Metabolic effects of three ketogenic diets in the treatment of severe epilepsy.
Pre- and post-prandial circulating concentrations of metabolic fuels and plasma insulin are documented in 59 patients with severe epilepsy while receiving either a normal diet, the classical high-fat ketogenic diet, a medium-chain triglyceride (MCT) diet, or a modified MCT diet. All three therapeutic diets improved the control of epilepsy and induced a significant increase in the concentrations of blood aceto-acetate and 3-hydroxybutyrate, the greatest elevation being seen in patients on the classical diet. The classical diet also caused a significant decrease in blood alanine values, which was not observed with the other therapeutic diets. The only consistent change to occur in all patients on therapeutic diets was an increase in plasma uric-acid. The mechanism by which ketogenic diets improve seizure control remains to be elicited.
Schwartz
R M
RM
University Department of Paediatrics, John Radcliffe Hospital, Oxford.
Boyes
S
S
Aynsley-Green
A
A
D000293:Adolescent; D000328:Adult; D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004041:Dietary Fats / Q000008:administration & dosage*; D004734:Energy Metabolism; D004827:Epilepsy / Q000097:blood / Q000178:diet therapy*; D005990:Glycerol / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood*; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008875:Middle Aged; D011773:Pyruvates / Q000097:blood; D019289:Pyruvic Acid; D014280:Triglycerides / Q000008:administration & dosage*; D014527:Uric Acid / Q000097:blood
D001786:Blood Glucose; D004041:Dietary Fats; D007328:Insulin; D007657:Ketone Bodies; D007773:Lactates; D011773:Pyruvates; D014280:Triglycerides; D014527:Uric Acid; D019344:Lactic Acid; D019289:Pyruvic Acid; D000409:Alanine; D005990:Glycerol