A CROSS SECTIONAL STUDY OF BONE DENSITY IN CHILDREN TREATED WITH THE KETOGENIC DIET
Abstract number :
2.244
Submission category :
Year :
2002
Submission ID :
3569
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Christina A.G. Bergqvist, Christina M. Peruto, Christy Frantz, Claire M. Chee, Babette Zemel, Joan Schall, Robert DeBaun, Sakita Sistrun, Virginia A. Stallings. Pediatrics, Division of Neurology, The Children[ssquote]s Hospital of Philadelphia, Philadelph
RATIONALE: Osteoporosis is increasingly recognized to occur in patients with epilepsy (both men and women) and in children with chronic disabilities. Older generation antiepileptic medications (AEDs) are known to to cause osteopenia/osteoporosis through various mechanisms. Little is known about the effcts on bone health of the newer AEDs or the ketogenic diet(KD). It has been postulated that the KD could have adverse effects on the bone health by leaching of the bone mineral content to compensate for the acidosis and by direct effects on vitamin -D metabolism.
The effects of the KD on bone health was assessed using a cross sectional study approach.
METHODS: A cross sectional study was designed using two groups of children, before and 12-24 months into the KD treatment. Group one was about to start the KD and group two had been treated with the traditional 4:1 KD (with a multivitamin with minerals, calcium and phosphoprus supplements) for 12-24 mo. Demographics, seizure history and weight, height was collected.
Changes in bone density was determined using Dual Energy X-ray Absorptiometry, (DXA QDR, Hologic 2000). The lumbar spine was assessed for bone area, bone mineral concentration, and bone mass density. Comparisons were made using Z score averages, two sample t-test and analysis of variance testing.
RESULTS: The two groups were similar in age, gender distribution, #AED exposed to prior to the measurement, and percent cerebral palsy. Group one (children who were about to start the KD) weighed less and were shorter than expected for their age. The group had a relative osteopenia of about one standard deviation. Group two showed similar weight and height characteristics but the males had a significantly worse osteopenia inspite of a 50% reduction in the number of AEDs.
See table 1.
CONCLUSIONS: 1. Children with intractable epilepsy are smaller and shorter than their age matched control.
2. A pattern of decreased bone density was observed in the ketogenic diet group even though they consumed fewer antiepileptic medication, this was significant in the males.
3. Prospective longitudinal studies are needed to evaluate the many different effects on growth, nutrition in children with intractable epilepsy and chronic disabilities who are treated with the ketogenic diet.[table1]