Daily Recommended Intake of Selenium is not sufficient for children treated with ketogenic diet therapy
Abstract number :
2.322
Submission category :
8. Non-AED/Non-Surgical Treatments (Hormonal, alternative, etc.)
Year :
2017
Submission ID :
339529
Source :
www.aesnet.org
Presentation date :
12/3/2017 3:07:12 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Yeoumei Christiana Liu, The Hospital for Sick Children, Toronto, Ontario, Canada; Helen Lowe, The Hospital for Sick Children, Toronto, Ontario, Canada; Elise Tanzini, The Hospital for Sick Children; Maria Zak, The Hospital for Sick Children, Toronto, Onta
Rationale: The ketogenic diet (KD) is an effective therapy for intractable epilepsy. Cardiomyopathy related to selenium deficiency has been reported. The objective of this study is to determine whether receiving adequate amounts of selenium, defined, as the Dietary Reference Intake (DRI) is sufficient to maintain blood selenium levels within reference range in order to reduce the risk of cardiomyopathy. Methods: Serum selenium levels were collected at 6 month intervals from children receiving either a classic (CKD) or medium chain triglyceride KD (MCT) at The Hospital for Sick Children, Toronto, Ontario. Selenium supplementation was started and adjusted if children did not meet DRI by diet and/or if serum selenium values dropped below reference range (1.27-2.09 umol/L). Each child’s total daily intake of selenium was compared to DRI values at 6, 12, 24 and last follow-up for >24 months. Mean selenium intake was calculated for each diet type and time point. Results: 70 children were studied. 14 children were excluded, one for severe gastrointestinal dysfunction and 13 did not reach 6 months. Fifty-six children remained, 37 (16 boys) receiving the CKD and 19 (11 boys) on the MCTKD. The mean age in the CKD group was 4.38 years (mean±SD=4.38±3.42) and 4.64 years (mean±SD=4.64±2.62) in the MCTKD group. In CKD group, at 6, 12, 24 months and last follow-up of >24 months, 28, 32, 32 and 21 children respectively required daily selenium supplementation. In the MCTKD group, 4, 6, 9 and 7 children required selenium supplementation at the same time points. In all groups, the selenium supplementation exceeded the DRI. At no time point did the mean selenium intake not exceed the DRI. See Table 1. Conclusions: Data from this cohort demonstrates that the DRI of selenium does not guarantee selenium levels are within reference range for children receiving a KD. The high fat content of KD may interfere with selenium absorption. Close monitoring of serum selenium levels during KD treatment is important to prevent selenium deficiency and may reduce the risk of cardiomyopathy among this vulnerable population. Funding: N/A
Non-AED/Non-Surgical Treatments