July 5, 2000
Meal Planning, Food and Diet
Question from Hotmail.com:
My son is on the ketogenic diet; he has been for 3 years. We chose the diet as treatment for seizures. It has worked 100%. However, his medical condition has just been diagnosed as a glucose transport defect of the brain barrier. His brain does not recognize glucose as fuel. Needless to say, he must remain on this high fat diet. There is research being done as I speak in New York. We have been invited to bring our son out at the end of the month for enhancing their studies regarding this syndrome. He is the 40th to be diagnosed.
Anyway, my question to you is: We are trying to make this diet as healthy as we possibly can. Of course, there are no answers as to the affects of being on a diet like this for any length of time, but we do not have a choice. So here is my question, I have been hearing a lot about the Glycemic Index and the fact that carbohydrates are broken down quicker or slower depending on the food. Does this affect the glucose in the brain? Certainly any glucose I would suspect that breaks down slower in the blood may get to the brain slower. Should we be concerned with what carbohydrates our son does get? He is allowed so many grams per meal say 15 grams. Which isn’t much but are some better than others. The glucose in his blood doesn’t matter, it is what happens when all the glucose hits his brain, it rejects 2/3 of it. Thus, his brain was literally starving. Does anyone have any information, or can they make any speculations on this? Would feeding him foods that are lower on the Index maybe allow him more carbohydrates thus making it a healthier diet?
There is a long medical literature about ketogenic diets for treating diabetes, before there was any insulin available in the early 1920s. It is a very difficult dietary approach.
I would guess for the treatment of intractable seizures, the ketogenic diet should be rather strictly followed. Therefore, it would be imperative for you to work extremely closely with neurologists and dietitians who are knowledgeable about such diets. I would also guess that it would not matter whether the carbohydrate would be fast or slow acting since the blood glucose levels would all be rather normal in such a patient with normal pancreas and normal insulin responsivity. The key concept of a ketogenic diet is to limit carbohydrate intake so severely that the body switches to using fat as its metabolic fuel and, in the process of doing so, generates ketone bodies.