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Observational Study
. 2020 Jan 24;12(2):306.
doi: 10.3390/nu12020306.

Safety and Effectiveness of the Prolonged Treatment of Children with a Ketogenic Diet

Jana Ruiz Herrero  1 , Elvira Cañedo Villarroya  2 , Juan José García Peñas  3 , Beatriz García Alcolea  2 , Begoña Gómez Fernández  2 , Laura Andrea Puerta Macfarland  2 , Consuelo Pedrón Giner  2
Affiliations
Observational Study

Safety and Effectiveness of the Prolonged Treatment of Children with a Ketogenic Diet

Jana Ruiz Herrero et al. Nutrients. .

Abstract

Background: The ketogenic diet (KD) is an effective treatment against drug-resistant epilepsy in children. The KD is a diet rich in fats that produces anticonvulsant and neuroprotective effects that reduces seizures and improves the cognitive state. Nevertheless, it can produce side effects that sometimes can be serious. Further, the effect on growth is quite controversial when used for an extended period of time. The aim of this paper was to assess the effectiveness, side effects, and repercussions in the development of children who have been treated with a KD for more than 2 years.

Methods: Observational descriptive study of 26 pediatric patients on a KD, with data collection at baseline, at 3, 6, and 12 months, and then once a year. Number of seizures, type of seizures, anti-seizure drugs, anthropometry, side effects, and alterations in laboratory assessment were monitored.

Results: In every assessment, about 60%-75% of the patients experienced a reduction in number of seizures of over 90%, and at least 50% experienced side effects, of which digestive issues, alteration in the lipid metabolism, and hypercalciuria were the most common. The KD significantly affected height after 2 years of treatment.

Conclusions: The KD is an effective treatment for drug-resistant epilepsy. Its side effects, although common, are very mild; therefore, this constitutes a very safe treatment for children of all ages. More studies are needed to identify and prevent potential causes of growth retardation in children on the KD.

Keywords: GLUT-1; drug-resistant epilepsy; growth; ketogenic diet.

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Conflict of interest statement

Ruiz Herrero has participated in two ketogenic diet courses sponsored by Nutricia and has received funding for travel from Nutricia. Cañedo Villarroya has received honorarium for lectures and funding for travel from Mead Johnson, Nestlé, Nutricia, and Abbott y Orphan. García Peñas has participated in courses and seminars sponsored by UCB, Eisai/Esteve, Bial, GW, Sanofi, and Nutricia. Puerta Macfarland has participated in two ketogenic diet courses sponsored by Nutricia. Pedrón Giner has served as a consultant or received honorarium for lectures from Nutricia, Vitaflo, Nestlé, and Mead Johnson, and has received funding for travel from Nutricia, Vitaflo, and Nestlé. García Alcolea and Gómez Fernández have no conflict of interest.

Figures

Figure 1
Figure 1
Evolution of the seizures throughout the follow-up. In one patient, the seizures were hard to account for because they happened during sleep. KD: ketogenic diet, m: months, y: years.
Figure 2
Figure 2
Number of patients in each range of the body mass index (BMI) z-score throughout time. KD: ketogenic diet, m: months, y: years.
Figure 3
Figure 3
Evolution of weight (A), height (B), and BMI (C) in z-score values. m: months, y: years.
Figure 4
Figure 4
z-score eight comparison after 2 years on the diet; group 1: children older than 2 years, group 2: children younger than 2 years.
See this image and copyright information in PMC

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