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Efficacy and Tolerability of the Ketogenic Diet According to Lipid:Nonlipid Ratios—Comparison of 3:1 with 4:1 Diet

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Title: Efficacy and Tolerability of the Ketogenic Diet According to Lipid:Nonlipid Ratios—Comparison of 3:1 with 4:1 Diet
Authors: Hoon Chul Kang, Joon Soo Lee, Joo Hee Seo, Heung Dong Kim, Young Mock Lee
Contributors: Joo Hee Seo, Young Mock Lee, Heung Dong Kim, Hoon Chul Kang, Joon Soo Lee, Kang, Hoon Chul, Kim, Heung Dong, Seo, Joo Hee, Lee, Young Mock, Lee, Joon Soo
Source: Epilepsia. 48:801-805
Publisher Information: Wiley, 2007.
Publication Year: 2007
Subject Terms: Male, Epilepsy/metabolism, Adolescent, Lipids/therapeutic use, Dietary Fats/therapeutic use, Ketone Bodies, Disease-Free Survival, Spasms, Dietary Proteins/administration & dosage, 03 medical and health sciences, 0302 clinical medicine, Dietary Carbohydrates, Humans, Lipids/administration & dosage, Longitudinal Studies, Preschool, Child, Epilepsy/diet therapy, Ketosis/chemically induced, Dietary Fats/metabolism, Food, Formulated, Formulated/adverse effects, Epilepsy, Infantile/diet therapy, Infant, Ketosis, Ketosis/metabolism, Dietary Carbohydrates/administration & dosage, Dietary Fats, Lipids, 3. Good health, Treatment Outcome, Food, Child, Preschool, Ketone Bodies/biosynthesis, Infantile/metabolism, Female, Dietary Proteins, Dietary Fats/administration & dosage, Spasms, Infantile
Description: Summary: Purpose: The ketogenic diet (KD) has been considered a highly potent antiepileptic treatment for intractable childhood epilepsy. In this study, we compared the antiepileptic efficacy and diet tolerability of two different diets with lipid:nonlipid ratios of 3:1 and 4:1. Methods: Seventy‐six patients with refractory childhood epilepsy were randomly placed into two groups and were started on KD diets with nonlipid:lipid ratios of either 3:1 or 4:1. Antiepileptic efficacy and diet tolerability were evaluated 3 months after initiating the diet. Patients showing seizure‐free outcome with the 4:1 diet were changed to the 3:1 diet, and those without a seizure‐free outcome on the 3:1 diet were changed to the 4:1 diet, for three more months, after which time their progress was monitored. Results: (1) Antiepileptic efficacy was higher for the 4:1 than the 3:1 diet (p < 0.05). Twenty‐two (55.0%) of 40 patients on the 4:1 diet and 11 (30.5%) of 36 patients on the 3:1 diet became seizure free. Seizure reduction of over 90% was observed in 2 (5.0%) patients on the 4:1 diet, and 2 (5.6%) on the 3:1 diet.(2) Dietary tolerability was better for the 3:1 than the 4:1 diet. Gastrointestinal symptoms were observed in 5 (13.9%) patients with the 3:1 diet and 14 (35.0%) patients with the 4:1 diet (p < 0.05). (3) For seizure‐free patients who started on the 4:1 diet, antiepileptic efficacy was maintained after changing to the 3:1 diet, while 10 (83.3%) of 12 patients who were not seizure free with the 3:1 diet showed increased seizure reduction after changing to the 4:1 diet. (4) Complications from the KD and laboratory data were not significantly different between the two groups. Conclusions: The 4:1 KD showed greater antiepileptic efficacy than the 3:1 diet with higher seizure‐free outcome. In most cases, seizure free outcome was maintained even after changing the ratio to 3:1. Dietary tolerability was better in the 3:1 diet than the 4:1 with less frequent gastrointestinal symptoms.
Document Type: Article
File Description: 801~805
Language: English
ISSN: 1528-1167
0013-9580
DOI: 10.1111/j.1528-1167.2007.01025.x
Access URL: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1528-1167.2007.01025.x
https://pubmed.ncbi.nlm.nih.gov/17386059
https://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2007.01025.x
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1528-1167.2007.01025.x
https://yonsei.pure.elsevier.com/en/publications/efficacy-and-tolerability-of-the-ketogenic-diet-according-to-lipi
https://europepmc.org/article/MED/17386059
https://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2007.01025.x/full
https://pubmed.ncbi.nlm.nih.gov/17386059/
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CC BY NC ND
Accession Number: edsair.doi.dedup.....c1bee7e55fc04a9182f8ce48581d5932
Database: OpenAIRE
Description
Abstract:Summary: Purpose: The ketogenic diet (KD) has been considered a highly potent antiepileptic treatment for intractable childhood epilepsy. In this study, we compared the antiepileptic efficacy and diet tolerability of two different diets with lipid:nonlipid ratios of 3:1 and 4:1. Methods: Seventy‐six patients with refractory childhood epilepsy were randomly placed into two groups and were started on KD diets with nonlipid:lipid ratios of either 3:1 or 4:1. Antiepileptic efficacy and diet tolerability were evaluated 3 months after initiating the diet. Patients showing seizure‐free outcome with the 4:1 diet were changed to the 3:1 diet, and those without a seizure‐free outcome on the 3:1 diet were changed to the 4:1 diet, for three more months, after which time their progress was monitored. Results: (1) Antiepileptic efficacy was higher for the 4:1 than the 3:1 diet (p < 0.05). Twenty‐two (55.0%) of 40 patients on the 4:1 diet and 11 (30.5%) of 36 patients on the 3:1 diet became seizure free. Seizure reduction of over 90% was observed in 2 (5.0%) patients on the 4:1 diet, and 2 (5.6%) on the 3:1 diet.(2) Dietary tolerability was better for the 3:1 than the 4:1 diet. Gastrointestinal symptoms were observed in 5 (13.9%) patients with the 3:1 diet and 14 (35.0%) patients with the 4:1 diet (p < 0.05). (3) For seizure‐free patients who started on the 4:1 diet, antiepileptic efficacy was maintained after changing to the 3:1 diet, while 10 (83.3%) of 12 patients who were not seizure free with the 3:1 diet showed increased seizure reduction after changing to the 4:1 diet. (4) Complications from the KD and laboratory data were not significantly different between the two groups. Conclusions: The 4:1 KD showed greater antiepileptic efficacy than the 3:1 diet with higher seizure‐free outcome. In most cases, seizure free outcome was maintained even after changing the ratio to 3:1. Dietary tolerability was better in the 3:1 diet than the 4:1 with less frequent gastrointestinal symptoms.
ISSN:15281167
00139580
DOI:10.1111/j.1528-1167.2007.01025.x