title: Is hospitalization really necessary during the introduction of the ketogenic diet?
abstract: The ketogenic diet is traditionally introduced with an initial period of fasting. This study compares the efficacy and tolerability of the introduction of a prediet (2:1 ratio of fat:protein + carbohydrates) before hospitalization with the aim at reducing the time of same and the period of fasting necessary to reach ketosis. For a minimum period of 1 year, adverse effects, metabolic profile, and linear growth were prospectively evaluated in 46 children. Twenty-three children received a prediet for a period of 10 days, and in the other 23 children, the ketogenic diet was introduced by hospitalization regimen after a fasting period. The use of the prediet led to a shorter fasting period of a mean 18.3 hours compared with the group without prediet, in which the fasting period was 41.3 hours (P = .001). At the end, there was no difference in the adverse effects between the groups. In those submitted to the prediet, a better adaptation to the diet and acceptance to the proposal of introducing the ketogenic diet were observed.
authors.affiliation: Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, São Paulo, Brazil. surizzutti@ig.com.br
authors.forename: Sueli
authors.initials: S
authors.lastname: Rizzutti
authors.forename: Ana Maria Figueiredo
authors.initials: AM
authors.lastname: Ramos
authors.forename: Mauro
authors.initials: M
authors.lastname: Muszkat
authors.forename: Alberto Alain
authors.initials: AA
authors.lastname: Gabbai
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D005215:Fasting / Q000378:metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007662:Ketosis / Q000378:metabolism; D008297:Male; D011446:Prospective Studies
chemical_list: D004040:Dietary Carbohydrates