| Revision as of 03:41, 7 July 2004 view sourceWhitis (talk | contribs)197 edits Initial Creation | Revision as of 04:17, 7 July 2004 view source Maximus Rex (talk | contribs)21,625 editsNo edit summaryNext edit → | ||
| Line 7: | Line 7: | ||
| the diet was not widely adopted by doctors: | the diet was not widely adopted by doctors: | ||
| *Lack of ] studies. (see below) | *Lack of ] studies. (see below) | ||
| *The method of |
*The method of causality is not known. | ||
| *Lack of promotion by pharmaceutical companies. No one stands to make a lot of money off the diet, so doctors are bombarded with info on pharmaceutical solutions rather than simple solutions. | *Lack of promotion by pharmaceutical companies. No one stands to make a lot of money off the diet, so doctors are bombarded with info on pharmaceutical solutions rather than simple solutions. | ||
| *Money corrupts science. It can influence which studies are undertaken and which are not, which conclusions are drawn, and which are published. | *Money corrupts science. It can influence which studies are undertaken and which are not, which conclusions are drawn, and which are published. | ||
| Line 23: | Line 23: | ||
| A | A | ||
| [http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM | [http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM | ||
| study conducted by |
study conducted by Johns Hopkins] | ||
| reported that 50% of those patients starting the ketogenic diet reported a decrease in seizures of 50% or more, with 29% of patients reporting a 90% reduction in symptoms; these patients had previously tried an average of six anticonvulsant drugs. The success rate on patients who responded to anticonvulsants was not measured in that study (and appears to be lacking | reported that 50% of those patients starting the ketogenic diet reported a decrease in seizures of 50% or more, with 29% of patients reporting a 90% reduction in symptoms; these patients had previously tried an average of six anticonvulsant drugs. The success rate on patients who responded to anticonvulsants was not measured in that study (and appears to be lacking | ||
| in other recent studies as well - there appears to be reluctance to try the diet on subjects except as a last resort). The success rate of the diet on those who are successfully treated with anti-convulsants may be higher, lower, or the same as those who do not respond. It may be that the diet and anti-convulsants are effective | in other recent studies as well - there appears to be reluctance to try the diet on subjects except as a last resort). The success rate of the diet on those who are successfully treated with anti-convulsants may be higher, lower, or the same as those who do not respond. It may be that the diet and anti-convulsants are effective | ||
| Line 30: | Line 30: | ||
| The Ketogenic Diet has been reported to work in cases | The Ketogenic Diet has been reported to work in cases | ||
| were multiple Epilepsy drugs have failed. There may also be cases where the Ketogenic Diet has failed and Epilepsy drugs succeeded. When one Epilepsy drug | were multiple Epilepsy drugs have failed. There may also be cases where the Ketogenic Diet has failed and Epilepsy drugs succeeded. When one Epilepsy drug | ||
| fails, there is a high |
fails, there is a high likelihood that other drugs | ||
| will also fail. When the diet works, the response is | will also fail. When the diet works, the response is | ||
| often rapid and dramatic. | often rapid and dramatic. | ||
| Line 47: | Line 47: | ||
| *] | *] | ||
| *Researchers expectations may prejudice their observations | *Researchers expectations may prejudice their observations | ||
| *Researchers |
*Researchers inadvertently prejudicing patients through body language, tone of voice, etc. There was a case of a horse that could answer math problems by tapping its hoof the appropriate number of times; it turns out it had simply learned to tap its hoof until there was a noticeable change in body language of the observers. | ||
| However, doctors who oppose the Ketogenic Diet on the basis of lack of double blind studies are being somewhat hypocritical: combinations of anti-convulsants commonly prescribed also lack double blind studies on their interactions and it is not possible to do double blind studies on surgery, either. | However, doctors who oppose the Ketogenic Diet on the basis of lack of double blind studies are being somewhat hypocritical: combinations of anti-convulsants commonly prescribed also lack double blind studies on their interactions and it is not possible to do double blind studies on surgery, either. | ||
| Line 63: | Line 63: | ||
| ==External |
==External links== | ||
| * | * | ||
| * | * | ||
| Line 71: | Line 71: | ||
| *NICUS: [http://webhost.sun.ac.za/nicus/Factsheets/ketogenic.htm | *NICUS: [http://webhost.sun.ac.za/nicus/Factsheets/ketogenic.htm | ||
| Ketogenic Diet: Fact or Fiction?] | Ketogenic Diet: Fact or Fiction?] | ||
| {{stub}} | |||
Revision as of 04:17, 7 July 2004
The Ketogenic Diet is a treatment for Epilepsy that relies on inducing a state of ketosis.
The medical profession does not widely prescribe the use of the Ketogenic Diet, preferring instead to use a variety of Anticonvulsant Drugs and surgery. However some of the anticonvulsent drugs are themselves quite toxic and approximately 20%-30% of patients do not respond to available drugs. Among the possible reasons the diet was not widely adopted by doctors:
- Lack of double blind studies. (see below)
- The method of causality is not known.
- Lack of promotion by pharmaceutical companies. No one stands to make a lot of money off the diet, so doctors are bombarded with info on pharmaceutical solutions rather than simple solutions.
- Money corrupts science. It can influence which studies are undertaken and which are not, which conclusions are drawn, and which are published.
- Doctors own financial self interest. A doctors own income can depend on sick patients who are reliant on doctors for pills and surgery.
- Concerns about patient compliance with diet
- Concerns about potential nutritional deficiency
- An obsession with the products of science rather than the methods of science.
- It is possible that early anti-convulsants were statistically more effective than diets as treatment for new patients but that they worked on separate population groups.
The TV movie First Do No Harm recently increased awareness of the Ketogenic Diet, though a curative link between fasting and Epilepsy was even mentioned in the bible.
Scientific Studies
A [http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM study conducted by Johns Hopkins] reported that 50% of those patients starting the ketogenic diet reported a decrease in seizures of 50% or more, with 29% of patients reporting a 90% reduction in symptoms; these patients had previously tried an average of six anticonvulsant drugs. The success rate on patients who responded to anticonvulsants was not measured in that study (and appears to be lacking in other recent studies as well - there appears to be reluctance to try the diet on subjects except as a last resort). The success rate of the diet on those who are successfully treated with anti-convulsants may be higher, lower, or the same as those who do not respond. It may be that the diet and anti-convulsants are effective on different segments of the population.
The Ketogenic Diet has been reported to work in cases were multiple Epilepsy drugs have failed. There may also be cases where the Ketogenic Diet has failed and Epilepsy drugs succeeded. When one Epilepsy drug fails, there is a high likelihood that other drugs will also fail. When the diet works, the response is often rapid and dramatic.
Links to more studies
Clinical efficacy of the ketogenic diet.]
The ketogenic diet in children, adolescents and young adults with refractory epilepsy: an Italian multicentric experience.]
Double Blind Studies
Lack of double blind studies is an issue preventing wider acceptance by the medical profession. Reliance on proper studies rather than anecdotal evidence or flawed studies is important. There will always be some people who are spontaneously cured, there will be Double blind studies help eliminate:
- Placebo effect
- Spontaneous Remission
- Researchers expectations may prejudice their observations
- Researchers inadvertently prejudicing patients through body language, tone of voice, etc. There was a case of a horse that could answer math problems by tapping its hoof the appropriate number of times; it turns out it had simply learned to tap its hoof until there was a noticeable change in body language of the observers.
However, doctors who oppose the Ketogenic Diet on the basis of lack of double blind studies are being somewhat hypocritical: combinations of anti-convulsants commonly prescribed also lack double blind studies on their interactions and it is not possible to do double blind studies on surgery, either.
It is difficult to conduct truly double blind studies on a diet. Unlike pills, the constituents of a diet are often rather obvious. One could argue that the placebo effect is not a factor since in one of the studies the patents have already tried six different "placebos" in the form of ineffective prescription drugs and the diet studies deal with a population group that has a low spontaneous remission rate. Also, in the patients previous clinical experience, they experienced a negative outcome when a positive outcome was expected by their doctors.
A double blind study of the Ketogenic Diet is underway.
External links
- Epilepsy Action: The Ketogenic Diet
- Johns Hopkins
- http://www.clinicaltrials.gov/ct/gui/c/a1r/show/NCT00004729?order=5&JServSessionIdzone_ct=blet58c3r1
- Bible: Mark 9:29
- Bible: Mathew 17:21
- NICUS: [http://webhost.sun.ac.za/nicus/Factsheets/ketogenic.htm
Ketogenic Diet: Fact or Fiction?]