A saliva test could help people with epilepsy follow a keto diet

Adam Read says the keto diet, which is high-fat and low carbohydrate, changed his life. Now, following the diet properly will get easier for others like him who have epilepsy.

A simple saliva test could replace daily blood tests for millions of people with epilepsy, offering a painless way to track the ‘keto’ diet without finger pricks tests.

A Melbourne-led research team has trialled a non-invasive, painless test that they hope will expand access – particularly among children – to the “under-utilised” treatment.

For people like Adam Read, whose epilepsy was not responding well to medication, the specialised, high-fat, low-carbohydrate diet has been life-changing.

It reduces seizures for some patients with drug-resistant epilepsy, and often requires monitoring via finger prick tests, which can deter some patients.

But a new study, by Monash University and local biotech firm MX3 diagnostics, has shown patients can accurately track the diet by testing their saliva, instead of blood.

Monash neuroscience researcher Dr Neha Kaul said the test, developed by MX3, would be a “game-changer” for patients and measures the level of ketones.

“The ketogenic diet is often a forgotten treatment in epilepsy,” she said.

Ketones are released when the body enters the ‘ketosis stage’ – the goal of the diet – and has to burn fat, instead of carbohydrates, for fuel.

Dr Kaul said these ketones become the “brain’s main fuel source” and they suspect the “switch in fuel is what reduces seizures”.

“Unfortunately for one third of people living with epilepsy, they will not respond to medication and so that’s where we’re now using dietary treatment,” she said.

“It has actually been available as a treatment now for over a hundred years.

“It still remains a really under-utilised treatment, particularly for adults living with epilepsy.”

Dr Kaul said tracking ketones helped healthcare teams measure the diet’s impact and enabled patients to adjust their eating in real-time based on their levels.

“Parents could administer the test in the morning and use the information for their menu planning the same day,” she said.

The keto diet has been helpful for people suffering with medication-resistant epilepsy.

The study, published in journal Epilepsia, compared blood and saliva samples from 40 children who were admitted to China’s Shenzzhen Children’s Hospital to begin the ketogenic diet.

Patients place a small strip on their tongue to collect saliva and further research will be needed to test its accuracy for those who have been on the diet long-term.

Dr Kaul said while the diet – which should only be done under medical supervision – was not a universal epilepsy treatment, she hoped the test would make it more accessible.

“This isn’t the type of diet that someone can read off the internet and institute themselves,” she said.

“Like any diet, it is hard to follow all the time ... however I think for people who see a benefit, the benefits can just be so life-changing that they’re more likely to then be able to stay on the diet more longer term.

The keto diet is low in carbs and high in protein.

“Anything we can do to make the diet easier is I think really important.”

Mr Read welcomed the test and said the ketogenic diet, which he was prescribed several years ago as an addition to his medication, had “dramatically decreased” his seizures’s frequency.

“If it’s easier to treat, it’s a step in the right direction,” he said.

“Epilepsy has such a strong impact on my life.

“Epileptic seizures can kill you. I’ve fractured my skull.

“But the ketogenic diet is something that’s real and it’s been medically examined, researched and for me it’s been proven to work.”

But he said it wasn’t like other diets where you could have a cheat meal or cheat day.

“It’s really easy to go off track,” he said.

“I think that this device is a really user friendly way to keep you on track and to ensure that there are better outcomes for people that have been diagnosed with epilepsy.”

Originally published as A saliva test could help people with epilepsy follow a keto diet