Importance of Establishing Healthy Eating Habits in Epilepsy: Orrin Devinsky, MD

WATCH TIME: 4 minutes

"It’s slow across generations. My grandparents may have consumed 20% of the sugar I consumed. If you go back for generations, it was probably because sugar became very cheap around the mid 1800s. Before that, people just didn’t use it. It was a luxury."

In the literature, its shown that glucose metabolism can be impaired in epilepsy and contribute to altered neuronal membrane potentials that foster a feed-forward cycle in seizure generation. For patients with treatment-resistant epilepsy, there is evidence that modifying brain metabolism with high fat and low carbohydrate diets may result in reduced seizure frequency. Published in Neurology, a recent study assessed molecular mechanisms in brain tissue and plasma from adults with epilepsy after an average of 10 days of modified Atkins diet (MAD) prior to brain surgical resection relative to those on a non-modified, higher carbohydrate diet.

Led by Orrin Devinsky, MD, the study findings identified altered metabolites in these areas, including increased plasma ketone body 3-hydroxybutryric acid that correlated to cortex levels and altered brain metabolites associated with mitochondrial functions. Additionally, brain proteomics and RNAseq identified few differences, including 2.75-fold increased hippocampal MT-ND3 and trends in hippocampal nicotinamide adenine dinucleotide (NADH)-related signaling pathways.

Devinsky, director of the Comprehensive Epilepsy Center at NYU Langone, sat down with NeurologyLive^® to discuss situations in which MAD may be applicable to patients with epilepsy. Additionally, he spoke on the challenges of maintaining healthy lifestyles in today’s society.

REFERENCE
1. Leitner DF, Siu Y, Korman A, et al. Metabolic, proteomic, and transcriptomic changes in adults with epilepsy on modified Atkins diet. Epilepsia. Published online February 12, 2023. doi:10.1111/epi.17540