title: Efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy: a meta-analysis.
abstract: OBJECTIVE
  Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice.
  
  
  METHODS
  Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes.
  
  
  RESULTS
  In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%.
  
  
  CONCLUSIONS
  The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet.
authors: Department of Neurology, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
authors: Fang
authors: F
authors: Ye
authors: Department of Neurology, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
authors: Xiao-Jia
authors: XJ
authors: Li
authors: Department of Neurology, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
authors: Wan-Lin
authors: WL
authors: Jiang
authors: Department of Neurology, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
authors: Hong-Bin
authors: HB
authors: Sun
authors: Department of Neurology, Sichuan Provincial Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
authors: Jie
authors: J
authors: Liu
keywords: adult; compliance; efficacy; intractable epilepsy; ketogenic diet
references: Seizure. 2011 Mar;20(2):151-5
references: 21126887
references: Clin Neurol Neurosurg. 2008 Sep;110(8):797-803
references: 18572306
references: Epilepsia. 2011 Apr;52(4):775-80
references: 21269295
references: Epilepsy Behav. 2011 Jun;21(2):115-21
references: 21514240
references: N Engl J Med. 2011 Sep 8;365(10):919-26
references: 21899452
references: Continuum (Minneap Minn). 2013 Jun;19(3 Epilepsy):756-66
references: 23739109
references: Epilepsia. 1999 Dec;40(12):1721-6
references: 10612335
references: Seizure. 2012 May;21(4):237-40
references: 22425426
references: Epilepsy Behav. 2013 Dec;29(3):437-42
references: 24386671
references: Epilepsia. 2006 Feb;47(2):421-4
references: 16499770
references: Curr Opin Neurol. 2012 Apr;25(2):173-8
references: 22322415
references: Seizure. 2014 Jun;23(6):439-42
references: 24675110
references: Epilepsia. 2012 Apr;53(4):728-32
references: 22332768
references: Seizure. 2009 Jan;18(1):30-3
references: 18675556
references: Epilepsia. 2010 Dec;51(12):2496-9
references: 21204815
references: J Child Neurol. 2013 Aug;28(8):1034-40
references: 23670244
references: Epilepsy Behav. 2010 Dec;19(4):575-9
references: 20937568
references: Epilepsia. 2011 Nov;52(11):1941-8
references: 22004525
references: Acta Neurol Scand. 2013 Dec;128(6):402-8
references: 23679058
references: Epilepsy Behav. 2013 Feb;26(2):162-4
references: 23266114
references: Epilepsia. 2008 Feb;49(2):316-9
references: 17919301
references: Epilepsy Behav. 2012 Mar;23(3):310-4
references: 22366051