Charlie’s seizures were completely controlled as long as he was on the diet. The amazing
success of the ketogenic diet where other treatments had failed led Charlie’s father to create the
Charlie Foundation, which has produced several videos, published the book “The Epilepsy Diet
Treatment: An introduction to the ketogenic diet”, and has sponsored conferences to train
physicians and dietitians to implement the diet. Although the exact mechanisms of how the
ketogenic diet works to control epilepsy are still unknown , the diet continues to gain acceptance
as an alternative to drug therapy.
Other clinical conditions
Epilepsy is arguably the medical condition that has been treated the most with ketogenic
diets (1-3). However, preliminary evidence suggests that the ketogenic diet may have other
clinical uses including respiratory failure (6), certain types of pediatric cancer (7-10), and possibly
head trauma (11). Interested readers can examine the studies cited, as this book focuses
primarily on the use of the ketogenic diet for fat loss.
Obesity
Ketogenic diets have been used for weight loss for at least a century, making occasional
appearances into the dieting mainstream. Complete starvation was studied frequently including
the seminal research of Hill, who fasted a subject for 60 days to examine the effects, which was
summarized by Cahill (12). The effects of starvation made it initially attractive to treat morbid
obesity as rapid weight/fat loss would occur. Other characteristics attributed to ketosis, such as
appetite suppression and a sense of well being, made fasting even more attractive for weight loss.
Extremely obese subjects have been fasted for periods up to one year given nothing more than
water, vitamins and minerals.
The major problem with complete starvation is a large loss of body protein, primarily from
muscle tissue. Although protein losses decrease rapidly as starvation continues, up to one half of
the total weight lost during a complete fast is muscle and water, a ratio which is unacceptable.
In the early 70’s, an alternative approach to starvation was developed, termed the Protein
Sparing Modified Fast (PSMF). The PSMF provided high quality protein at levels that would
prevent most of the muscle loss without disrupting the purported ‘beneficial’ effects of starvation
ketosis which included appetite suppression and an almost total reliance on bodyfat and ketones
to fuel the body. It is still used to treat severe obesity but must be medically supervised (13).
At this time, other researchers were suggesting ‘low-carbohydrate’ diets as a treatment for
obesity based on the simple fact that individuals tended to eat less calories (and hence lose
weight/fat) when carbohydrates were restricted to 50 grams per day or less (14,15). There was
much debate as to whether ketogenic diets caused weight loss through some peculiarity of
metabolism, as suggested by early studies, or simply because people ate less.
The largest increase in public awareness of the ketogenic diet as a fat loss diet was due to
“Dr. Atkins Diet Revolution” in the early 1970’s (16). With millions of copies sold, it generated