A prospective study: growth and nutritional status of children treated with the ketogenic diet.
OBJECTIVE
To assess the nutritional status of children treated with the classic and medium-chain triglyceride (MCT) ketogenic diets.


METHODS
A prospective, nonrandomized study design was used to measure nutrient intakes, growth, and biochemical indexes of children, age 1 to 16 years, with intractable epilepsy before and after 4 months' treatment with the classic and MCT ketogenic diets. None of the children had been on earlier dietary regimens.


METHODS
Of 58 children asked to participate in the study between September 1998 and July 2000, consent was obtained for 30 children. Fourteen children on the classic diet and 11 children on the MCT diet completed the study (83% completed). Statistical analysis performed Paired t tests were done on anthropometric and biochemical indexes. Nutrient intakes were compared with Dietary Reference Intakes (DRIs).


RESULTS
Both groups had statistically significant height increases of 2 to 3 cm (P<.05), but did not have significant increases in height/age percentiles. Weight percentiles decreased by approximately 10 percentiles for both diets; P=.043 for classic diet and.051 for MCT diet. Nutrient intakes from the diet and vitamin and mineral supplements met the DRIs except for phosphorus (both diets) and folate (classic diet). All biochemical indexes, including albumin, remained within the normal range. For the MCT diet, there was a 0.7 decrease in the ratio of total cholesterol to high-density lipoprotein ratios (P<.0009) at 4 months.


CONCLUSIONS
When treating children on a ketogenic diet, clinicians should recommend adequate intake of energy and protein, a higher proportion of unsaturated to saturated dietary fats, and consider vitamin and mineral supplements.
Liu
Yeou-Mei Christiana
YM
The Hospital for Sick Children, Room 6D47 Atrium, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. christiana.liu@sickkids.ca
Williams
Shelley
S
Basualdo-Hammond
Carlota
C
Stephens
Derek
D
Curtis
Rosalind
R
D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001827:Body Height; D001835:Body Weight; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004041:Dietary Fats / Q000008:administration & dosage; D002149:Energy Intake; D004827:Epilepsy / Q000178:diet therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D007657:Ketone Bodies / Q000378:metabolism*; D008297:Male; D008903:Minerals / Q000008:administration & dosage; D009751:Nutritional Requirements; D009752:Nutritional Status; D009864:Ontario; D011446:Prospective Studies; D014280:Triglycerides / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage
D004041:Dietary Fats; D007657:Ketone Bodies; D008903:Minerals; D014280:Triglycerides; D014815:Vitamins