Ketogenic Diet Therapies in Children and Adults with Epilepsy

Abstract

Despite a wide array of anti-epileptic drugs and the option of surgery, one-third of children and adults with epilepsy continue to suffer from drug-resistant seizures. Many of these patients may benefit from a ketogenic diet, a non-pharmacologic therapy proven to improve seizure control in epilepsy. Ketogenic diets aim to mimic the metabolic profile of fasting, and probably improve seizure control through a variety of mechanisms that collectively stabilize synaptic function. Although many similarities exist with regards to patient selection, patient preparation, and diet implementation in children compared to adults, there are also important differences. The most conspicuous challenge to the more widespread use of ketogenic diets in children and adults with epilepsy is a lack of access to ketogenic services in many regions of the world. Moreover, the culinary and social restrictions associated with conventional ketogenic diets pose a significant barrier to their use in adults.

Glycemic biomarkers in children with drug‐resistant epilepsy on various types of ketogenic diet therapies: A cross‐sectional study

“…The patients were grouped into different KD regimes, namely classical KD (cKD), modified KD (mKD), modified Atkins diet (MAD), and medium‐chain triglyceride KD (MCT‐KD). In our study, cKD was defined by diet comprising a fat:nonfat ratio of at least 3:1, with the fat source predominantly long‐chain triglyceride (LCT) obtained mainly from standard foods, 1 whereas for MCT‐KD, MCT oil or products were used to yield at least 30% of total calories 1,15 . In MAD, carbohydrate intake was limited to 10‐15 g/day without restriction on fat or protein 1 …”

“…Blood ketone was measured with FreeStyle Optium Neo H ketone meter (Abbott Laboratories), expressed in mmol·L –1 . Good ketosis was defined as blood ketone of 4–6 mmol·L –1 15,18 . Estimated average plasma glucose was generated from HbA1c via the equation adopted by the American Diabetic Association 19 .…”