Effects of Classic Ketogenic Diet in Children with Refractory Epilepsy: A Retrospective Cohort Study in Kingdom of Bahrain.
diet therapy
ketogenic diet
pediatric epilepsy
seizures
Journal
Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595
Informations de publication
Date de publication:
22 Apr 2022
22 Apr 2022
Historique:
received:
06
03
2022
revised:
19
04
2022
accepted:
20
04
2022
entrez:
14
5
2022
pubmed:
15
5
2022
medline:
18
5
2022
Statut:
epublish
Résumé
Background: The classic ketogenic diet (cKD) has been used worldwide as an effective therapy for children with drug-resistant epilepsy. However, there have been no studies performed in Middle Eastern countries in order to assess the efficacy, side effects, predictors of cKD response and factors mostly associated with diet adherence. This study aims to assess the efficacy of cKD ratios of 4:1 and 3:1 and their influence on growth and biochemical parameters, particularly lipid profile and liver function tests (LFTs), and the factors most associated with diet adherence in a cohort of children with drug-resistant epilepsy in Bahrain. Methods: Baseline and follow-up data related to patients’ demographic and biochemical variables, epilepsy episodes, diet history and anthropometric measurements were retrieved for a total of 24 children treated with cKD in Bahrain. Results: After 6 months cKD initiation, 58.3% were positive responders with >50% seizure rate reduction, and 33.3% became seizure-free at 12 months. After 6 months of intervention with cKD, the level of triglycerides and albumin had a significant (p < 0.05) average increase over time of +1.47 mmol/L and 4.3 g/L, respectively. Although the median values of total cholesterol and alanine transaminase increased, respectively, following cKD initiation, the difference over time was not statistically significant. The mean z-scores for weight, height, and body mass index (or weight-for-length) did not change significantly at 12 months follow-up. cKD duration was the highest correlated variable with cKD efficacy (r = 0.76), which was followed by age at cKD initiation (r = 0.47). The cKD was discontinued by 14 patients (58.3%) during the first follow-up period (6 months), which was mainly due to inefficacy (n = 8), poor compliance (n = 3), food refusal (n = 1), achieved required efficacy (n = 1) and death (n = 1). Conclusions: cKD is an effective treatment for patients with drug-resistant epilepsy, and positive response to cKD was the main factor that increased adherence to the diet. Although long-term cKD could increase the risk of dyslipidemia and hepatic problems, it appears safe for children. Consequently, close monitoring and emphasis on healthy fats is of high priority.
Identifiants
pubmed: 35565714
pii: nu14091744
doi: 10.3390/nu14091744
pmc: PMC9105742
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Références
Seizure. 2018 May;58:41-46
pubmed: 29653328
Iran J Child Neurol. 2019 Fall;13(4):83-90
pubmed: 31645869
Seizure. 2010 Sep;19(7):404-8
pubmed: 20598586
Nutrients. 2019 Jun 26;11(7):
pubmed: 31247999
Seizure. 2016 Dec;43:32-38
pubmed: 27866088
Epilepsy Res. 2011 Sep;96(1-2):172-5
pubmed: 21700429
J Child Neurol. 2013 Apr;28(4):479-83
pubmed: 23427065
Epilepsia. 2010 Jun;51(6):1069-77
pubmed: 19889013
Nutrients. 2020 Aug 27;12(9):
pubmed: 32867258
Dev Med Child Neurol. 2014 Sep;56(9):898-904
pubmed: 24749520
Epilepsia. 2009 May;50(5):1109-17
pubmed: 19054400
Epilepsia. 2007 Jan;48(1):43-58
pubmed: 17241207
Pediatrics. 2007 Mar;119(3):535-43
pubmed: 17332207
Epilepsia. 1998 Jul;39(7):744-8
pubmed: 9670903
Nutr Hosp. 2010 Mar-Apr;25(2):317-8
pubmed: 20449544
Seizure. 2011 Oct;20(8):640-5
pubmed: 21763159
Eur J Clin Nutr. 2020 Sep;74(9):1290-1298
pubmed: 32404902
Epilepsia. 2016 Jan;57(1):41-50
pubmed: 26617284
J Child Neurol. 2012 Jun;27(6):754-8
pubmed: 22532541
Stat Med. 2004 Mar 30;23(6):859-74; discussion 875-7,879-80
pubmed: 15027075
Clin Nutr. 2012 Apr;31(2):246-9
pubmed: 22019282
Nutrients. 2019 Jul 14;11(7):
pubmed: 31337135
Epilepsia Open. 2018 May 21;3(2):175-192
pubmed: 29881797
Pediatr Neurol. 2018 May;82:13-18
pubmed: 29610033
Cochrane Database Syst Rev. 2020 Jun 24;6:CD001903
pubmed: 32588435
Acta Neurol Belg. 2016 Dec;116(4):529-534
pubmed: 26791878
Epilepsy Res. 2013 Jul;105(1-2):189-94
pubmed: 23357723
Neuropsychiatr Dis Treat. 2016 Oct 12;12:2605-2616
pubmed: 27789949
Epilepsia. 2010 Aug;51(8):1403-7
pubmed: 20477843
Epilepsy Behav. 2015 Oct;51:261-6
pubmed: 26301622
Dement Geriatr Cogn Dis Extra. 2011 Jan;1(1):330-57
pubmed: 22203825
Acta Neurol Scand. 2017 Feb;135(2):231-239
pubmed: 27027847
Seizure. 2013 Apr;22(3):174-8
pubmed: 23273808
J Pediatr. 2015 Apr;166(4):1030-6.e1
pubmed: 25649120
Epilepsia. 2014 Apr;55(4):475-82
pubmed: 24730690
Epilepsy Res Treat. 2016;2016:5873208
pubmed: 27752367
J Child Neurol. 2008 Jul;23(7):758-61
pubmed: 18658075
Eur J Paediatr Neurol. 2015 Nov;19(6):701-5
pubmed: 26206425
Epilepsy Res. 2011 Jun;95(1-2):110-8
pubmed: 21482075
World J Pediatr. 2017 Dec;13(6):528-536
pubmed: 28702868
Eur J Paediatr Neurol. 2010 May;14(3):229-34
pubmed: 19632870
Nutrients. 2020 Jun 17;12(6):
pubmed: 32560503
Seizure. 2014 Oct;23(9):751-5
pubmed: 25011392