Ketogenic diet in pediatric seizures: a randomized controlled trial review and meta-analysis

Pizzo, Francesco; Collotta, Ausilia Desiree; Nora, Alessandra Di; Costanza, Giuseppe; Ruggieri, Martino; Falsaperla, Raffaele

doi:10.1080/14737175.2022.2030220

Cited by 25 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present study provided evidence for the benefits of KD therapy in drug-resistant epilepsy patients, with efficacy rates at 3, 6, 12, and 18 months of 51.8%, 53.6%, 39.2%, and 23.2%, respectively. These results were in agreement with those of previous workers, which ranged from 35% to 85%, 4,[8][9][10] indicating that the ketogenic diet was an optional treatment method for children with drug-resistant epilepsy. The retention rate in previous study groups ranged from 20% to 80% at six months and from 10% to 60% at twelve months and was significantly related to overall clinical teamwork, the educational level of parents, and the efficacy of KD therapy.…”

Section: Discussionsupporting

confidence: 93%

“…2 Ketogenic diet (KD), a high-fat, low-carbohydrate, and protein-restricted diet, was developed over 90 years in the United States and then promoted and used worldwide. Increasing evidence [3][4][5] suggests that KD is an effective therapeutic option for refractory epileptic seizures, and its effectiveness, safety, and tolerability in drug-resistant epilepsy have been documented in children. [6][7] It is hypothesized that a KD exerts antiepileptic effects by affecting ketone bodies, neuronal function, neurotransmitter release, ion channels, and the mechanistic target of rapamycin (mTOR) pathway and drives immunological adjustments.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…6,7 It is hypothesized that a KD exerts antiepileptic effects by affecting ketone bodies, neuronal function, neurotransmitter release, ion channels, and the mechanistic target of rapamycin (mTOR) pathway and drives immunological adjustments. 4 Compared to ASMs, the advantages of KD therapy are obvious. 8 The diet treatment led to seizure-free status among 15 to 27.6% of drug-resistant epilepsy patients 9 and was also shown to reduce the overall usage of ASMs in a previous report.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy, Retention Rate, and Influencing Factors of Ketogenic Diet Therapy in Children with Refractory Epilepsy: A Retrospective Study

et al. 2022

View full text Add to dashboard Cite

Aim This study aimed to evaluate the efficacy and retention rate of a ketogenic diet (KD) and assess factors that influence the efficacy of KD therapy in children with refractory epilepsy (RE). Methods We retrospectively studied the efficacy and retention rate of 56 RE children who accepted KD therapy from January 2013 to December 2019. Patients who had a ≥50% reduction in seizure frequency were defined as responders. The retention rate was calculated as the proportion of children who continued KD/the total number of children who were followed up at the time of enrollment. We also analyzed the effects of different factors (such as gender, KD initial age, KD duration, the type of epilepsy syndrome, and others) on the efficacy of the KD. Results (1) The efficacy rates for the KD at 3, 6, 12, and 18 months were 51.8%, 53.6%, 39.2%, and 23.2%, respectively. (2) The retention rates for the KD at 3, 6, 12 and 18 months were 100%, 69.6%, 41.1% and 23.2%, respectively. (3) There was no correlation between efficacy and gender, epilepsy onset age, the type of epilepsy syndrome, EEG improvement, or the number of antiseizure medications (ASMs), while cranial magnetic resonance imaging (MRI) abnormalities, KD duration, and KD initial age affected its efficacy at three months. Conclusion (1) KD therapy for refractory childhood epilepsy was effective and produced a high retention rate. (2) MRI abnormalities and the initial age and duration of KD influenced its short-term efficacy in RE children.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy, Retention Rate, and Influencing Factors of Ketogenic Diet Therapy in Children with Refractory Epilepsy: A Retrospective Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A meta-analysis of 2022, based on the studies conducted on epileptic children, demonstrated a reduction in the number of seizures by at least 50%, together with a complete absence of seizures in as many as 48.31% of children. It was demonstrated that children on a ketogenic diet had a 5.6 times greater chance for seizure frequency reduction by at least 50% compared with a control group [ 101 ]. Another extensive study revealed that in patients observing a ketogenic diet for epilepsy, a reduction in seizure frequency by ≥50% occurred in 35–56.1% of the participants compared with 6–18% in the control group [ 102 ].…”

Section: The Role Of the Ketogenic Diet In The Treatment Of Epilepsymentioning

confidence: 99%

The Role of Ketogenic Diet in the Treatment of Neurological Diseases

2022

View full text Add to dashboard Cite

Over a hundred years of study on the favourable effect of ketogenic diets in the treatment of epilepsy have contributed to a long-lasting discussion on its potential influence on other neurological diseases. A significant increase in the number of scientific studies in that field has been currently observed. The aim of this paper is a widespread, thorough analysis of the available scientific evidence in respect of the role of the ketogenic diet in the therapy of neurological diseases such as: epilepsy, Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS) and migraine. A wide range of the mechanisms of action of the ketogenic diet has been demonstrated in neurological diseases, including, among other effects, its influence on the reduction in inflammatory conditions and the amount of reactive oxygen species (ROS), the restoration of the myelin sheath of the neurons, the formation and regeneration of mitochondria, neuronal metabolism, the provision of an alternative source of energy for neurons (ketone bodies), the reduction in glucose and insulin concentrations, the reduction in amyloid plaques, the induction of autophagy, the alleviation of microglia activation, the reduction in excessive neuronal activation, the modulation of intestinal microbiota, the expression of genes, dopamine production and the increase in glutamine conversion into GABA. The studies discussed (including randomised controlled studies), conducted in neurological patients, have stressed the effectiveness of the ketogenic diet in the treatment of epilepsy and have demonstrated its promising therapeutic potential in Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS) and migraine. A frequent advantage of the diet was demonstrated over non-ketogenic diets (in the control groups) in the therapy of neurological diseases, with simultaneous safety and feasibility when conducting the nutritional model.

show abstract

“…In drug-resistant epilepsy, KD has shown anti-epileptic effect and has a major benefit compared with standard epilepsy treatment with AEDs in children and adolescents due to less long-term adverse effects ( 81 ). A meta-analysis showed that treatment with KD in refractory epilepsy in children gives a 5.6 times more likely chance than the control group to have a 50% reduction of seizures after three months of the diet or earlier ( 82 ).…”

Section: Ketogenic Diet In (Intractable) Epilepsymentioning

confidence: 99%

Ketogenic diets and Ketone suplementation: A strategy for therapeutic intervention

Saris

Timmers²

2022

Front. Nutr.

View full text Add to dashboard Cite

Ketogenic diets and orally administered exogenous ketone supplements are strategies to increase serum ketone bodies serving as an alternative energy fuel for high energy demanding tissues, such as the brain, muscles, and the heart. The ketogenic diet is a low-carbohydrate and fat-rich diet, whereas ketone supplements are usually supplied as esters or salts. Nutritional ketosis, defined as serum ketone concentrations of ≥ 0.5 mmol/L, has a fasting-like effect and results in all sorts of metabolic shifts and thereby enhancing the health status. In this review, we thus discuss the different interventions to reach nutritional ketosis, and summarize the effects on heart diseases, epilepsy, mitochondrial diseases, and neurodegenerative disorders. Interest in the proposed therapeutic benefits of nutritional ketosis has been growing the past recent years. The implication of this nutritional intervention is becoming more evident and has shown interesting potential. Mechanistic insights explaining the overall health effects of the ketogenic state, will lead to precision nutrition for the latter diseases.

show abstract

Ketogenic diet in pediatric seizures: a randomized controlled trial review and meta-analysis

Cited by 25 publications

References 20 publications

Efficacy, Retention Rate, and Influencing Factors of Ketogenic Diet Therapy in Children with Refractory Epilepsy: A Retrospective Study

Efficacy, Retention Rate, and Influencing Factors of Ketogenic Diet Therapy in Children with Refractory Epilepsy: A Retrospective Study

The Role of Ketogenic Diet in the Treatment of Neurological Diseases

Ketogenic diets and Ketone suplementation: A strategy for therapeutic intervention

Contact Info

Product

Resources

About