Effects of the ketogenic diet on nutritional status, resting energy expenditure, and substrate oxidation in patients with medically refractory epilepsy: a 6-month prospective observational study.
OBJECTIVE
This 6-month prospective, single-arm observational study was designed to assess the effects of the KD on the nutritional status, resting energy expenditure (REE), and substrate oxidation in patients with drug-resistant epilepsy.


METHODS
Eighteen patients with medically refractory epilepsy underwent assessment of body composition, REE, and substrate oxidation rates before and after 6 months of KD.


RESULTS
Compared with baseline, there were no statistically significant differences at 6 months in terms of height, weight, BMI z-scores, and REE. However, the respiratory quotient decreased significantly (from 0.80 ± 0.06 to 0.72 ± 0.05, p < 0.001) whereas fat oxidation was significantly increased (from 50.9 ± 25.2 mg/min to 97.5 ± 25.7 mg/min, p < 0.001). Interestingly, we found that the increase in fat oxidation was the main independent predictor of the reduction in seizure frequency (beta = -0.97, t = -6.3, p < 0.05).


CONCLUSIONS
Administering a KD for 6 months in patients with medically refractory epilepsy increases fat oxidation and decreases the respiratory quotient, without appreciable changes in REE.
Human Nutrition and Eating Disorders Research Centre, University of Pavia, Pavia, Italy. anna.tagliabue@unipv.it
Anna
A
Tagliabue
Simona
S
Bertoli
Claudia
C
Trentani
Paola
P
Borrelli
Pierangelo
P
Veggiotti
D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage; D001481:Basal Metabolism; D001823:Body Composition; D001835:Body Weight; D002648:Child; D055423:Diet, Ketogenic / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004827:Epilepsy / Q000178:diet therapy*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D010084:Oxidation-Reduction; D010865:Pilot Projects; D011446:Prospective Studies; D012640:Seizures / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
D000927:Anticonvulsants