Ketogenic diet in children and adolescents: The effects on growth and nutritional status

Corsello, Antonio; Trovato, Chiara Maria; Profio, Elisabetta Di; Cardile, Sabrina; Campoy, Cristina; Zuccotti, Gianvincenzo; Verduci, Elvira; Diamanti, Antonella

doi:10.1016/j.phrs.2023.106780

Cited by 7 publications

(7 citation statements)

References 157 publications

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“…Exploiting a process known as nutritional ketosis, the diet reduction of carbohydrates intake facilitates ketogenesis in order to provide an alternate source of energy. It has proved to reduce the frequency and severity of seizure in some forms of epilepsy [ 74 •]. The ketogenic diet also poses some issues as nausea, constipation, fatigue, dehydration, electrolyte imbalances, and micronutrient deficiency.…”

Section: Medical Conditions Associated With Micronutrient Deficienciesmentioning

confidence: 99%

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Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

Panzeri,

Pecoraro,

Dianin

et al. 2024

Curr Obes Rep

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Purpose of Review This study is to examine potential micronutrient deficiencies and any need for supplementation in children following specific diet plans in the first 1000 days of life. Recent Findings Optimal nutrition in the first 1000 days of life has a lifelong positive impact on child development. Specific intrauterine and perinatal factors, pathological conditions, and dietary restrictions can represent potential risk factors for micronutrient deficiencies in the first 1000 days of life, which can have negative systemic consequences. Preterm and low-birth-weight infants are intrinsically at risk because of immature body systems. Children affected by cystic fibrosis are prone to malnutrition because of intestinal malabsorption. The risk of micronutrient deficiency can increase in various situations, including but not limited to children following selective dietary regimens (vegetarian and vegan diets and children affected by specific neuropsychiatric conditions) or specific dietary therapies (children affected by food allergies or specific metabolic disorders and children following restricted diet as a part of therapeutic approach, i.e., ketogenic diet for epilepsy). In light of this situation, the micronutrient status in these categories of children should be investigated in order to tailor strategies specific to the individual’s metabolic needs, with a particular focus on deficiencies which can impair or delay the physical and cognitive development of children, namely, vitamin B12, vitamin D and folic acid, as well as oligo-elements such as iron, zinc, calcium, sodium, magnesium, and phosphorus, and essential fatty acids such as omega-3. Summary Identification of micronutrient deficiency in the first 1000 days of life and timely supplementation proves essential to prevent their long-term consequences. Graphical Abstract

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Section: Medical Conditions Associated With Micronutrient Deficienciesmentioning

confidence: 99%

“…Constant monitoring is necessary for all patients on KDT in order to assess its impact on child’s growth. Further studies are needed to investigate possible long-term effects of these diets when started in children [ 74 •].…”

Section: Medical Conditions Associated With Micronutrient Deficienciesmentioning

confidence: 99%

Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

Panzeri,

Pecoraro,

Dianin

et al. 2024

Curr Obes Rep

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“…The exact mechanisms by which the ketogenic diet exerts its anticonvulsant effects are not entirely understood, but several hypotheses have been proposed [ 180 , 181 ]. One of the key factors contributing to the diet’s efficacy is the elevation of ketone bodies in the bloodstream, which is believed to have anticonvulsant properties [ 182 , 183 ].…”

Section: Ketogenic Diet and Epilepsymentioning

confidence: 99%

“…One of the key factors contributing to the diet’s efficacy is the elevation of ketone bodies in the bloodstream, which is believed to have anticonvulsant properties [ 182 , 183 ]. Ketone bodies provide an alternative fuel source for the brain, supporting neuronal function and stabilizing excitability, potentially reducing the likelihood of seizures [ 180 , 183 ]. Moreover, the ketogenic diet may influence the balance of neurotransmitters in the brain [ 183 , 184 ].…”

Section: Ketogenic Diet and Epilepsymentioning

confidence: 99%

A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

Ghosh,

Sinha,

Ghosh

et al. 2023

Brain Sciences

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Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.

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“…A strict follow-up should therefore be performed, especially in the first few weeks of administration. Common adverse effects may include hypoglycemia, dyslipidemia, gastrointestinal symptoms, carnitine deficiency, bone diseases such as osteopenia and osteoporosis, nephrolithiasis, and even growth failure, and a strict follow-up is then advisable, especially in pediatric patients [54][55][56][57][58][59][60][61]. Some authors have occasionally reported pancreatitis (generally developed in children with more than one risk factor), cardiac abnormalities with prolonged QT intervals, and vascular changes, such as a transient reduction in carotid distensibility [62][63][64][65].…”

Section: Safety and Contraindicationsmentioning

confidence: 99%

The Influence of Ketogenic Diet on Gut Microbiota: Potential Benefits, Risks and Indications

Santangelo,

Corsello,

Spolidoro

et al. 2023

Nutrients

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The ketogenic diet (KD) restricts carbohydrate consumption, leading to an increase in ketone bodies, such as acetoacetate, β-hydroxybutyrate, and acetone, which are utilized as energy substrates. This dietary approach impacts several biochemical processes, resulting in improved clinical management of various disorders, particularly in childhood. However, the exact mechanisms underlying the efficacy of KD remain unclear. Interestingly, KD may also impact the gut microbiota, which plays a pivotal role in metabolism, nutrition, and the development of the immune and nervous systems. KD has gained popularity for its potential benefits in weight loss, blood sugar control, and certain neurological conditions. This narrative review sums up KD-related studies published over 30 years. While short-term studies have provided valuable insights into the effects of KD on the gut microbiota, persistent uncertainties surround its long-term efficacy and potential for inducing dysbiosis. The significant influence of KD on epigenetic mechanisms, intracellular pathways, and gut microbial composition underscores its potential as a therapeutic choice. However, a judicious consideration of the potential risks associated with the strict adherence to a low-carbohydrate, high-fat, and high-protein regimen over prolonged periods is imperative. As KDs gain popularity among the adolescent and young adult demographic for weight management, it becomes imperative to undertake additional research to comprehensively assess their impact on nutritional status and gut microbiota, ensuring a holistic and sustainable approach to medical nutrition.

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Ketogenic diet in children and adolescents: The effects on growth and nutritional status

Cited by 7 publications

References 157 publications

Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

The Influence of Ketogenic Diet on Gut Microbiota: Potential Benefits, Risks and Indications

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