Growth and Nutritional Outcomes of Children Treated with the Ketogenic Diet

Couch, Sarah C.; Schwarzman, Flavia; Carroll, Joanne; Koenigsberger, Dorcas; Nordli, Douglas R.; Deckelbaum, Richard J.; DeFelice, Amy R.

doi:10.1016/s0002-8223(99)00387-9

Cited by 49 publications

(34 citation statements)

References 7 publications

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“…Weight gain was significantly reduced in all but one of the ketogenic diet groups, and this could potentially prevent an increase in plasma cholesterol. Our present data are consistent with the report that children with intractable epilepsy who are on the ketogenic diet have normal plasma cholesterol (28). However, adults on the ketogenic diet have the expected rise in plasma cholesterol associated with high saturated fat intake (3).…”

Section: Discussionsupporting

confidence: 92%

Lipid and fatty acid profiles in rats consuming different high‐fat ketogenic diets

Dell

Likhodii

Musa

et al. 2001

Lipids

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High-fat ketogenic diets are used to treat intractable seizures in children, but little is known of the mechanism by which these diets work or whether fats rich in n-3 polyunsaturates might be beneficial. Tissue lipid and fatty acid profiles were determined in rats consuming very high fat (80 weight%), low-carbohydrate ketogenic diets containing either medium-chain triglyceride, flaxseed oil, butter, or an equal combination of these three fat sources. Ketogenic diets containing butter markedly raised liver triglyceride but had no effect on plasma cholesterol. Unlike the other fats, flaxseed oil in the ketogenic diet did not raise brain cholesterol. Brain total and free fatty acid profiles remained similar in all groups, but there was an increase in the proportion of arachidonate in brain total lipids in the medium-chain triglyceride group, while the two groups consuming flaxseed oil had significantly lower arachidonate in brain, liver, and plasma. The very high dietary intake of alpha-linolenate in the flaxseed group did not change docosahexaenoate levels in the brain. Our previous report based on these diets showed that although ketosis is higher in rats consuming a ketogenic diet based on medium-chain triglyceride oil, seizure resistance in the pentylenetetrazol model is not clearly related to the degree of ketosis achieved. In combination with our present data from the same seizure study, it appears that ketogenic diets with widely differing effects on tissue lipids and fatty acid profiles can confer a similar amount of seizure protection.

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Section: Discussionsupporting

confidence: 92%

Lipid and fatty acid profiles in rats consuming different high‐fat ketogenic diets

Dell

Likhodii

Musa

et al. 2001

Lipids

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“…Only short-term information on growth in a limited number of patients has previously been available (Couch et al 1999). This study provides information about the impact of the diet on growth over a more protracted and clinically relevant period during which both weight change and linear growth can be assessed.…”

Section: Discussionmentioning

confidence: 99%

Growth of children on the ketogenic diet

Vining

Pyzik

McGrogan

et al. 2002

Develop Med Child Neuro

161

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This is a prospective cohort study of 237 children (130 males, 107 females) placed on the ketogenic diet for control of intractable epilepsy (mean age at starting diet 3 years 8 months; age range 2 months to 9 years 10 months); average length of follow-up was 308 days. There were 133 children on the diet at 1 year and 76 at 2 years. Height and weight measurements were converted into age-and sex-appropriate z scores. There was a rapid drop in weight z scores in the first 3 months. After this initial period, the weight z score remained constant in children who started the diet below the median weight for their age and sex, although z scores continued to decrease in children starting above the median. There was a small decrease in height z scores in the first 6 months (<0.5); however, there were larger changes by 2 years. There was no difference based on sex for either height or weight. The ketogenic diet generally provides sufficient nutrition to maintain growth within normal parameters over a defined period. Very young children grow poorly on the diet and should be followed-up carefully over long periods of use.

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“…Serum vitamin D concentrations improve while on the KD, as a result of supplementation (4). Despite bone-sparing effects of improved vitamin D status, some data indicate that use of the KD treatment may lead to growth failure, alteration in body composition, and osteopenia in some patients (5)(6)(7)(8). The purpose of this pilot study was to evaluate the pattern of change in bone health in children with IE during 15 mo of exposure to the KD compared with healthy children.…”

Section: Introductionmentioning

confidence: 99%