The Effect of the Ketogenic Diet on the Vascular Structure and Functions in Children With Intractable Epilepsy

Özdemir, Rahmi; Güzel, Orkide; Küçük, Mehmet; Karadeniz, Cem; Katipoğlu, Nagehan; Yılmaz, Ünsal; Yılmazer, Murat Muhtar; Meşe, Timur

doi:10.1016/j.pediatrneurol.2015.10.017

Cited by 27 publications

(25 citation statements)

References 20 publications

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“…[146][147][148] Although the risk for coronary artery disease may increase with long-term elevations of cholesterol levels, previous pediatric studies showed no change in the carotid intima-media thickness compared to baseline at 6 and 12 months of therapy. 150,151 On the other hand, local and systemic arterial stiffness was significantly increased in 2 studies involving children and young adults, correlated with serum cholesterol and triglycerides levels. 152,153 Nevertheless, long-term vascular outcomes of this high fat diet are not known.…”

Section: Adverse Effectsmentioning

confidence: 99%

Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group

Kossoff¹,

Zupec‐Kania²,

et al. 2018

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SummaryKetogenic dietary therapies (KDTs) are established, effective nonpharmacologic treatments for intractable childhood epilepsy. For many years KDTs were implemented differently throughout the world due to lack of consistent protocols. In 2009, an expert consensus guideline for the management of children on KDT was published, focusing on topics of patient selection, pre‐KDT counseling and evaluation, diet choice and attributes, implementation, supplementation, follow‐up, side events, and KDT discontinuation. It has been helpful in outlining a state‐of‐the‐art protocol, standardizing KDT for multicenter clinical trials, and identifying areas of controversy and uncertainty for future research. Now one decade later, the organizers and authors of this guideline present a revised version with additional authors, in order to include recent research, especially regarding other dietary treatments, clarifying indications for use, side effects during initiation and ongoing use, value of supplements, and methods of KDT discontinuation. In addition, authors completed a survey of their institution's practices, which was compared to responses from the original consensus survey, to show trends in management over the last 10 years.

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Section: Adverse Effectsmentioning

confidence: 99%

Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group

Kossoff¹,

Zupec‐Kania²,

et al. 2018

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“…27 The long-term effect of KD-induced dyslipidemia on vascular structure and atheroma formation remains unclear. Although it appears to have no effect on the carotid intima-media thickness and elastic properties after 12 months of KD treatment, 28 Doppler studies and echocardiogram may be necessary in the presence of chronic dyslipidemia and to screen for cardiomyopathy. A higher proportion of unsaturated to saturated dietary fats, the addition of MCT oil, a lower KD ratio, and carnitine supplementation may help prevent the risk of dyslipidemia.…”

Section: Dyslipidemia and Cardiovascular Complicationsmentioning

confidence: 99%

The Ketogenic Diet: A Practical Guide for Pediatricians

Luat¹,

Coyle²,

Kamat³

2016

Pediatr Ann

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The ketogenic diet is an effective treatment for drug-resistant epilepsies in children. In addition, it is the first-line treatment for some metabolic disorders, such as glucose transporter 1 deficiency syndrome. This article discusses the proposed mechanisms of a ketogenic diet's antiseizure action, its clinical indications, and its contraindications. The steps involved in ketogenic diet initiation, monitoring, and management of its side effects are also discussed. This review provides general pediatricians with the necessary skills to provide comprehensive care of children using the ketogenic diet and counsel their families and caregivers. [Pediatr Ann. 2016;45(12):e446-e450.]

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“…Dyslipidemia associated with KD also appears to have no disturbing effects on ventricular function. 35,36 Not all our patients underwent laboratory tests after completing treatment. In those who did, cholesterol levels normalized in 5/6 and the triglycerides in 4/5.…”

Section: Discussionmentioning

confidence: 99%

Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre

et al. 2019

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Introduction: Ketogenic diet is a low carbohydrate diet, which can be used as a treatment for refractory childhood epilepsy. The first aim of this study was to evaluate its efficacy, in patients receiving ketogenic diet for at least three months, on epilepsy control, behaviour and awareness. The secondary aims were to evaluate the variation in the number of antiepileptic drugs, reasons for discontinuing the diet and adverse effects. Material and Methods: Retrospective analysis of clinical records of patients who underwent ketogenic diet for refractory epilepsy, from October 2007 to January 2018, in a tertiary pediatric hospital. Results: In the twenty-nine eligible patients, the mean age of initiation was 7.9 years-old (+/-5.6). Of those, 18 had a ≥ 50% reduction of seizure activity, 19 a marked behaviour improvement and 18 improved awareness. The median number of antiepileptic drugs remained equal for the 15 patients who completed 18 months of treatment (three drugs). The main reason for discontinuing ketogenic diet was a familiar decision. The main adverse effects were hypercholesterolemia (n = 23) and hypertriglyceridemia (n = 21). Discussion: Results were comparable to those of other cohorts, namely age of initiation, proportion of patients completing ketogenic diet, most frequent reasons for stopping and significant improvement of alertness and behavior. Conclusion: Beyond seizure control, patients experienced a marked improvement in behavior and awareness. It is necessary to develop strategies to increase the adherence of families to the diet. RESUMOIntrodução: A dieta cetogénica é uma dieta com baixo teor de hidratos de carbono, que pode ser usada no tratamento da epilepsia infantil refratária. O principal objetivo deste estudo foi avaliar a eficácia nos doentes que completaram pelo menos três meses de dieta, no que respeita ao controlo das crises, comportamento e estado de alerta. Foi também avaliada a variação do número de fármacos antiepiléticos, as razões de descontinuação e os efeitos secundários. Material e Métodos: Análise retrospetiva dos processos clínicos dos doentes com epilepsia refratária sob dieta cetogénica, de outubro de 2007 a janeiro de 2018, num hospital pediátrico de nível 3. Resultados: Nos 29 doentes elegíveis, a média da idade de implementação foi 7,9 anos (+/-5,6). Destes, 18 tiveram uma redução ≥ 50% das crises, 19 tiveram uma melhoria marcada do comportamento e 18 do seu estado de alerta. Dos 15 que completaram 18 meses, a mediana do número de fármacos antiepiléticos permaneceu idêntica à do início (três fármacos). A principal razão de descontinuação foi por decisão familiar. Os principais efeitos secundários foram a hipercolesterolémia (n = 23) e a hipertrigliceridémia (n = 21). Discussão: Os resultados foram semelhantes aos obtidos noutras coortes, nomeadamente no que respeita à idade de início, à percentagem de doentes que completou a dieta, às razões da suspensão e à melhoria do comportamento e estado de alerta. Conclusão: Para além do controlo das crises, os doentes tiveram u...

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The Effect of the Ketogenic Diet on the Vascular Structure and Functions in Children With Intractable Epilepsy

Cited by 27 publications

References 20 publications

Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group

Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group

The Ketogenic Diet: A Practical Guide for Pediatricians

Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre

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