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Ketonuria and Seizure Control in the Medium Chain Triglyceride and Classic Ketogenic Diets

Published online by Cambridge University Press:  02 June 2021

Helen Lowe*
Affiliation:
The Division of Clinical Dietetics, The Hospital for Sick Children, Toronto, ON, Canada
Anne E. Keller
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Elise Tanzini
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Sabrina Aimola
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Y. M. Christiana Liu
Affiliation:
The Division of Clinical Dietetics, The Hospital for Sick Children, Toronto, ON, Canada
Maria Zak
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Valerie Chan
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Jeff Kobayashi
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada Department of Paediatrics, The University of Toronto, Toronto, ON, Canada
Elizabeth J. Donner
Affiliation:
The Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada Department of Paediatrics, The University of Toronto, Toronto, ON, Canada
*
Correspondence to: Helen Lowe, The Division of Clinical Dietetics, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8, Canada. Email: helen.lowe@sickkids.ca

Abstract

We hypothesized that children receiving medium-chain triglyceride ketogenic diet (MCTKD) experience similar seizure reduction despite lower ketosis compared with classic ketogenic diet (CKD). Children initiating CKD or MCTKD were enrolled in a prospective observational study. Forty-five children completed 6 months of KD (n = 17 MCTKD, n = 28 CKD). The proportion achieving ≥50% seizure reduction was 71% CKD group and 59% MCTKD group; ≥90% reduction was 32% and 36% in CKD and MCTKD groups, respectively. CKD had higher urine ketones (≥8 mmol/L: 79% vs. 36%, p = 0.005). Children receiving MCTKD experience similar seizure control to CKD despite lower urine ketone measures.

Résumé :

RÉSUMÉ :

La cétonurie et la diminution du nombre de crises épileptiques par la diète à base de triglycérides à chaîne moyenne et la diète cétogène classique.

D’après l’hypothèse des auteurs, les enfants soumis à la diète à base de triglycérides à chaîne moyenne (TCM) connaîtraient une réduction du nombre de crises épileptiques malgré une faible cétose, réduction comparable à celle enregistrée chez les enfants soumis à la diète cétogène classique (DCC). Ainsi, des enfants soumis pour la première fois à la DCC ou à la diète à TCM ont participé à une étude d’observation prospective. Quarante-cinq enfants ont suivi une diète cétogène durant 6 mois (diète à TCM : n = 17; DCC : n = 28). La proportion d’enfants ayant connu une réduction du nombre de crises épileptiques ≥ 50 % était de 71 % dans le groupe de la DCC et de 59 % dans le groupe de la diète à TCM; et la proportion de ceux ayant connu une réduction de ≥ 90 % s’élevait à 32 % et à 36 % dans les groupes de la DCC et de la diète à TCM respectivement. Quant au taux de corps cétoniques dans l’urine, il était plus élevé dans le groupe de la DCC (≥ 8 mmol/L : 79 % contre 36 %; p = 0,005) que dans l’autre. Enfin, la diminution du nombre de crises épileptiques enregistrées chez les enfants soumis à la diète à TCM était comparable à celle enregistrée chez les enfants soumis à la DCC, et ce, malgré une cétonurie plus faible

Type
Brief Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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References

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