The effect of ketogenic diet escalation in adolescents and adults with drug-resistant epilepsy: a prospective study

Kishk, Nirmeen A.; Yousof, Hanaa; Ebraheim, Asmaa M.; Elkholy, Thanaa; Soliman, Shaimaa H.; Mohammed, Randa Adel; Shamloul, Reham

doi:10.1080/1028415x.2021.1927604

Cited by 6 publications

(12 citation statements)

References 35 publications

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“…Other studies did not find a significant difference in the efficacy of the ketogenic diet in groups with differing ketogenic ratios [13]. Increasing the ratio of the diet was associated with less compliance in adolescents and adults, though the latter reported an improvement in general health score questionnaires [14].…”

Section: Classic Ketogenic Dietmentioning

confidence: 80%

Dietary carbohydrates in the management of epilepsy

Haridas

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewThe role of dietary carbohydrates in the management of epilepsy is intrinsically linked to the ketogenic diet. The ketogenic diet has been in use for well over a century now. There have been numerous adaptations to the diet. It is crucial to understand the indications and role of the ketogenic diet in the management of epilepsy.Recent findingsThere have been new studies that have looked at the role of ketogenic ratios in seizure control. In addition, there has been new evidence in the role of using the ketogenic diet therapy instead of antiseizure medications. These data highlight that the ketogenic diet should be tailored for patients and caregivers. When used appropriately, it can result in a significant improvement in seizure control as well as cognitive and developmental gains.SummaryThe ketogenic diet therapy has undergone numerous revisions and reiterations from its initial reported use in patients a century ago. This has enabled us to tailor the diet specific to each patient's underlying diagnosis.

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Section: Classic Ketogenic Dietmentioning

confidence: 80%

Dietary carbohydrates in the management of epilepsy

Haridas

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…Most studies in this review focused on diet interventions (n = 16) for PWE. 17,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Diet interventions included ketogenic diet (n = 6), 17,27,29,33,37,38 modified Atkins diet (n = 9), 25,26,28,30,32,33,35,36,39 low glutamate diet (n = 1), 34 and low glycemic index therapy (n = 3). 26,31,37 Additional lifestyle interventions included physical activity (n = 9) [40][41][42][43][44][45][46] and sleep (n = 1).…”

Section: Overview Of Interventionsmentioning

confidence: 99%

Lifestyle Behavioral Interventions and Health-Related Outcomes Among People with Epilepsy: A Review of Randomized Controlled Trials

Sauls,

Buro,

Kirby

2024

Am J Health Promot

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Objective To gather and assess current literature on the prevalence and efficacy of lifestyle behavioral interventions (sleep, nutrition, physical activity) for health outcomes, including QOL, psychological well-being, behavioral changes, and seizure frequency, among PWE. Data Source A review was conducted of English-language articles identified from PubMed, Scopus, and Embase between January 2013 to January 2023. Study Inclusion and Exclusion Criteria Inclusion criteria were randomized controlled trials (RCT) with human subjects diagnosed with epilepsy who participated in a lifestyle behavioral intervention. Data Extraction Two researchers independently completed the title, abstract, and full-text reviews. Information extracted includes study population, duration, type of intervention, findings, and outcomes. Data Synthesis Data was narratively synthesized to show level of evidence and degree of consistency in findings. Results: 4001 studies identified, 66 full texts reviewed, and 24 included. A majority (n = 16) of studies utilized diet specific RCTs, and some focused on physical activity (n = 7) and sleep (n = 1). Diet-specific RCTs (eg, ketogenic, Modified Atkins) reported reduced seizure frequency with adverse effects, such as gastrointestinal complications. Physical activity-based interventions found that maintained levels of exercise improved QOL and psychological well-being. However, physical activity and diet-based interventions did not have lasting effects after study conclusion. Only the behavioral sleep intervention reported that sleep quality improved significantly and was maintained post-intervention. Conclusion Future research is needed to establish the relationship between lifestyle behavioral interventions on QOL and other health outcomes (eg, seizure frequency).

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“…The primary outcome of interest was results pertaining to adult nervous system function. Of the sixty-four publications reporting neurological outcomes (Table 2), twenty-two provided measures on cortical excitability (nineteen epilepsy studies (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) , one narcolepsy (40) , one glucose transporter-1 deficiency syndrome (41) and one general physiology (42) ). Additional categories included fifteen psychological publications (eleven mood and/or cognition (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) , one schizophrenia (56) and one orexinergic system (57) ), twelve neurodegenerative disease publications (three Alzheimer's disease (58)(59)(60) , three multiple sclerosis (61)(62)(63) , three cognitive impairment (64)(65)…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Weight loss prepost intervention was common (n = 45), but not always significant. Five studies reported no weight loss (26,32,36,38,48) , and nine did not report weight changes (25,45,53,56,63,64,67,70,83) .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain

Field

Pourkazemi

et al. 2022

Nutr. Res. Rev.

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Dietary restriction of carbohydrate has been demonstrated to be beneficial for nervous system dysfunction in animal models and may be beneficial for human chronic pain. The purpose of this review is to assess the impact of a low-carbohydrate/ketogenic diet on the adult nervous system function and inflammatory biomarkers to inform nutritional research for chronic pain. An electronic data base search was carried out in May 2021. Publications were screened for prospective research with dietary carbohydrate intake <130g/day and duration of ≥2 weeks. Studies were categorised into those reporting adult neurological outcomes to be extracted for analysis and those reporting other adult research outcomes Both groups were screened again for reported inflammatory biomarkers. From 1548 studies there were 847 studies included. Sixty-four reported neurological outcomes with 83% showing improvement. Five hundred and twenty-three studies had a different research focus (metabolic n=394, sport/performance n=51, cancer n=33, general n=30, neurological with non-neuro outcomes n=12, or gastrointestinal n=4). The second screen identified 63 studies reporting on inflammatory biomarkers with 71% reporting a reduction in inflammation. The overall results suggest a favourable outcome on the nervous system and inflammatory biomarkers from a reduction in dietary carbohydrates. Both nervous system sensitisation and inflammation occur in chronic pain and the results from this review indicate it may be improved by low-carbohydrate nutritional therapy. More clinical trials within this population are required to build on the few human trials that have been done.

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The effect of ketogenic diet escalation in adolescents and adults with drug-resistant epilepsy: a prospective study

Cited by 6 publications

References 35 publications

Dietary carbohydrates in the management of epilepsy

Dietary carbohydrates in the management of epilepsy

Lifestyle Behavioral Interventions and Health-Related Outcomes Among People with Epilepsy: A Review of Randomized Controlled Trials

Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain

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