Abstracts

Rationale: The ketogenic diet is a high fat, low carbohydrate diet that is effective for intractable seizures in children. Hyperlipidemia has been reported to occur shortly after initiation of the ketogenic diet and to gradually increase or stabilize over time. However, in one study, children fed a formula-based ketogenic diet were reported to be less likely to have hypercholesterolemia (>200 mg/dL). The purpose of this study is to determine the differences in plasma levels of cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) at baseline, 6 months and 12 months in children with intractable epilepsy who are given a solely formula-based ketogenic diet. Methods: A prospective study of 12 children (median age 2.8 years) with intractable epilepsy were started on the ketogenic diet and fed a formula-based high-fat formula at a 4:1 ratio. Plasma cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were drawn at baseline, 6 months, and 12 months. Data were analyzed using one-way, repeated measures analysis of variance (ANOVA). The Geisser-Greenhouse was used to adjust degrees of freedom. Demographic characteristics were summarized using descriptive statistics. Results: The mean baseline levels of cholesterol (160 ± 22), triglycerides (104 ± 56), HDL (51 ± 12), and LDL (89 ± 12) were all within normal limits. Although mean triglyceride levels increased and mean HDL levels decreased, they remained within normal limits. There was a significant decrease in LDL levels over time, F (1.376, 11.009) = 7.443, p = .014. There were no significant differences in mean levels of cholesterol, triglycerides, or HDL over time. Conclusions: Children with intractable epilepsy who are fed a solely formula-based ketogenic diet have significant decreases in LDL levels after 12 months on the diet. The mean levels of cholesterol, triglycerides, and HDL remained within normal limits. These findings suggest that a formula-based ketogenic diet does not lead to dyslipidemia.