Focus on diet: “It’s clear that you need to restrict calories in your diet to lose weight—and exercise to keep it off,” says Tim Church, M.D., the director of preventive medicine research at Louisiana State University, in Baton Rouge. “Most people who exercise to lose weight and don’t restrict calories shed only 2 to 3 percent of their weight over 6 to 12 months,” says Church. The reason? It’s much easier to deny yourself 500 calories a day—the amount you typically need to cut to lose a pound a week—than to burn that much through exercise. For instance, to work off almost 500 calories, a 155-pound woman would have to spend an hour pedaling a stationary bike at moderate intensity. Compare that with swapping a Starbucks Grande Caffé Mocha with 2 percent milk (200 calories without whipped cream) for a plain brewed coffee (5 calories) and eliminating a nightly bowl of ice cream (about 200 calories in a half cup) and a handful of potato chips (almost 160 calories). A bonus benefit of losing weight: Shedding about 5 percent of your body weight will reduce your risk of developing diabetes by almost 60 percent.
The next time you want to grab a fattening snack, reach for some sugar-free gum instead. Chewing some types of gum gives you fresh breath and can also help manage hunger, control snack cravings, and aid in weight loss. (Keep in mind, however, that excess sorbitol, a sugar alcohol sometimes used in low calorie gums, can have an laxative effect in some people.) Although gum might make you eat less, it doesn't mean you can stop eating right. A good diet and exercise are still important.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more
Focus on exercise: The most compelling studies favor physical activity for mental acuity, says Gary W. Small, M.D., the director of the UCLA Longevity Center and a coauthor of The Alzheimer’s Prevention Program ($14, amazon.com). A study from the Annals of Internal Medicine found that people who were fitter at midlife had a 36 percent lower risk of developing dementia later in life than did their less-fit peers. “When people exercise, the areas that control memory, thinking, and attention increase in the brain,” says Small. “Regular exercisers also have less of the abnormal protein deposits in the brain that have been linked to Alzheimer’s.” That’s not to say that diet has no impact, says Small: “It’s just that the effects of exercise are more pronounced based on the evidence we have now.” Foods rich in omega-3 fatty acids (such as fish, nuts, and flaxseed) and antioxidant-rich fruits and vegetables (like strawberries and spinach) have been shown to improve brain health, while refined sugars and processed foods can have the opposite effect.
Some diet plans, such as the MIND diet and the DASH diet, are meant to focus on certain areas of health — and weight loss may be a bonus. Others are created with weight loss as a primary goal. “It is important to remember that we are all very unique individuals,” says Kyle. “We all have different states of health and different lifestyles, which could affect what diet plan is best for us. That means that you should not be considering what is working for your friends or family members — and instead should pay attention to what works for you individually.”
The Mayo Clinic Diet is the official diet developed by Mayo Clinic, based on research and clinical experience. It focuses on eating healthy foods that taste great and increasing physical activity. It emphasizes that the best way to keep weight off for good is to change your lifestyle and adopt new health habits. This diet can be tailored to your own individual needs and health history — it isn't a one-size-fits-all approach.
The guidelines are extensive, but you do not need to meet every recommendation all at once. To establish a healthy eating plan, the goal is to begin to make gradual changes to your eating and activity. You can select one or two guidelines a week or month to focus on. Over time, you will be able to make most, if not all, of the guidelines a part of your life.
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on their DNA makeup or on their tolerance for carbs or fat.
Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).
Eating a well-balanced diet can help you get the calories and nutrients you need to fuel your daily activities, including regular exercise. When it comes to eating foods to fuel your exercise performance, it’s not as simple as choosing vegetables over doughnuts. You need to get the right types of food at the right times of the day. Learn about the importance of healthy breakfasts, workout snacks, and meal plans.
This principle involves eating low-energy-dense foods and can help you lose weight by feeling full on fewer calories. Healthy choices in each of the other food groups in moderate amounts make up the rest of the pyramid — including whole-grain carbohydrates, lean sources of protein such as legumes, fish and low-fat dairy, and heart-healthy unsaturated fats.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
As for the mantra? Turoff thinks they are good words to live by, saying, “I kind of like it — it’s a pretty good description of balance, and people should include fun foods in their diet.” Also, Turoff adds, it’s a much better line than what model Kate Moss once said: “Nothing tastes as good as skinny feels.” (Though Elle has since reported that the veteran model now regrets saying that.)
“There are many diet plans on the market today that promote good health,” says Emily Kyle, RDN, who is in private practice in Rochester, New York. “The key is finding one that does not cause you stress or agony.” Ask yourself questions such as: Would the diet guidelines make you happy? Anxious? Stressed? Are you able to follow them long term? “Factors such as enjoyment, flexibility, and longevity should be strongly considered,” adds Kyle.