title: Early efficacy of the ketogenic diet is not affected by initial body mass index percentile.
abstract: BACKGROUND
  Predictors of the ketogenic diet's success in treating pediatric intractable epilepsy are not well understood. The aim of this study was to determine whether initial body mass index and weight percentile impact early efficacy of the traditional ketogenic diet in children initiating therapy for intractable epilepsy.
  
  
  METHODS
  This retrospective study included all children initiating the ketogenic diet at Mayo Clinic, Rochester from January 2001 to December 2010 who had body mass index (children ≥2 years of age) or weight percentile (those <2 years of age) documented at diet initiation and seizure frequency recorded at diet initiation and one month. Responders were defined as achieving a >50% seizure reduction from baseline.
  
  
  RESULTS
  Our cohort consisted of 48 patients (20 male) with a median age of 3.1 years. There was no significant correlation between initial body mass index or weight percentile and seizure frequency reduction at one month (P = 0.72, r = 0.26 and P = 0.91, r = 0.03). There was no significant association between body mass index or weight percentile quartile and responder rates (P = 0.21 and P = 0.57). Children considered overweight or obese at diet initiation (body mass index or weight percentile ≥85) did not have lower responder rates than those with body mass index or weight percentiles <85 (6/14 vs 19/34, respectively, P = 0.41).
  
  
  CONCLUSIONS
  Greater initial body mass index and weight-for-age percentiles do not adversely affect the efficacy of the ketogenic diet.
authors.affiliation: Mayo Medical School, Mayo Clinic, Rochester, Minnesota.
authors.forename: Shastin
authors.initials: S
authors.lastname: Shull
authors.affiliation: Department of Pediatric Neurology, Baylor College of Medicine, Houston, Texas.
authors.forename: Gloria
authors.initials: G
authors.lastname: Diaz-Medina
authors.affiliation: Division of Child Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lily
authors.initials: L
authors.lastname: Wong-Kisiel
authors.affiliation: Division of Child Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Katherine
authors.initials: K
authors.lastname: Nickels
authors.affiliation: Division of Child Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Susan
authors.initials: S
authors.lastname: Eckert
authors.affiliation: Division of Child Neurology, Mayo Clinic, Rochester, Minnesota. Electronic address: wirrell.elaine@mayo.edu.
authors.forename: Elaine
authors.initials: E
authors.lastname: Wirrell
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D055423:Diet, Ketogenic; D004827:Epilepsy / Q000150:complications* / Q000178:diet therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications*; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications / Q000178:diet therapy; D016896:Treatment Outcome
keywords: body mass index; efficacy; epilepsy; ketogenic diet; seizure; weight