Improving the effects of ketogenic diet therapy in children with drug-resistant epilepsy

Yang, Ruijie; Wen, Jialun; Wei, Wenjing; Chen, Haili; Cao, Dezhi; Chen, Li; Xiao, Lu; Hu, Yanrong; Huang, Tongwang; Li, Bing; Lin, Sufang; Zou, Dongfang; Ye, Jinghua; Zhang, Man; Wang, Yaoye; Yu, Mengmeng; Liao, Jianxiang; Zhang, Xiao

doi:10.1016/j.seizure.2021.10.021

Cited by 12 publications

(6 citation statements)

References 43 publications

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“…Epilepsy research indicates that glucose ketone index may be more strongly correlated to seizure control than either ketone or glucose level alone. 24, 25 In an analysis of GKI we observed covariation and significant granger causality between GKI level and mood (Z = 2.32, p < 0.05), energy (Z = 2.28, p < 0.05) and anxiety (44.51, p < 0.001) and particularly in the responder group who remained on the diet (mood (Z = 3.11 p < 0.01), energy (Z = 3.60 p < 0.001) and anxiety (Z = 55.14 p < 0.001)). The GKI plots exhibit further evidence of an adaptation period where mood and energy increase as GKI falls (indicating an increasing ratio of ketones to glucose).…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of a Ketogenic Diet in Bipolar Disorder: Clinical, Metabolic and Magnetic Resonance Spectroscopy Findings

Campbell,

Needham,

Grossi

et al. 2023

Preprint

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Background Bipolar disorder and epilepsy are treated with anti-seizure medications. Preliminary evidence indicates that a ketogenic diet (a metabolic treatment for epilepsy) may be effective in the treatment of bipolar disorder. Aims To explore the impact of a ketogenic diet on clinical outcomes, and metabolomic and brain magnetic resonance spectroscopy biomarkers. Methods Euthymic individuals with bipolar disorder (N=27) were recruited to a 6-8 week single-arm trial of a modified ketogenic diet and a range of metabolic and clinical outcome measures were assessed. Results There was a positive correlation between daily ketone levels and ecological momentary assessments of mood (p < 0.001) and energy (p < 0.001) and an inverse correlation between ketone levels and impulsivity (p < 0.001) and anxiety (p < 0.001). Mean weight fell by 4.2kg (p < 0.001), mean BMI fell by 5.3% (p < 0.001) and mean systolic blood pressure was reduced by 7.4 mmHg (p < 0.041). Brain Glx (a putative marker of treatment response to anti-seizure medication) decreased by 13.1% in the posterior cingulate cortex (PCC) (p < 0.001) and by 9.2% in the anterior cingulate cortex ACC (p = 0.02). At the dietary cessation period, one third of participants, who reported reduced mood lability, opted to remain on a ketogenic diet. Conclusion The majority of participants had improved cardiometabolic risk parameters and approximately one third experienced improvement in psychiatric symptoms. The study findings are consistent with our a priori hypothesis of ketone bodies acting as an alternative metabolic substrate under conditions of impaired insulin signalling in a subgroup of patients with bipolar disorder.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study of a Ketogenic Diet in Bipolar Disorder: Clinical, Metabolic and Magnetic Resonance Spectroscopy Findings

Campbell,

Needham,

Grossi

et al. 2023

Preprint

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show abstract

“…Thus, education and training for participants or caregivers prior to dietary intervention is important. Some researchers believe that new therapies are urgently needed to broaden the management options and improve the prognosis of patients ( 51 ), thus, tools of e-health management and recipe software could have increased the treatment compliance ( 52 , 53 ). Additionally, correct management of the KD in patients with refractory epilepsy is important from the beginning to avoid side effects ( 54 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of the Ketogenic Diet for Mitochondrial Disease With Epilepsy: A Prospective, Open-labeled, Controlled Study

Huang

Zhong

et al. 2022

Front. Neurol.

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BackgroundThe ketogenic diet (KD) is increasingly used to treat drug-resistant epilepsy because of its favorable effect on seizure reduction. Patients with mitochondrial diseases tend to experience seizures. Therefore, this study aimed to test the efficacy of the KD on participants with mitochondrial diseases in a controlled trial.MethodsParticipants from fourteen clinical centers who were diagnosed with mitochondrial disease were semi-randomized to either the intervention (KD) or control group. The KD group followed a 3-month KD intervention, while the control group received a 1-month normal diet initially and then a 3-month KD intervention. The primary outcome measure was seizure reduction. Biomarker changes, cognitive impairments, and side effects were also recorded, if available.ResultA total of 33 participants were assigned to the KD (n = 22) and control groups (n = 11). In the KD group, 31.8% (7/22) of participants achieved ≥50% seizure reduction after 1 month of diet intervention, which increased to 40.9% (9/22) at 3 months. In the control group, only 18.2% (2/11) of the participants had ≥50% seizure reduction during the normal diet period. After the control group was transferred to the KD, 63.6% (7/11) of participants had >50% seizure reduction, and this rate increased to 72.7% (8/11) at 3 months. The KD also showed high efficacy in participants with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) or pathogenic variants in mitochondrial DNA (mtDNA) (90% and 93.3% response rates, respectively). The most frequent side effects reported at the 3-month review were vomiting, cold, hyperlipidemia, and bloating.ConclusionThe KD is a safe and effective therapy for seizure control in mitochondrial diseases, especially MELAS and pathogenic variants of mtDNA. KD intervention can be considered in the management of these patients.

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“…Ketogenic diets tend to cause high serum LDL cholesterol due to the principle of low protein intake. The intake of low protein is in addition associated with the risk of developing hypoproteinemia [16].…”

Section: Limitation Of the Kdmentioning

confidence: 99%

Clinical efficacy and safety of ketogenic diet

Liu

et al. 2023

Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022)

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Dietary Guidelines for Chinese Residents (2022) states more than half (50.7%) of Chinese adult residents are overweight or obese. In global term, about 1.3 million people die in the world annually due to obesity and its complications. With the increasing number of weight-watcher, various ways to lose weight emerge in an endless stream. However, this hotdebated weight loss diet scientific or not? This paper evaluates the efficacy and safety of the ketogenic diet through literature researches. Results show that Ketogenic diet (KD) is quite effective in weight loss and related diseases, but it is can also be harmful and cannot be promoted without basic cognition to it. In the future, new ketogenic diets need to be created considered by the complex and changeable individual situations.

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Improving the effects of ketogenic diet therapy in children with drug-resistant epilepsy

Cited by 12 publications

References 43 publications

A Pilot Study of a Ketogenic Diet in Bipolar Disorder: Clinical, Metabolic and Magnetic Resonance Spectroscopy Findings

A Pilot Study of a Ketogenic Diet in Bipolar Disorder: Clinical, Metabolic and Magnetic Resonance Spectroscopy Findings

Efficacy and Safety of the Ketogenic Diet for Mitochondrial Disease With Epilepsy: A Prospective, Open-labeled, Controlled Study

Clinical efficacy and safety of ketogenic diet

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