Biochemical Abnormalities of the Ketogenic Diet in Children

Chesney, David S.; Brouhard, Ben H.; Wyllie, Elaine; Powaski, Kathy

doi:10.1177/000992289903800207

Cited by 37 publications

(21 citation statements)

References 5 publications

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“…However, the risk of serious adverse events is low. Metabolic abnormalities include hypoproteinemia that causes muscular mass loss or alteration in bone metabolism; hyperlipidemia or hypercholesterolemia, reported in 14–59% of children on KD (Chesney et al., 1999; Kwiterovich et al., 2003; Kang et al., 2004) that can cause atherosclerosis; hypocalcemia (2%) that can worsen a preexisting osteopenia or osteoporosis; potassium or selenium deficit that can cause cardiac abnormalities; hyperuricemia (2–26%), hypomagnesemia (5%), decreased amino acid levels, and acidosis (2–5%) (Schwartz et al.,1989; Chesney et al., 1999; Kang et al., 2004). Metabolic abnormalities can be prevented by careful monitoring.…”

Section: Consensus Recommendationsmentioning

confidence: 99%

The ketogenic diet for Dravet syndrome and other epileptic encephalopathies: An Italian consensus

et al. 2011

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SUMMARYKetogenic diet is a nonpharmacologic treatment for childhood epilepsy not amenable to drugs. At the present time, two works based on national research, one in Germany and one in the United States provide international guidelines to ensure a correct management of the ketogenic diet. Our Italian collaborative study group was set up in order to formulate a consensus statement regarding the clinical management of the ketogenic diet, patient selection, pre-ketogenic diet, counseling, setting and enforcement of dietary induction of ketosis, follow-up management, and eventual discontinuation of the diet.

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Section: Consensus Recommendationsmentioning

confidence: 99%

The ketogenic diet for Dravet syndrome and other epileptic encephalopathies: An Italian consensus

et al. 2011

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“…There were no differences in blood or brain potassium or calcium concentrations in rats consuming a ketogenic diet, although rats on the diet did have lower brain (but not blood) sodium levels than controls [42]. Serum levels of sodium, potassium, and calcium were similarly unaltered in humans consuming a ketogenic diet [77]. Table 2 summarizes the profile of the ketogenic diet in mouse models commonly used to identify the anticonvulsant activity of test substances.…”

Section: Changes In Cerebral Ph and Ion Concentrations In The Ketogenmentioning

confidence: 99%

The Neuropharmacology of the Ketogenic Diet

Hartman

Gąsior

Vining

et al. 2007

Pediatric Neurology

280

169

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The ketogenic diet is a valuable therapeutic approach for epilepsy, one in which most clinical experience has been with children. Although the mechanism by which the diet protects against seizures is unknown, there is evidence that it causes effects on intermediary metabolism that influence the dynamics of the major inhibitory and excitatory neurotransmitter systems in brain. The pattern of protection of the ketogenic diet in animal models of seizures is distinct from that of other anticonvulsants, suggesting that it has a unique mechanism of action. During consumption of the ketogenic diet, marked alterations in brain energy metabolism occur, with ketone bodies partly replacing glucose as fuel. Whether these metabolic changes contribute to acute seizure protection is unclear; however, the ketone body acetone has anticonvulsant activity and could play a role in the seizure protection afforded by the diet. In addition to acute seizure protection, the ketogenic diet provides protection against the development of spontaneous recurrent seizures in models of chronic epilepsy, and it has neuroprotective properties in diverse models of neurodegenerative disease.

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“…Even though efficacy and safety have been demonstrated in several studies over the past decade [1][2][3][4], GI intolerability and various other complications have limited its use in many patients [5][6][7][8][9]. A high-fat diet prolongs gastric emptying time and can cause vomiting, especially in patients with gastroesophageal reflux [12].…”

Section: Discussionmentioning

confidence: 99%

“…Despite its potent antiepileptic efficacy, wide application of the KD for long-term maintenance has been limited in some children by poor tolerability [5][6][7][8]. Significant numbers of patients suffer from GI discomfort during KD treatment, in addition to its unpalatability [9].…”

Section: Introductionmentioning

confidence: 99%