Growth of children on the ketogenic diet

Abstract

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.

A ketogenic diet rescues the murine succinic semialdehyde dehydrogenase deficient phenotype

“…This was evidenced by significantly higher daily weight gain in the KD fed mutants. Clinically, the KD is associated with significantly attenuated growth compared to humans consuming a non-KD (Vining et al, 2002;Liu et al, 2003;Papandreou et al, 2006). This has also been shown in rats fed a KD (Zhao et al, 2004;Nylen et al, 2005;Nylen et al, 2006).…”

“…We did not measure weight gain in KD fed Aldh5a1 +/+ mice. There are several studies, both clinical and experimental, that report KD fed subjects being lighter than normal diet fed subjects (Rho et al, 1999;Bough & Eagles, 2001;Vining et al, 2002;Zhao et al, 2004;Nylen et al, 2005). Despite having significantly stunted growth, rodents fed a KD do not experience anywhere near the stunting seen in SSADH mutants fed either a KD or a CD.…”

Ketogenic diet guidelines for infants with refractory epilepsy

“…Therefore for the young child with psychomotor delay, with a realistic chance of growth retardation, a ratio of 3:1 is usually chosen [4,19].…”

“…There is evidence of impaired growth in children on the KD [29,30]; younger children may be more at risk [19]. Long-term follow up of children treated with the KD in the past suggests that although growth does improve after the diet is discontinued, height gain can still be below expected [31].…”

Avaliação do perfil metabólico, nutricional e efeitos adversos de crianças com epilepsia refratária em uso da dieta cetogênica

“…Neste estudo, três pacientes ganharam peso nos primeiros três meses de dieta, devido ao seu estado nutricional prévio inadequado, nos demais pacientes que iniciaram a dieta com peso acima da média observou-se uma queda do peso, após esse período inicial observou-se crescimento pôndero estatural linear esperado para a idade, confirmando as anotações relatadas em outros trabalhos na literatura [19][20][21] .…”