The ketogenic diet: adolescents can do it, too.
OBJECTIVE
To determine both the efficacy of and compliance with the ketogenic diet in the adolescent population.


METHODS
A retrospective study of 45 patients, aged 12-19 years, consecutively enrolled in a ketogenic diet program from 1994 to 2002, was performed. Thirty-seven patients were from The Johns Hopkins Medical Institutions; eight were from The University of Texas at Houston. Charts were reviewed, and patients were contacted by telephone.


RESULTS
Six months after diet initiation, 28 (62%) of 45 remained on the ketogenic diet, with six (21%) of 28 having 50-90% seizure reduction, and eight (29%) of 28 having >90%. At 12 months, 20 (44%) of 45 remained on the diet, with seven (35%) of 20 having 50-90% seizure reduction and six (30%) of 20 achieving >90% efficacy. Only 22% discontinued the diet for perceived restrictiveness. The mean diet duration was 1.2 years. Patients with multiple seizure types did best, whereas gender, prior seizure frequency, diet ratio, and age did not influence outcome. Patients dependent on parents for daily care were more likely to remain on the diet at 6 months, but had less efficacy. Weight loss (60%) and menstrual dysfunction (45% of female subjects) were the most commonly reported side effects.


CONCLUSIONS
The ketogenic diet is as well tolerated and efficacious for adolescents with epilepsy as for the general childhood population.
Mady
Mackenzie A
MA
Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Kossoff
Eric H
EH
McGregor
Amy L
AL
Wheless
James W
JW
Pyzik
Paula L
PL
Freeman
John M
JM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D018753:Diet, Protein-Restricted / Q000379:methods*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004827:Epilepsy / Q000178:diet therapy* / Q000378:metabolism; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D006801:Humans; D007657:Ketone Bodies / Q000096:biosynthesis; D007662:Ketosis / Q000139:chemically induced / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000209:etiology; D010352:Patient Dropouts; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D007657:Ketone Bodies