Impact of a Low-Carbohydrate, High-Fat Modified Ketogenic Diet on Anthropometrics, Biochemical Values, and Gastrointestinal Symptoms in Adult Patients with Epilepsy.

摘要

Low-carbohydrate, high-fat (LCHF) modified ketogenic diets (KDs) effectively reduce seizure frequency in adult patients with epilepsy, but side effects are largely unknown. In addition, to our knowledge, no investigators have published detailed nutrient intake data using valid tools while on this diet. Therefore, the purpose of this study was to investigate the effect of a LCHF modified KD on gastrointestinal (GI) symptoms, biochemical and anthropometric values, and dietary intake in adult patients with epilepsy. In this prospective, pre-post intervention study, 18 subjects were enrolled, with 50% providing dietary data at 3 months and 28% providing initial and follow up labs and questionnaires. Percent of energy and grams of total fat increased (from 38.3% to 63.6%), and percent of energy from total carbohydrate and net carbohydrate intake decreased (43.9% to 11.9% and 166.8 grams to 26.9 grams, respectively) (p<0.05). Ninety-one percent of subjects were compliant to the diet at 1 month, and 67% were compliant at 3 months (daily net carbohydrate intake of ≤75 grams). Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and high-sensitivity C-reactive protein increased non-significantly at 3 months on the diet. Weight decreased from 102.0 kg to 96.0 kg (71.0, 98.0) at 3 months (p=0.042) (-5.9% change). There was an upward trend in total GI symptom scores due to an increase in constipation on the diet in two subjects. In conclusion, changes in biochemical and anthropometric values were similar to that of the current research in this population, and changes in GI symptoms were minimal. Dietary intake of subjects was poor at baseline (lacking in several micronutrients compared to Dietary Guideline recommendations), and remained poor on the diet, providing evidence for continued education by a registered dietitian while on a LCHF modified KD.