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A ketogenic diet ( high-fat, low-carbohydrate ) was first tested in the 1920s, but became less used with the advent of effective anticonvulsants.
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ketogenic and diet
* A ketogenic diet may have similar response to taking niacin ( lowered LDL and increased HDL ) through beta-hydroxybutyrate, a ketone body, coupling the niacin receptor ( HM74A ).
The brain gets a portion of its energy from ketone bodies when glucose is less available ( e. g., during fasting, strenuous exercise, low carbohydrate, ketogenic diet and in neonates ).
A mild acidosis may result from prolonged fasting or when following a ketogenic diet or a very low calorie diet.
Ketosis is deliberately induced by use of a ketogenic diet as a medical intervention in cases of intractable epilepsy.
The Induction phase of the Atkins diet is ketogenic.
A very low-carbohydrate, ketogenic diet was the standard treatment for diabetes throughout the 19th century.
A ketogenic diet impairs the ability of the kidney to excrete uric acid, due to competition for transport between uric acid and ketones.
A mild acidosis may result from prolonged fasting or when following a ketogenic diet or a very low calorie diet.
Diets very low in carbohydrates, such as a ketogenic diet, have been shown to increase the amount of delta activity and slow wave sleep in healthy individuals.
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control ( refractory ) epilepsy in children.
This classic ketogenic diet contains a 4: 1 ratio by weight of fat to combined protein and carbohydrate.
A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories.
The classic therapeutic ketogenic diet was developed for treatment of pediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant drugs.
In 2008, a randomised controlled trial showed a clear benefit for treating refractory epilepsy in children with the ketogenic diet.
When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.
The ketogenic diet is a mainstream, nonpharmacologic therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.
Russel Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketones in the blood ( ketonemia ) through an excess of fat and lack of carbohydrate.
His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.
Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.
ketogenic and high-fat
Although it is also a high-fat diet ( with approximately 60 % calories from fat ), the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40 – 60 g per day.
ketogenic and was
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides ( discovered 1857 ) and phenobarbital ( 1912 ), the ketogenic diet was widely used and studied.
By 2007, the ketogenic diet was available from around 75 centres in 45 countries, and less restrictive variants, such as the modified Atkins diet, were in use, particularly among older children and adults.
The ketogenic diet was also under investigation for the treatment of a wide variety of disorders other than epilepsy.
When first developed and used, the ketogenic diet was not a treatment of last resort ; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy.
As with most studies of the ketogenic diet, there was no control group ( patients who did not receive the treatment ).
ketogenic and less
The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet.
The low glycemic index treatment ( LGIT ) is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regime.
There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants.
ketogenic and used
It is used to administer the 4: 1 ratio classic ketogenic diet in children over one year.
Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.
The ketogenic diet has been used successfully to treat glioblastomas in a single case study.
In pediatric studies, ketogenic or carb-restricted diets result in a marked decrease in tumor size and growth when used in conjunction with standard therapies.
ketogenic and with
However, medium-chain triglycerides ( MCTs )— made from fatty acids with shorter carbon chains than LCTs — are more ketogenic.
Children with refractory epilepsy are more likely to find the ketogenic diet to be effective than to benefit from trying another anticonvulsant drug.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time.
Experts on the ketogenic diet recommend it be strongly considered for children with uncontrolled epilepsy who have tried and failed two or three anticonvulsant drugs ; most children who start the ketogenic diet have failed at least three times this number.
The ketogenic diet is indicated as an adjunctive ( additional ) treatment in children with drug-resistant epilepsy.
Children with a focal lesion ( a single point of brain abnormality causing the epilepsy ) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.
Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regime, though patients may be weaned off anticonvulsants if the diet is successful.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy ; as with any serious medical therapy, there may be complications.
About 1 in 20 children on the ketogenic diet will develop kidney stones ( compared with one in several thousand for the general population ).
Team members include a registered paediatric dietitian who coordinates the diet programme ; a paediatric neurologist who is experienced in offering the ketogenic diet ; and a registered nurse who is familiar with childhood epilepsy.
This fine-tuning is typically done over the telephone with the hospital dietitian and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.
Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet.
Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
Fat is energy-rich, with 9 kcal / g ( 38 kJ / g ) compared to 4 kcal / g ( 17 kJ / g ) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal.
This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D. A typical day of food for a child on a 4: 1 ratio, 1, 500 kcal ( 6, 300 kJ ) ketogenic diet comprises:
Compared with the ketogenic diet, the modified Atkins diet ( MAD ) places no limit on calories or protein, and the lower overall ketogenic ratio ( approximately 1: 1 ) does not need to be consistently maintained by all meals of the day.
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