The Nutritional Consequences of the Ketogenic Diet
Abstract number :
3.157
Submission category :
Year :
2001
Submission ID :
3129
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
E. Wassmer, MRCP, Paediatric Neurology, Birmingham Children[ssquote]s Hospital, Birmingham, United Kingdom; G. McGrath, BSc, Dietetic, Birmingham Children[ssquote]s Hospital, Birmingham, United Kingdom; C. Ross, MRCP, Paediatric Neurology, Birmingham Chil
RATIONALE: The ketogenic diet has been used as a treatment for children with intractable epilepsy for many years.
Although the diet has reduced seizure frequency in some children, there have been some concerns regarding the nutritional value of the diet. A detailed nutritional and biochemical study of the diet has never been undertaken.
We aimed to study the biochemical and nutritional status of children on the classical ketogenic diet (CKGD).
METHODS: 10 children were enrolled (6 months to 15 years). Each child was assessed before starting the diet and at 1, 3, 6, 12, 18 and 24 months. Changes in seizure frequency and severity (history and EEGs), cognitive and behavioural function, physical examination of weight and height, adverse events and detailed biochemical markers of nutritional status were recorded
RESULTS: The children were on the diet from 2 months to 24 months; five are currently on the diet (3 for 12 months, 1 for 18 months and 1 for 24 months). Four children abandoned the diet (2 to 6 months after starting) due to poor compliance resulting in the child being hungry and irritable (3) or having a low blood sugar (1). One child died from aspiration pneumonia, two months after starting the CKGD. Two children developed asymptomatic selenium deficiency at 3 months. Cholesterol and triglycerides levels were raised in half the children at 6 months and in all children at 12 months. Two wheel chair bound children became overweight. No other adverse effects were noted in spite of detailed nutritional assessments. Improvement in alertness, concentration and behaviour were reported in 6 children. Swallowing improved in 2 children and 5 children experienced fewer infections. Six children had markedly reduced frequency and severity of epileptic seizures.
CONCLUSIONS: Our preliminary experience with the diet confirms the efficacy of the diet in reducing seizure severity and frequency. The diet has other beneficial effects including improving cognitive function and reducing infections. To date we have encountered no significant untreatable adverse nutritional or biochemical effects. The nutritional and biochemical monitoring will continue.