Abstracts

RATIONALE: To determine whether there are common standards of care practiced by the ketogenic diet programs in the United States.
METHODS: A survey of 26 questions was developed by our ketoteam (RD, RN, MD). The survey was then mailed to 50 registered dietitians (RDs) in Epileptic Centers using the ketogenic diet across the United States to assess what standards they follow. An initial response rate was analyzed after a 3-week time period.
RESULTS: The survey was returned by 14 out of 50 centers (28%). In general, the response of the survey shows that there are indeed no consistent standards of care followed. While RDs answered some categories similarly, there are a variety of areas that differ in the monitoring process. Examples of differences include (1) routine monitoring of labs, (2) initiating or tapering of the diet, (3) assessment of calorie and protein needs, and (4) nutritional supplements prescribed. Additional monitoring variations are illustrated in the two tables below.[table1][table2]
CONCLUSIONS: The American Dietetic Association (ADA) has developed standards of care for monitoring the nutritional status of various diseases of the pediatric population such as renal disease, diabetes, etc. By following these standards, RDs are able to assess patients in a consistent manner and to provide optimal recommendations based on the disease. The responses of the survey indicate that there is great variation in how the ketogenic diet is monitored and assessed among epilepsy programs in the United States. The ketogenic diet limits calories, protein, and micronutrients, which could lead to severe side effects. Therefore, the development of standards of care for the management of the ketogenic diet across the United States would provide great benefit to this population. Further research and collaborating discussion among ketogenic programs is needed in effort to develop such standards.
[Supported by: NIH - 1K23RR16074]