Abstracts

Despite widespread use of the ketogenic diet as a successful treatment for children with intractable epilepsy, there are concerns that it may adversely affect growth, possibly due to the restricted calorie and limited protein nature of the dietary regimen. Previous studies have only included children on the classical diet; the alternative Medium Chain Triglyceride (MCT) diet is usually more generous in protein. The aim of this study was to examine growth in children following both classical and MCT diets, as part of a randomised controlled trial comparing the two dietary protocols., Weight and height Z-scores were recorded on 75 children who were randomised to receive one of two ketogenic diets, at baseline, 3, 6, and 12 months. Mean calorie and protein intakes during treatment were calculated for all children completing 12 months. Changes in growth were compared between the two diets, and the association between growth and dietary intake examined., Although the MCT children were as a group both heavier and taller than the classical children at baseline, differences were not significant. Analysis of the paired differences in weight Z-score between baseline and 3, 6 and 12 months showed a significant fall in the MCT group only at 3 months (p=0.014) and 6 months (p=0.014), and in both groups at 12 months (p=0.014 for MCT and p=0.041 for classical). Height Z-score fell significantly in both groups by 6 months (p=0.003 for MCT and p=0.029 for classical), and 12 months (p=0.000 for both groups). 40 children completed 12 months of treatment; in this group the slopes of the best-fit regression lines of serial weight and height Z-score measures were used as values to represent growth trend during the year. There were no significant differences in mean slope between the classical (n=19) and MCT (n=21) diet groups for either weight (p=0.611) or height (p=0.912). There was no significant difference in mean calorie intake over the 12 months between the two diets, but the MCT group had significantly higher protein intake (1.67g/kg v1.13g/kg, p=0.000). There was no significant correlation between calorie or protein intakes and the slope of the best-fit line for either weight or height., This data supports previous findings of a fall in both weight and height Z-scores during ketogenic diet treatment. By 12 months, there was no difference in outcome between the classical and MCT diet protocols, despite the increased protein allowed on the latter diet.,