Impact of two ketogenic diet types in refractory childhood epilepsy

Abstract

Background Ketogenic diet (KD) refers to any diet in which food composition induces a ketogenic state of human metabolism. Objective To assess short- and long-term efficacy, safety, and tolerability of KD [classic KD and modified Atkins diet (MAD)] in childhood drug-resistant epilepsy (DRE) and to investigate the effect of KD on electroencephalographic (EEG) features of children with DRE. Methods Forty patients diagnosed with DRE according to International League Against Epilepsy were included and randomly assigned into classic KD or MAD groups. KD was initiated after clinical, lipid profile and EEG documentation, and regular follow-up was done for 24 months. Results Out of 40 patients with DRE, 30 completed this study. Both classic KD and MAD were effective in seizure control as 60% in classic KD group and 53.33% in MAD group became seizure free, and the remaining showed ≥50% seizure reduction. Lipid profile remained within acceptable levels throughout the study period in both groups. Adverse effects were mild and managed medically with an improvement of growth parameters and EEG during the study period. Conclusions KD is an effective and safe non-pharmacologic, non-surgical therapy for the management of DRE with a positive impact on growth and EEG. Impact Both common types of KD (classic KD and MAD) are effective for DRE, but unfortunately, nonadherence and dropout rates are frequent. High serum lipid profile (cardiovascular AE) is often suspected in children following a high-fat diet, but lipid profile remained in the acceptable level up to 24 months. Therefore, KD constitutes a safe treatment. KD had a positive impact on growth, despite inconsistent results of the KD’s effect on growth. In addition to showing strong clinical effectiveness, KD also considerably decreased the frequency of interictal epileptiform discharges and enhanced the EEG background rhythm.

Dietary habits, depression and obesity: an intricate relationship to explore in pediatric preventive strategies

“…Moreover, it's worth to underline that in children a specific and rigid dietary plan, as the KD, may need constant clinical evaluations of its possible side effects, with a precise evaluation of growth and nutritional status, in order to avoid possible malnutrition and ensure a linear growth (174). In addition, adherence to this plan may be difficult in the long term, but short nutritional intervention may be anyway sufficient to obtain health improvements (175). Despite these challenges, dietary interventions including KD represents a possible preventive and therapeutic option for pediatric patients, thus, further research is needed to better understand the potential side effects of this nutritional approach and to find strategies to increase the adherence to the plan.…”

Recent advancements in catalyst coated membranes for water electrolysis: a critical review

“…Mostafa El-Shafie provided insights into the state-of-the-art technologies capable of utilizing contaminated water in WE systems. 42 N. S. Hassan et al delved into the water electrolysis process and its techno-commercial prospects, including case studies from various countries related to green hydrogen production. 43 Hannes Lange et al discussed the collection of flexibility parameters for comparing and introducing modularization in electrolysis systems for orchestration purposes.…”

“…presents a comprehensive overview of recent review articles published in well-reputed journals focusing on various aspects of the water electrolysis phenomenon. Mostafa El-Shafie provided insights into the state-of-the-art technologies capable of utilizing contaminated water in WE systems 42. N. S. Hassan et al delved into the water electrolysis process and its techno-commercial prospects, including case studies from various countries related to green hydrogen production.…”

Ketogenic Diet Plus Resistance Training Applied to Physio-Pathological Conditions: A Brief Review

“…Importantly, the protein/fat ratio varies based on the intended goal; for example, a 4:1 ratio for fat/protein intake has been discussed for pediatric epilepsy [24], and our research group has applied the 2.5:1 ratio to manage lipedema [16]. Its clinical use as well as short-and long-term non-desired effects [16,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] are listed in Table 1.…”