Ketogenic diet is anticonvulsive

[IslandDiversHI]

I thought I would post this to try and did up the collective SB knowledge on this subject. In the October issue of Outside Magazine there was a brief mention of this in an article called "Always be Moving" by Christopher Keyes. It was a short mention of Dr. Dom D'agostino, who apparently has a grant from the office of Naval Research. The quick mention includes this: "D'Augustino's team has produced encouraging results in testing ketone esters, an exogenous form that you can drink or eat to boost ketone bodies with or without a ketogenic diet."

An admittedly quick internet search didn't turn up too much, but apparently the anti convulsive effects of a ketogenic diet have been known since the 1920's. I am admittedly not highly plugged into the cutting edge of technical diving knowledge, but I was surprised to not find anything on scubaboard about this subject. Anyone want to share what they know?

 

[KevinNM]

There are some forms of epilepsy that are controlled by a very high fat diet. Not sure if this extends to any other type of seizure.

 

[Dizzi Lizzi]

I have patients on this diet for severe seizures. It's pretty tough, and exacting diet for it to be effective. The patients are very thin. Even the amount of water is restricted.

 

[LowDrag]

I have done a high protein, low carb diet in the past and it works great for me for losing weight as well as working with my Crohn's disease. A high protein, low carb diet really makes my stomach feel much better. My wife and I are starting this ketogenic diet this week to give it a trial.

 

[Eric Sedletzky]

Yep, the bad breath diet, know it well.
Competitive bodybuilders do this to burn off every remainig scrap of fat from under their skin. The body is forced to convert four times the amoint of fat as it would carbs to keep the glycogen levels up in your brain so you can function, and stay alive. The result is fat burning at an accelerated rate and all that fat burning also means a lot of residual ketones in your blood stream.
Eskimos survived just fine on nothing but blubber and fish for eons before the white man showed up with all his carbs.
Just be carefull, hard on the liver and kidneys if you're not used to it.

 

[KevinNM]

The diet used for epilepsy that I'm vaguely familiar with is really hard. It's more like the Eskimo diet than Atkins or paleo. It's things like ounces of butter at a meal and very little else. I have no idea if it would have any effect on oxygen toxicity or if there is even any pathway where it might based on our current understanding of oxygen toxicity.

 

[dreamdive]

There is a preliminary study with rats to determine if ketogenic rats are resistant to oxygen seizures. The results are promissing, but should not be taken to mean that the same results can be expected in humans!

If you are interested, Dr. Harry Whelan from the university of Wisconsin is currently enrolling people in a study that will ultimately test the hypothesis.

Lisa Jome is his assistant and can be contacted:

Ljome@mcw.edu
414-266-7540

The more support the better!

Cheers, Claudia Sotis MD

 

[kelemvor]

There is a preliminary study with rats to determine if ketogenic rats are resistant to oxygen seizures. The results are promissing, but should not be taken to mean that the same results can be expected in humans!

Have anti-convulsive medications (depakote, norontin, etc) ever been studied with regards to oxygen toxicity?

 

[dreamdive]

There is a study from 1991 suggesting Tegretol having a dose-related effect but not Zarontin.
The effect of carbamazepine and ethosuximide on hyperoxic seizures
Amikam Reshef, Noemi Bitterman, Dan Kerem

Here is a case report from 1983 on Phenytoin (Dilantin) which suppressed O2 tox seizures:
Phenytoin sodium in oxygen-toxicity-induced seizures
MD Lindell K. Weaver
We have to keep in mind that these medications also have unfavorable side effects. They may be a consideration for chamber use rather than for use in diving!

The ketone study is interesting because most people can tolerate ketosis well. Right now Whelan is collecting data on diving while ketotic. If there are no adverse profiles, he can advance it further towards testing ketosis and oxtox in humans.

 

[Dizzi Lizzi]

There is a study from 1991 suggesting Tegretol having a dose-related effect but not Zarontin.
The effect of carbamazepine and ethosuximide on hyperoxic seizures
Amikam Reshef, Noemi Bitterman, Dan Kerem

Here is a case report from 1983 on Phenytoin (Dilantin) which suppressed O2 tox seizures:
Phenytoin sodium in oxygen-toxicity-induced seizures
MD Lindell K. Weaver
We have to keep in mind that these medications also have unfavorable side effects. They may be a consideration for chamber use rather than for use in diving!

The ketone study is interesting because most people can tolerate ketosis well. Right now Whelan is collecting data on diving while ketotic. If there are no adverse profiles, he can advance it further towards testing ketosis and oxtox in humans.

I'm a new diver just simple OW. Don't know diddly squat about technical diving, well ok maybe a little diddly, but just enough to know its a super fine line to balance.
I'm a nurse. Just a regular old RN.

From the medication standpoint using them in the chamber sounds ok, but you would have to load them pretty rapidly to get a therapeutic effect. I'm not sure how effective that could be but certainly a possible viable treatment for patients in a longer chamber ride. You don't want patients having seizures in the chamber.
And the side effect of drowsiness of phenytoin certainly could mask other symptoms but thats why we have studies. I like that.

As to being in ketosis (esp long term), that seems to be dangerous as there are a lot side effects that CAN occur. * I was going to post the list of side effects but it looked kinda alarmist. The ones that drew my eye where cardiac arrythmias, muscle cramps/weakness, impaired cognition and concentration. No bueno. Of course this is most likely related to the degree of ketosis.

Our patients get lab draws to reevaluate, and most stay on the diet for a limited time as the effects seem to diminish with time (my anecdotal experience).

It seems drastic to place a diver in ketosis just in case he gets oxtox. This is not what is being suggested is it? However it looks like caffeine is good as a protection! Yay more caffeine!

If I am way out of line in my thinking I apologize and remind you about my diddly squat comment and I will refrain from commenting further.