Does a preference for fatty foods prior to commencing treatment with the ketogenic diet predict the efficacy of this diet?

Abstract

The ketogenic diet can be effective in children who suffer from drug-resistant epilepsy. However, it is still hard to predict how large an effect this diet will have for an individual child. Previous data suggests a high-fat food preference is more likely in those with epilepsy, as assessed by in-person forced-choice design. The aim of this study is to examine whether a partiality to fatty foods prior to commencing the ketogenic diet can be used as a predictive factor for the efficacy of this diet in children with drug-resistant epilepsy. Data from 43 children aged between 2 and 19 years was used in this retrospective, non-controlled, non-randomised, open study. All children had followed the ketogenic diet for a period of 3 months or more. Before commencing the diet, a food record was collected for each child to determine the percentage of daily energy-intake accounted for by fats. Parents of the participants completed a questionnaire to measure fat-preference in the pre-diet period and received a score to objectify the efficacy of the treatment. The raw scores on the food record and on the questionnaire were divided into subgroups. Subsequently Kendall's tau-b was calculated for the correlation between each combination of variables. A non-significant correlation was found for the relationship between the food record and the questionnaire (p=.939), the relationship between the food record and the efficacy of the treatment (p=.827) and the relationship between the questionnaire and the efficacy of the treatment (p=.539). This means treatment efficacy cannot be predicted by the child's food preference.

Exploring the relationship between preferences for high fat foods and efficacy of the ketogenic and modified Atkins diets among children with seizure disorders

“…Although tentative, these results provide initial support for the predictive value of fat preference for responsiveness to dietary intervention. The modest correlations between fat preference and diet efficacy obtained in this study stand in contrast to the null findings of Dekker et al 8 It seems likely that the difference in outcomes is a result of the methods used to assess preference. Further study utilizing direct measurement of preference is warranted.…”

“…Dekker et al 8 examined the preferences of 43 children and did not identify a significant correlation between fat preferences and ketogenic diet efficacy. However, these researchers utilized a retrospective, non-validated questionnaire completed by the children's parents (at times recollecting up to 5 years in the past) in addition to review of a parent-report food log completed prior to diet commencement, measuring consumption and not preference specifically.…”

Pilot study of a ketogenic diet in bipolar disorder: a process evaluation

“…Research in paediatric groups has shown that dietary preferences have mixed impact on the ketogenic diet. For example, while existing preference for high-fat food types is not considered to influence adherence [62], overall dietary preferences are one of the strongest drivers of discontinuation [63]. There remains work to be done to better understand the role of preferences in adults with bipolar disorder, who can experience concomitant challenges of disordered eating.…”