Low Blood-sugar Diet Reduces Angelman Patients’ Seizures, Study Shows

A diet that keeps blood sugar levels in check can help Angelman syndrome patients reduce the number epileptic seizures they have, Massachusetts researchers report.

The Massachusetts General Hospital team said the diet, called low glycemic index treatment, or LGIT, also improved patients’ cognition, physical function, and behavior.

Their study, published in Epilepsy & Behavior, is titled “Low glycemic index treatment for seizure control in Angelman syndrome: A case series from the Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital.”

The idea of controlling what a person eats to help manage their epilepsy has been around for a long time. As an example, the ketogenic diet significantly reduced patients’ seizure activity by changing their brain metabolism, studies have shown.

In 2002, Massachusetts General’s Center for Dietary Therapy of Epilepsy developed the low glycemic index treatment diet. It does not require a specific meal plan. Instead it focuses on increasing a person’s intake of carbohydrates with a low glycemic index, which means food that will have a low impact on blood sugar levels.

In a previous study, researchers showed that LGIT could reduce seizures by at least 90 percent in half of the patients who went on the diet. In addition, a pilot study showed that a combination of anti-epileptic therapies and LGIT led to long-term seizure reduction in Angelman patients.

Massachusetts General researchers wanted to confirm whether LGIT could benefit Angelman patients. Their study involved 23 patients, aged 2 to 31, who tried the diet an average of three years.

Before they adopted the diet, the patients were experiencing between two and four types of seizures. These included atonic seizures, generalized tonic–clonic seizures, focal seizures, myoclonic seizures, tonic seizures, and five kinds of atypical absence seizures.

Doctors recommended that the group eat about 45 g of carbohydrates a day. This regimen resulted in patients obtaining less energy from carbohydrates and more from fats.

The diet led to most patients having fewer seizures. Five stopped having seizures at all. Ten  had seizures only when they were ill, or experienced a type of epilepsy that did not involve convulsions. And seven had fewer seizures. There was not enough information on one patient to evaluate their response to therapy.

Parents reported that the change in diet improved the cognition, physical function and social skills of 13 patients. The improvements included better walking ability, less shaking, clearer speech, and better focus.

Most of the patients took epilepsy drugs with the diet. But four had fewer seizures with the diet alone.

Adverse effects were mild and could be managed with supplements or tweaking the diet.

Researchers said the diet’s ability to reduce seizures with few side effects “make it an excellent alternative or supplement to anti-epileptic drug therapy” in Angelman syndrome patients.

The team advised anyone considering the diet to read about it and work with “a registered dietitian with experience in dietary therapy for epilepsy as well as a knowledgeable neurologist.” This is particularly important to ensure that patients achieve the correct nutrient balance, the team said.