Efficacy of Ketogenic Diet, Modified Atkins Diet, and Low Glycemic Index Therapy Diet Among Children With Drug-Resistant Epilepsy

Sondhi, Vishal; Agarwala, Anuja; Pandey, Ravindra Mohan; Chakrabarty, Biswaroop; Jauhari, Prashant; Lodha, Rakesh; Toteja, G S; Sharma, Shobha; Paul, Vinod K.; Kossoff, Eric H.; Gulati, Sheffali

doi:10.1001/jamapediatrics.2020.2282

Cited by 96 publications

(112 citation statements)

References 25 publications

(51 reference statements)

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“…The current standard of care for GLUT1DS is the ketogenic diet (KD), a high-fat diet that raises the levels of ketone bodies in the blood to make them available to the brain [ 28 , 29 ]. This carbohydrate-restricted diet mimics the metabolic state of fasting.…”

Section: Discussionmentioning

confidence: 99%

GLUT1 Deficiency Syndrome—Early Treatment Maintains Cognitive Development? (Literature Review and Case Report)

Kolić

Nišević

Cicvarić

et al. 2021

Genes

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Glucose transporter type 1 (GLUT1) is the most important energy carrier of the brain across the blood–brain barrier, and a genetic defect of GLUT1 is known as GLUT1 deficiency syndrome (GLUT1DS). It is characterized by early infantile seizures, developmental delay, microcephaly, ataxia, and various paroxysmal neurological phenomena. In most cases, GLUT1DS is caused by heterozygous single-nucleotide variants (SNVs) in the SLC2A1 gene that provoke complete or severe impairment of the functionality and/or expression of GLUT1 in the brain. Despite the rarity of these diseases, GLUT1DS is of high clinical interest since a very effective therapy, the ketogenic diet, can improve or reverse symptoms, especially if it is started as early as possible. We present a clinical phenotype, biochemical analysis, electroencephalographic and neuropsychological features of an 11-month-old boy with myoclonic seizures, hypogammaglobulinemia, and mildly impaired gross motor development. Using sequence analysis and deletion/duplication testing, deletion of an entire coding sequence in the SLC2A1 gene was detected. Early introduction of a modified Atkins diet maintained a seizure-free period without antiseizure medications and normal cognitive development in the follow-up period. Our report summarizes the clinical features of GLUT1 syndromes and discusses the importance of early identification and molecular confirmation of GLUT1DS as a treatable metabolic disorder.

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Section: Discussionmentioning

confidence: 99%

GLUT1 Deficiency Syndrome—Early Treatment Maintains Cognitive Development? (Literature Review and Case Report)

Kolić

Nišević

Cicvarić

et al. 2021

Genes

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show abstract

“…These characteristics include fatty acid composition and nutrient density [ 29 ]. There are currently four main ketogenic dietary therapies (KDTs) [ 30 , 31 ]: the classic KD (as mentioned above), the modified Atkins diet (MAD) (for obesity treatment) [ 32 ], the medium-chain triglyceride (MCT) (control of metabolic diseases) diet [ 33 ], and the low glycemic index treatment (LGIT) (treatment of intractable epilepsy) [ 30 , 34 , 35 , 36 ].…”

Section: Ketosis-inducing Diets Definition Types and Effectsmentioning

confidence: 99%

Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs. Ketosis-Inducing Diet

Napoleão¹,

Fernandes²,

Miranda³

et al. 2021

Nutrients

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As the incidence of Chronic Non-Communicable Diseases (CNCDs) increases, preventive approaches become more crucial. In this review, calorie restriction (CR) effects on human beings were evaluated, comparing the benefits and risks of different CR diets: classic CR vs. ketosis-inducing diets, including intermittent fasting (IF), classic ketogenic diet (CKD), fasting mimicking diet (FMD), very-low-calorie ketogenic Diet (VLCKD) and Spanish ketogenic Mediterranean diet (SKMD). Special emphasis on insulin resistance (IR) was placed, as it mediates metabolic syndrome (MS), a known risk factor for CNCD, and is predictive of MS diagnosis. CR is the most robust intervention known to increase lifespan and health span, with high evidence and known biochemical mechanisms. CR improves cardiometabolic risk parameters, boosts exercise insulin sensitivity response, and there may be benefits of implementing moderate CR on healthy young and middle-aged individuals. However, there is insufficient evidence to support long-term CR. CKD is effective for weight and MS management, and may have additional benefits such as prevention of muscle loss and appetite control. SKMD has extreme significance benefits for all the metabolic parameters studied. Studies show inconsistent benefits of IF compared to classic CR. More studies are required to study biochemical parameters, reinforce evidence, identify risks, and seek effective and safe nutritional CR approaches.

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“…These characteristics include fatty acid composition and nutrient density [29]. There are currently 4 main Ketogenic Dietary Therapies (KDTs) [30,31]: the classic KD (as mentioned above), the Modified Atkins Diet (MAD) (treated for obesity treatment) [32], the Medium-Chain Triglyceride (MCT) (control of metabolic diseases) diet [33], and the Low Glycemic Index Treatment (LGIT) (treatment of intractable epilepsy) [30,[34][35][36].…”

Section: Ketogenic Dietmentioning

confidence: 99%

Comparative Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs Ketosis-Inducing Diet

Napoleão¹,

Fernandes²,

Miranda³

et al. 2021

Preprint

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As Chronic Non-Communicable Diseases (CNCD) increase, preventive approaches become more crucial. In this review, Calorie Restriction (CR) effects on human beings were evaluated, comparing benefits and risks of different CR diets: classic CR vs ketosis-inducing diets, including Intermittent Fasting (IF), Classic Ketogenic Diet (CKD), Fasting Mimicking Diet (FMD), Very-Low-Calorie Ketogenic Diet (VLCKD) and Spanish Ketogenic Mediterranean Diet (SKMD). Special emphasis on Insulin Resistance (IR) was placed, as it mediates Metabolic Syndrome (MS), a risk factor for CNCD, and predicts MS diagnosis. CR is the most robust intervention known to increase lifespan and health span, with high evidence and known biochemical mechanisms. CR improves cardiometabolic risk parameters, boosts exercise insulin sensitivity response, and there may be benefits of implementing moderate CR on healthy young and middle-aged individuals. However, there is insufficient evidence to support long-term CR. CKD is effective for weight and MS management, and may have additional benefits such as prevention of muscle loss and appetite control. SKMD has extreme significance benefits for all the metabolic parameters studied. Studies show inconsistent benefits of IF compared to classic CR. More studies are required to study biochemical parameters, reinforce evidence, identify risks, and seek effective and safe nutritional CR approaches.

show abstract

Efficacy of Ketogenic Diet, Modified Atkins Diet, and Low Glycemic Index Therapy Diet Among Children With Drug-Resistant Epilepsy

Cited by 96 publications

References 25 publications

GLUT1 Deficiency Syndrome—Early Treatment Maintains Cognitive Development? (Literature Review and Case Report)

GLUT1 Deficiency Syndrome—Early Treatment Maintains Cognitive Development? (Literature Review and Case Report)

Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs. Ketosis-Inducing Diet

Comparative Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs Ketosis-Inducing Diet

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