Fueling Change: Dietary Interventions in Epilepsy Treatment

Epilepsy is a disease that affects approximately 50 million people worldwide and is characterized by recurrent seizures. These seizures cause involuntary movement in parts of the body or the entire body and can lead to a loss of consciousness. Although antiepileptic drug (AED) therapy stops seizures in most individuals, studies estimate that 30% to 40% of patients become resistant to treatment with AEDs, a condition known as drug resistant epilepsy (DRE). While the exact cause for DRE is unknown, one potential treatment that has been explored is dietary therapy.

Dietary therapy, used in conjunction with seizure medications, improves the therapeutic effects of AED treatment. It can also be used as a management option for those suffering from DRE. One common diet used for epileptic dietary therapy is the ketogenic diet. The ketogenic diet is a high fat, low carb diet that can be prescribed by a physician and is usually monitored by a dietician. In this diet, the body relies on the breakdown of fats rather than carbs for energy. These fats are metabolized into ketones and ketone bodies, which are able to cross the blood-brain barrier and enter the brain where it can be used for energy. Some food choices specific to this diet include butter, heavy whipping cream, mayonnaise, and oil (e.g., canola or olive). However, this diet is more commonly recommended for children, as it is more difficult for adults to follow such a strict diet plan. 

Despite the difficulty in maintaining the diet, it has proven to be extremely effective. Research has shown that the  ketogenic diet typically reduces the number of seizures by 50% or more in half of patients. This occurs because epilepsy, and seizures in general, are often caused by higher levels of glutamate and GABA—excitatory neurotransmitters—in the brain. However, the ketogenic diet reduces the amount of glutamate in the brain and lowers the production of GABA. The exact mechanism by which this occurs remains an active area of research, but it opens the door to a compelling question: what other diseases might be effectively treated or cured through dietary therapy?

Reviewed By: Ashley Gutierrez-Torres

Citations:

“Drug Resistant Epilepsy.” Epilepsy Society, 3 Aug. 2023, epilepsysociety.org.uk/about-epilepsy/drug-resistant-epilepsy. 

“Ketogenic Diet.” Epilepsy Foundation, www.epilepsy.com/treatment/dietary-therapies/ketogenic-diet. Accessed 30 Nov. 2024. 

“Epilepsy.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/epilepsy. Accessed 30 Nov. 2024. 

Wnuk, Alexis. “How Do Ketogenic Diets Help People with Epilepsy?” BrainFacts.Org, www.brainfacts.org/diseases-and-disorders/epilepsy/2018/how-do-ketogenic-diets-help-people-with-epilepsy-081418. Accessed 30 Nov. 2024. 

The Fast-Food Industry: Ethical Dilemmas, Health Impact and Consumer Autonomy

The fast-food industry stands at the intersection of public health, ethics, and corporate profitability, creating challenges that extend beyond personal diets. Through aggressive and ubiquitous marketing, fast-food companies influence consumer behavior, particularly children’s eating habits. The industry’s convenience and affordability appeal to a broad demographic, but its widespread consumption has raised significant public health concerns. A study in the American Journal of Clinical Nutrition links fast-food consumption to obesity and poor dietary outcomes, which not only affect individual health but also impose a heavy economical burden on healthcare systems.1 Efforts to address these issues through policy have faced resistance, raising pressing questions about the industry’s impact on public health and wellbeing. 

Fast-food thrives on maximizing profitability, often at the expense of public health. Companies invest billions annually in advertising campaigns designed to target vulnerable populations, including children and low-income families. A 2021 study by the Rudd Center for Food Policy and Obesity revealed that fast food advertising expenditures in the United States exceeded $5 billion in 2019 alone.2 These advertisements, using bright colors, catchy songs, and promotional incentives, are designed to foster brand loyalty from an early age. Children, due to limited cognitive development, are particularly vulnerable to such tactics, as they struggle to critically assess the persuasive intent behind these ads. The Rudd Center’s research underscores how these marketing efforts not only increase short-term consumption but also establish lifelong dietary patterns that prioritize convenience over nutrition. This cyclical relationship highlights the deep-rooted public health challenges posed by the fast-food industry.

The rising consumption of calorie-dense, ultra-processed foods with low nutritional value contributes significantly to rising obesity rates in the United States. The CDC reports that over 42% of adults are obese, a condition linked to heart disease, diabetes, and certain cancers.3 Obesity also imposes substantial economic costs, with costs exceeding $173 billion annually. Furthermore, obesity disproportionately impacts marginalized populations, exacerbating existing health disparities and raising ethical questions about the responsibility of corporations in addressing these inequities.

The proximity of fast-food establishments to schools further exacerbates these issues. A study published in the American Journal of Public Health found that schools near fast-food restaurants reported higher adolescent obesity rates.4 The convenience and affordability of these establishments make them especially attractive options to students from low-income families, reinforcing unhealthy eating habits that persist into adulthood. The strategic placements of fast-food outlets exploits the dietary vulnerabilities of youth, entrenching public health challenges associated with obesity and related illnesses.

Efforts to counteract these trends have faced significant resistance from the food industry. Regulatory measures, such as taxes on sugary drinks or restrictions on advertising to children, have been challenged by well-funded legal campaigns. For example, New York City’s 2012 proposal to ban large sugary drinks was struck down after intense lobbying by the beverage industry, which framed the regulation as an infringement on personal freedom.5 This illustrates the influence of corporate lobbying in shaping policy and underscores the ethical dilemmas policymakers face in balancing individual freedoms with the collective need to address the public health crisis.

Food accessibility is another ethical concern. Low-income and marginalized communities often live in “food deserts”, with limited access to affordable, nutritious food options, leading to a reliance on fast food. A 2020 study highlighted that urban poverty restricts access to a healthy diet, contributing to malnutrition and diet-related diseases.6 Moreover, the strategic dense placement of fast-food outlets in low-income neighborhoods worsens health disparities.7 This targeted proliferation raises ethical questions about corporate responsibility and the perpetuation of health inequities through the exploitation of vulnerable populations.

The impact of fast food extends beyond physical health to mental well-being. A 2023 study published in BMC Psychiatry found that diets high in processed and fast foods are linked to increased risks of mental health disorders.8 The inflammatory response triggered by these diets, characterized by elevated markers like C-reactive protein, exacerbates symptoms of anxiety and depression.9 Corporations capitalize on these dietary habits, using engineered flavors and addictive additives to drive consumption. While this ensures profitability, it often harms consumer health. As the American Psychological Association notes, diets dominated by ultra-processed foods not only reduce emotional resilience but also contribute to cognitive decline, particularly in communities with limited access to healthier alternatives.10 Without structural intervention, these patterns—rooted in corporate strategy—will continue to undermine community health and well-being.

The fast-food industry's marketing strategies raise ethical concerns regarding consumer autonomy. While consumers are presumed to make free choices, the industry's deliberate tactics influence purchasing decisions without conscious awareness, thus undermining this autonomy. These tactics can lead individuals to select less healthy, higher-margin items, thereby compromising informed decision-making.11

Moreover, the pervasive advertising of fast food, especially to children, exploits cognitive vulnerabilities. Children lack the developmental capacity to critically evaluate marketing messages, making them particularly susceptible to persuasive advertising. One of the most prominent examples of this is the McDonald’s Happy Meal, which combines toys, colorful packaging, and heavily marketed characters to create a powerful appeal to children. The inclusion of toys fosters an emotional connection with the brand, while the meal’s affordability ensures accessibility for parents. This targeted marketing fosters early brand loyalty and establishes unhealthy eating habits that can persist into adulthood.12

The fast-food industry poses a threat to public health, ethical responsibility, and consumer autonomy. The aggressive marketing strategies, combined with the widespread availability of unhealthy food, exacerbate obesity, diet-related diseases and even mental health disorders. 

Reviewed By: Ashley Gutierrez-Torres

Bibliography

1. Poti, J. M., Duffey, K. J., & Popkin, B. M. (2014). The association of fast food consumption with poor dietary outcomes and obesity among children: Is it the fast food or the remainder of the diet? American Journal of Clinical Nutrition, 99(1), 162–171.

2. Jennifer L. Harris, Frances Fleming-Milici, and Jocelyn Kelly, "Fast Food FACTS 2021: Fast Food Advertising Aimed at Children and Teens," Rudd Center for Food Policy and Obesity, University of Connecticut, December 2021, https://uconnruddcenter.org/research/food-marketing/fast-food-facts/. 

3. Centers for Disease Control and Prevention, "Adult Obesity Facts," https://www.cdc.gov/obesity/data/adult.html. 

4. N. M. Laraia et al., "Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity Rates," American Journal of Public Health 94, no. 9 (September 2004): 1575-81.

5. Margot Sanger-Katz, "Why New York City’s Sugary Drink Ban Was Struck Down," The New York Times, June 26, 2014, https://www.nytimes.com.

6. Elizabeth L. Sweet, "The Urban Food Desert as a Space of Inequity," International Journal for Equity in Health 19, no. 1 (2020): 2-12, https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01330-0. 

7. N. D. Lee, "Fast-Food Restaurants and Obesity Rates in Low-Income Communities," American Journal of Medicine 132, no. 8 (2019): 979-985, https://www.amjmed.com/article/S0002-9343%2819%2930747-8/fulltext. 

8. BMC Psychiatry Editorial Board, "Dietary Patterns and Mental Health Outcomes," BMC Psychiatry 23, no. 3 (2023): 243-255, https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05889-8. 

9. Samantha L. Hodge et al., "The Role of Diet-Induced Inflammation in Depression and Anxiety," Journal of Psychiatric Research 135, no. 4 (2021): 47-57, https://doi.org/10.1016/j.jpsychires.2020.11.015. 

10. American Psychological Association, "Diet and Mental Health: How Food Affects Mood," Monitor on Psychology 48, no. 9 (2017): 28-31, https://www.apa.org/monitor/2017/09/food-mental-health. 

11. Sarah Bowen et al., "Menu Engineering and Consumer Autonomy," Journal of Consumer Research 46, no. 5 (2019): 1123-1138, https://academic.oup.com/jcr/article/46/5/1123/5584408. 

John Quelch, "Marketing Fast Food to Children," Harvard Business Review 89, no. 3 (2011): 102-110, https://hbr.org/2011/03/marketing-fast-food-to-children.

Food Insecurity and Diabetes: How Sweet Foods Lead to a Not So Sweet Disease

Food insecurity, unfortunately, is a too-common dilemma affecting millions worldwide everyday. But what exactly is it, and who does it predominantly affect?

Food insecurity is defined into two categories by the United States Department of Agriculture (USDA). The first category of food insecurity involves “reduced quality, variety, or desirability of diet and little or no indication of reduced food intake” [1], whereas the second category more severely involves “multiple indications of disrupted eating patterns and reduced food intake” [1]. Food insecurity is a national issue, yet it seems to predominantly affect low-income and unemployed households. According to the Economic Research Service (ERS) branch of the USDA, while the national average of food-insecure households was 13.5% in 2023, 38.7% of households with incomes below the federal poverty line were food-insecure [6]. Food insecurity rates were also considerably higher for “single-parent households, women living alone, and Black and Hispanic households” [6].

Unfortunately, having a lower income also means having less access to healthier foods. A study conducted by the Harvard School of Public Health found that eating a healthy diet costs $1.50 more daily compared to eating an unhealthy diet, explaining why lower-income households opt for cheaper, albeit unhealthier, diet options [7]. As such, this limits access to healthy food for specific demographics and facilitates the consumption of more unhealthy, sugary food.

When considering the overconsumption of unhealthy food, diabetes is a disease that comes to mind, likely due to the fact that 11.6% of the U.S. population suffers from it [4]. Diabetes is essentially a “group of diseases that affect how the body uses glucose” [2] with two types: Type 1 and Type 2. Both types of diabetes can happen at any age, but Type 1 diabetes is an autoimmune condition and is more prevalent in children, while Type 2 diabetes usually develops in older people due to lifestyle and diet issues. Specific causes of diabetes are unknown, but environmental and genetic factors have proven influential [2]. Some ways diabetes can be prevented include a healthy diet, regular exercise, and maintaining a healthy weight. 

Now, you might be wondering: how exactly are food insecurity and diabetes connected? According to a study published by the Journal of Nutrition Education and Behavior, food insecurity increased the prevalence of maternal and infant consumption of sugary beverages in low-income households [3]. In other words, low-income families are consuming excess amounts of unhealthy foods as a result of food insecurity, potentially inciting a cycle of health deterioration and the development of Type 2 diabetes that could’ve been avoided with access to affordable nutritious options.

The interconnectedness of food insecurity and diabetes may have facilitated a cycle of health disparities, but studies have shown that programs such as “Food is Medicine” and federal nutrition assistance programs provide an outlet for addressing this food insecurity and reducing health disparities in low-income communities [5]. While there is still work to be done on the journey to food equality, such programs illuminate a path to a brighter future where millions worldwide can overcome food insecurity and improve their health.

Edited by: Sheldon Liu

Designed by: Eugene Cho

References

1. Office of Disease Prevention and Health Promotion (2020). Food insecurity. Food Insecurity - Healthy People 2030. (n.d.). https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/food-insecurity#:~:text=Food%20insecurity%20is%20defined%20as,possible%20outcome%20of%20food%20insecurity. 

2. Mayo Foundation for Medical Education and Research. (2024, March 27). Diabetes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444

3. Fernández, C. R., Chen, L., Cheng, E. R., Charles, N., Meyer, D., Monk, C., & Woo Baidal, J. (2020). Food Insecurity and Sugar-Sweetened Beverage Consumption Among WIC-Enrolled Families in the First 1,000 Days. Journal of nutrition education and behavior, 52(8), 796–800. https://doi.org/10.1016/j.jneb.2020.03.006 

4. American Diabetes Association. Statistics about diabetes. Statistics About Diabetes | ADA. (2023). https://diabetes.org/about-diabetes/statistics/about-diabetes. 

5. Levi, R., Bleich, S. N., & Seligman, H. K. (2023). Food Insecurity and Diabetes: Overview of Intersections and Potential Dual Solutions. Diabetes care, 46(9), 1599–1608. https://doi.org/10.2337/dci23-0002 

6. USDA. (2023). USDA ERS - Food Security and Nutrition Assistance. USDA.gov. https://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/food-security-and-nutrition-assistance/ 

Dwyer, M. (2013, December 5). Eating Healthy vs. Unhealthy Diet Costs about $1.50 More per Day. Harvard School of Public Health. https://www.hsph.harvard.edu/news/press-releases/healthy-vs-unhealthy-diet-costs-1-50-more/