Featuring the work of CURE Epilepsy grantee Dr. Manisha Patel.
A new publication from the University of Colorado lab of CURE Epilepsy grantee and former Scientific Advisory Council member Dr. Manisha Patel offers the latest scientific explanations for why ketogenic diets reduce seizures in people with epilepsy. The report brings together insights from both laboratory discoveries and real‑world patient outcomes, showing that ketogenic diets do far more than reduce seizures.
The review outlines how these strict high-fat, low-carbohydrate diets strengthen the brain’s energy systems, reduce inflammation, and protect neurons – providing therapeutic benefits that current medications do not offer.
The authors synthesize research from the past five years examining the clinical efficacy of ketogenic diets and the underlying mechanisms that drive their effects. They explain that ketogenic diets significantly limit carbohydrates, so the brain no longer relies on glucose as its main fuel. Instead, the body shifts to produce ketones, which provide a steadier, more efficient source of energy. That change helps stabilize overactive neurons and supports healthier energy regulation in the brain. Together, these effects can help make seizures less likely to occur.
These insights, the authors say, not only clarify how ketogenic therapies work but also open the door to new therapies that could replicate the diet’s effects without requiring patients to follow strict, long‑term eating plans. The review also identifies a major gap: most ketogenic diet research focuses on children. However, while some pediatric studies have compared different ketogenic diets and evaluated them against standard epilepsy care, these studies are still relatively limited. In adults, the evidence gap is even wider, and studies comparing ketogenic diets to standard care epilepsy treatments are extremely scarce, with only one randomized controlled trial conducted in adults in the past five years.
A key factor highlighted in the review is how the body’s ability to break down fat changes over time. Adults can develop liver changes, often influenced by long-term antiseizure medications, that can affect how well they tolerate or respond to ketogenic diets. This may be one reason early initiation, especially in childhood, appears most effective. The authors emphasize the importance of starting the diet early on to get the most benefit.
This review underscores the need for earlier adoption of the ketogenic diet, additional large-scale randomized controlled trials to assess long-term effects, continued innovations that improve how and when the diet is implemented, and the development of diet‑mimicking therapies that are easier for patients to sustain.
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