title: Ketogenic diet in epileptic children: impact on lipoproteins and oxidative stress.
abstract: OBJECTIVE
  Ketogenic diet (KD) is an important therapy used in the control of drug-refractory seizures. The major goal of this review is to update the knowledge about the adverse effects of KD on lipoproteins, lipid profile, and cardiometabolic risk.
  
  
  METHODS
  Articles on the effect of the KD on plasma lipoproteins of children and adolescents with refractory epilepsy, which were published in the past 15 years and indexed in the PubMed and MedLine databases, were included.
  
  
  RESULTS
  Dyslipidemia was recurrent in children, and adolescents treated with KD. Evidence suggests that hypercholesterolemia promotes structural modifications in low-density lipoprotein particles. Such modifications possibly favor oxidative processes and contribute to changes in the size of lipoproteins, particularly related to small and denser LDL. However, oxidative modifications in LDL of children on KD are not described in the literature.
  
  
  CONCLUSIONS
  The positive effects of KD on the health of children and adolescents with refractory epilepsy are unquestionable. Conversely, this positive role is associated with significant and negative changes in lipid metabolism. Moreover, the positive effects are possibly related to oxidative reactions and unbalance of antioxidants that can contribute to an increased cardiometabolic risk. Therefore, this review invites clinicians and researchers to investigate the lipid and oxidative metabolism in their clinical practice and trials, respectively.
authors.forename: Patricia Azevedo
authors.initials: PA
authors.lastname: Lima
authors.forename: Leticia Pereira
authors.initials: LP
authors.lastname: de Brito Sampaio
authors.forename: Nágila Raquel Teixeira
authors.initials: NR
authors.lastname: Damasceno
mesh_terms: D000293:Adolescent; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016208:Databases, Factual; D055423:Diet, Ketogenic / Q000009:adverse effects*; D004827:Epilepsy / Q000178:diet therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000209:etiology*; D018384:Oxidative Stress; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Dyslipidemias; Epilepsy; Ketogenic diet; Lipid metabolism; Low-density lipoprotein; Oxidative stress