The Short-Term Effect of Ketogenic Diet on Carotid Intima-Media Thickness and Elastic Properties of the Carotid Artery and the Aorta in Epileptic Children

Abstract

The aim of this prospective study is to investigate the effect of a 6-month-long ketogenic diet on carotid intima-media thickness, carotid artery, and aortic vascular functions. Thirty-eight drug-resistant epileptic patients who were being treated with ketogenic diet were enrolled. Fasting total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, and glucose concentrations were measured and echocardiography was performed in all patients before the beginning of ketogenic diet and at the sixth month of treatment. The body weight, height, body mass index, serum levels of triglyceride, total cholesterol, and low-density lipoprotein increased significantly at month 6 when compared to baseline values (P < .05). Carotid intima-media thickness, elastic properties of the aorta, and carotid artery did not change at the sixth month of therapy compared to baseline values. A 6-month-long ketogenic diet has no effect on carotid intima-media thickness and elastic properties of the carotid artery and the aorta.

The Effect of the Ketogenic Diet on the Vascular Structure and Functions in Children With Intractable Epilepsy

“…Similar to our findings, many studies reported increased serum levels of total cholesterol, triglyceride, and LDL and decreased serum levels of high density lipoprotein in patients treated with KD (2,5,6,7,16). Whereas, in a single study investigating the effect of KD treatment on serum lipids in 66 healthy obese subjects with a body mass index greater than 30 kg/m 2 , the level of total cholesterol, LDL cholesterol, and triglyceride levels were found significantly decreased, whereas HDL cholesterol ievels significantly increased after the treatment in patients both with and without prior hypercholesterolemia (15).…”

“…One of the reason for the absence of cardiovascular adverse effects may be the content of KD in our study; a Mediterranean diet with the major fat being olive oil. Cardioprotective effects of the olive oil have been demonstrated by several studies (2,19,20). In a previous study evaluating the relationship between carotid intima-media thickness and olive oil consumption, carotid intima-media thickness was found to be inversely associated with olive oil consumption in asymptomatic adults with high cardiovascular risk (9).…”

“…It is not a benign therapy, however, being associated with a number of side effects including disturbances of metabolic, gastrointestinal, and renal functions. On the other hand, its effects on vascular structure and functions have not been well defined and controversial (1)(2)(3). The KD is a high fat, low carbohydrate diet that aims to achieve a metabolic state called ketosis.…”

“…In this state, the body cells burn fats instead of glucose for energy. Since the KD contains a high percentage of fat, it may lead to dyslipidemia which is a primary risk factor for the development of atherosclerosis (2,(5)(6)(7). A number of echocardiography-derived reliable parameters and indexes for the assessment of vascular structural change have been identified.…”

“…Carotid intima media thickness (cIMT) and some measures assessing the elastic properties of the carotid artery and the aorta, such as strain, stiffness index, distensibility, and elastic modulus, have been used as useful predictors of subclinic atherosclerosis and cardiovascular diseases (2,4).…”