Implementing the Ketogenic Diet

Kelly, Millicent T.; Hays, Tiffani

doi:10.1097/00008486-199713010-00006

Cited by 1 publication

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“…It was developed to mimic the metabolic changes of starvation. The classic KD was generally initiated with a 24 -48 hour fast, fluids were limited and total calories were typically restricted to 75% of the recommended dietary allowance (RDA) with 87%-90% of the person's caloric intake derived from fat, based on the classical 3:1-4:1 ratio of fat to protein plus carbohydrate [1]. KD was widely used in the 1920's and 1930's but its use declined with the advent of new antiepileptic drugs (AEDs) [2].…”

Section: Introductionmentioning

confidence: 99%

An acidosis-sparing ketogenic (ASK) diet to improve efficacy and reduce adverse effects in the treatment of refractory epilepsy

Yuen

Walcutt

Sander

2017

Epilepsy & Behavior

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Diets that increase production of ketone bodies to provide alternative fuel for the brain are evolving from the classic ketogenic diet for epilepsy devised nearly a century ago. The classic ketogenic diet and its more recent variants all appear to have similar efficacy with approximately 50% of users showing a greater than 50% seizure reduction. They all require significant medical and dietetic support, and there are tolerability issues. A review suggests that low-grade chronic metabolic acidosis associated with ketosis is likely to be an important contributor to the short term and long term adverse effects of ketogenic diets. Recent studies, particularly with the characterization of the acid sensing ion channels, suggest that chronic metabolic acidosis may increase the propensity for seizures. It is also known that low-grade chronic metabolic acidosis has a broad range of negative health effects and an increased risk of early mortality in the general population. The modified ketogenic dietary treatment we propose is formulated to limit acidosis by measures that include monitoring protein intake and maximizing consumption of alkaline mineral-rich, low carbohydrate green vegetables. We hypothesize that this acidosis-sparing ketogenic diet is expected to be associated with less adverse effects and improved efficacy. A case history of life-long intractable epilepsy shows this diet to be a successful long-term strategy but, clearly, clinical studies are needed.

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Section: Introductionmentioning

confidence: 99%