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In the 1920s and early 1930s, phenobarbital and bromides were the only anticonvulsants available to treat seizures. There is an apocryphal story about the young daughter of a New York dentist who had uncontrollable seizures. She was taken to a group of disciples of Bernarr McFadden in Wisconsin, who would pray and fast with individuals for a price. Miraculously, the young lady’s seizures ceased. Prayer alone had no effect; prolonged fasting was effective but impractical. Searching for help to find an alternative to fasting, the family interested investigators at Johns Hopkins and elsewhere who were, at the time, studying infant nutrition. These investigators found that when an individual fasts, the body metabolizes its own protein, and large amounts of ketone bodies and uric acid are excreted in the urine. Erroneously believing that this had something to do with seizure control, they found that if the fast was broken by eating protein or carbohydrate, the uric acid disappeared. If the fast was broken with fat, the uric acid excretion continued. A diet was then constructed with minimal protein intake and most of the calories as fat. The diet had virtually no carbohydrates.

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