April 21, 2011 -- Nine-year-old Jack O'Connor's parents feed him a steady diet of bacon, heavy cream, sausage, and on special occasions, allow him a "treat" of a few strawberries or a slice of apple. Jack's diet is so fat-rich and nutrient-poor that he needs to take daily calcium and vitamin supplements so as not to stunt his growth.
While this may sound like malnourishment, this food is Jack's medicine, and this strictly regimented 90 percent fat diet offers relief from his debilitating epilepsy in a way that no drug ever could.
To learn more about Jack and other children like him, watch 'World News With Diane Sawyer' tonight at 6:30 p.m. ET on ABC
As of a year ago, Jack suffered 50 seizures a day, while his parents, Juliet and Chris O'Connor, bounced desperately from doctor to doctor, trying "X" number of medications.
But nothing worked -- until doctors at Massachusetts General Hospital Epilepsy Clinic suggested trying what to the O'Connors sounded like a shocking regimen: a high-fact ketogenic diet.
Stricter from a fat standpoint than the Atkins diet, about 90 percent of its calories -- measured down to the tenth of a gram -- come from fat.
"Many children get started on a 4:1 ratio -- meaning they get four grams of fat to every gram of carbohydrate plus protein. So a typical meal would be bacon, and often lots of it, with sometimes a small amount of carbohydrate in the form of vegetable or fruit," Dr. Elizabeth Thiele, director of pediatric epilepsy at Massachusetts General Hospital, told ABC's "World News." The children are then given vitamin and mineral supplements to ensure normal growth.
The diet has made all the difference for Jack and many children like him for whom pharmaceutical drugs have failed.
"After two months, we started to see a decrease in the seizures. They were cut in half within a few months," Chris O'Connor says.
Now, several months into the diet, Jack has fewer than five seizures a day. "Some days, especially recently, he's down to no seizures a day," says his father.
"The diet is a miracle," says Thiele. "Many children who go on this diet have already been on six or eight or 10 anti-convulsion medications without effective seizure control or with side effects that can't be tolerated. And they go on this diet and become seizure-free."
According to Thiele, a third will no longer experience seizures and another third will experience a greater than 50 percent reduction in their number, and for a final third, the diet doesn't work, or is not tolerated, "and that's across 80 years of the history of this diet," says Thiele.
Treating Epileptic Children With Fat
In an age in which one in five children are obese, a diet that doses kids with an overwhelming amount of fat sounds ludicrous, even dangerous. That such a diet could so alter a child's brain chemistry as to rid some of daily seizures is even harder to believe, but the evidence is in the miraculous stories of children like Jack.
The ketogenic diet was developed in the 1920s, after it was noticed that after fasting, epileptics would experience a marked reduction in their seizures.
"When a person fasts, your body starts breaking down your fat stores," Thiele explains. "Obviously, fasting is not great for a treatment for epilepsy, or other conditions, because it doesn't provide adequate nutrition. So the thought was, Gee, how could we mimic starvation and trick our bodies into thinking we're starving by using fats as the main energy source."
Whereas normally the body will break down carbohydrates as fuel, a ketogenic diet supplies calories mostly in the form of fat and hence the body must switch gears and break down fat for fuel instead, a state known as ketosis. This is also what the body does when fasting.
It's not known exactly how ketosis hinders seizures, Thiele says, but the impact a ketonic state has on cell production is currently under investigation for a number of diseases, including Parkinson's and Alzheimer's, and certain types of cancer.
Cancer cells grow rapidly and use a lot of energy, and the ketogenic diet basically shuts down the cell's energy production, thereby potentially slowly the progress of the cancer, Thiele says.
Short-Term Diet, Long-Term Cure
Luckily for Jack, he won't have to give up ice cream and cookies and other favorites forever: Kids can often be eased off the diet after two years.
"World News" spoke with Evan Kristal, 14, who is considered another "miracle" case when it comes to the ketogenic diet. When Evan's parents came to Mass General's Epilepsy Center years ago, "they were pretty much in a place of desperation," Thiele says. Evan was having 40 to 50 seizures a day. Within weeks of going on the diet, he was down to zero seizures a day. Two years later, Evan went off the diet, and began to eat like a normal kid again, and remained seizure free.