The efficacy of the ketogenic diet - 1998: A prospective evaluation of intervention in 150 children

John M. Freeman, Eileen P.G. Vining, Diana J. Pillas, Paula L. Pyzik, Jane C. Casey, Millicent T. Kelly

Research output: Contribution to journalArticle

Abstract

Objective. The ketogenic diet is a high-fat, low-protein, low- carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to- control seizures. This prospective study sought to determine the ketogenic diet's effectiveness and tolerability in children refractory to today's medications. Methods. One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. Seizure frequency was tabulated from patients' daily seizure calendars and seizure reduction calculated as percentage of baseline frequency. Adverse events and reasons for diet discontinuation were recorded. Results. The children (mean age, 5.3 years), averaged 410 seizures per month before the diet, despite an exposure to a mean of 6.2 antiepileptic medications. Three months after diet initiation, 83% of those starting remained on the diet and 34% had >90% decrease in seizures. At 6 months, 71% still remained on the diet and 32% had a >90% decrease in seizures. At 1 year, 55% remained on the diet and 27% had a >90% decrease in seizure frequency. Most of those discontinuing the diet did so because it was either insufficiently effective or too restrictive. Seven percent stopped because of intercurrent illness. Conclusions. The ketogenic diet should be considered as alternative therapy for children with difficult- to-control seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.

Original languageEnglish (US)
Pages (from-to)1358-1363
Number of pages6
JournalPediatrics
Volume102
Issue number6
StatePublished - Dec 1998

Fingerprint

Ketogenic Diet
Seizures
Diet
Anticonvulsants
Carbohydrate-Restricted Diet
Complementary Therapies
Epilepsy

Keywords

  • Children
  • Epilepsy
  • Ketogenic diet
  • Therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Freeman, J. M., Vining, E. P. G., Pillas, D. J., Pyzik, P. L., Casey, J. C., & Kelly, M. T. (1998). The efficacy of the ketogenic diet - 1998: A prospective evaluation of intervention in 150 children. Pediatrics, 102(6), 1358-1363.

The efficacy of the ketogenic diet - 1998 : A prospective evaluation of intervention in 150 children. / Freeman, John M.; Vining, Eileen P.G.; Pillas, Diana J.; Pyzik, Paula L.; Casey, Jane C.; Kelly, Millicent T.

In: Pediatrics, Vol. 102, No. 6, 12.1998, p. 1358-1363.

Research output: Contribution to journalArticle

Freeman, JM, Vining, EPG, Pillas, DJ, Pyzik, PL, Casey, JC & Kelly, MT 1998, 'The efficacy of the ketogenic diet - 1998: A prospective evaluation of intervention in 150 children', Pediatrics, vol. 102, no. 6, pp. 1358-1363.
Freeman JM, Vining EPG, Pillas DJ, Pyzik PL, Casey JC, Kelly MT. The efficacy of the ketogenic diet - 1998: A prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358-1363.
Freeman, John M. ; Vining, Eileen P.G. ; Pillas, Diana J. ; Pyzik, Paula L. ; Casey, Jane C. ; Kelly, Millicent T. / The efficacy of the ketogenic diet - 1998 : A prospective evaluation of intervention in 150 children. In: Pediatrics. 1998 ; Vol. 102, No. 6. pp. 1358-1363.
@article{61ca7f0ab92e4780bcd197ecdbc06d4f,
title = "The efficacy of the ketogenic diet - 1998: A prospective evaluation of intervention in 150 children",
abstract = "Objective. The ketogenic diet is a high-fat, low-protein, low- carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to- control seizures. This prospective study sought to determine the ketogenic diet's effectiveness and tolerability in children refractory to today's medications. Methods. One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. Seizure frequency was tabulated from patients' daily seizure calendars and seizure reduction calculated as percentage of baseline frequency. Adverse events and reasons for diet discontinuation were recorded. Results. The children (mean age, 5.3 years), averaged 410 seizures per month before the diet, despite an exposure to a mean of 6.2 antiepileptic medications. Three months after diet initiation, 83{\%} of those starting remained on the diet and 34{\%} had >90{\%} decrease in seizures. At 6 months, 71{\%} still remained on the diet and 32{\%} had a >90{\%} decrease in seizures. At 1 year, 55{\%} remained on the diet and 27{\%} had a >90{\%} decrease in seizure frequency. Most of those discontinuing the diet did so because it was either insufficiently effective or too restrictive. Seven percent stopped because of intercurrent illness. Conclusions. The ketogenic diet should be considered as alternative therapy for children with difficult- to-control seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.",
keywords = "Children, Epilepsy, Ketogenic diet, Therapy",
author = "Freeman, {John M.} and Vining, {Eileen P.G.} and Pillas, {Diana J.} and Pyzik, {Paula L.} and Casey, {Jane C.} and Kelly, {Millicent T.}",
year = "1998",
month = "12",
language = "English (US)",
volume = "102",
pages = "1358--1363",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "6",

}

TY - JOUR

T1 - The efficacy of the ketogenic diet - 1998

T2 - A prospective evaluation of intervention in 150 children

AU - Freeman, John M.

AU - Vining, Eileen P.G.

AU - Pillas, Diana J.

AU - Pyzik, Paula L.

AU - Casey, Jane C.

AU - Kelly, Millicent T.

PY - 1998/12

Y1 - 1998/12

N2 - Objective. The ketogenic diet is a high-fat, low-protein, low- carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to- control seizures. This prospective study sought to determine the ketogenic diet's effectiveness and tolerability in children refractory to today's medications. Methods. One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. Seizure frequency was tabulated from patients' daily seizure calendars and seizure reduction calculated as percentage of baseline frequency. Adverse events and reasons for diet discontinuation were recorded. Results. The children (mean age, 5.3 years), averaged 410 seizures per month before the diet, despite an exposure to a mean of 6.2 antiepileptic medications. Three months after diet initiation, 83% of those starting remained on the diet and 34% had >90% decrease in seizures. At 6 months, 71% still remained on the diet and 32% had a >90% decrease in seizures. At 1 year, 55% remained on the diet and 27% had a >90% decrease in seizure frequency. Most of those discontinuing the diet did so because it was either insufficiently effective or too restrictive. Seven percent stopped because of intercurrent illness. Conclusions. The ketogenic diet should be considered as alternative therapy for children with difficult- to-control seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.

AB - Objective. The ketogenic diet is a high-fat, low-protein, low- carbohydrate diet developed in the 1920s for the treatment of children with difficult to control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to- control seizures. This prospective study sought to determine the ketogenic diet's effectiveness and tolerability in children refractory to today's medications. Methods. One hundred fifty consecutive children, ages 1 to 16 years, virtually all of whom continued to have more than two seizures per week despite adequate therapy with at least two anticonvulsant medications, were prospectively enrolled in this study, treated with the ketogenic diet, and followed for a minimum of 1 year. Seizure frequency was tabulated from patients' daily seizure calendars and seizure reduction calculated as percentage of baseline frequency. Adverse events and reasons for diet discontinuation were recorded. Results. The children (mean age, 5.3 years), averaged 410 seizures per month before the diet, despite an exposure to a mean of 6.2 antiepileptic medications. Three months after diet initiation, 83% of those starting remained on the diet and 34% had >90% decrease in seizures. At 6 months, 71% still remained on the diet and 32% had a >90% decrease in seizures. At 1 year, 55% remained on the diet and 27% had a >90% decrease in seizure frequency. Most of those discontinuing the diet did so because it was either insufficiently effective or too restrictive. Seven percent stopped because of intercurrent illness. Conclusions. The ketogenic diet should be considered as alternative therapy for children with difficult- to-control seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.

KW - Children

KW - Epilepsy

KW - Ketogenic diet

KW - Therapy

UR - http://www.scopus.com/inward/record.url?scp=0031773486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031773486&partnerID=8YFLogxK

M3 - Article

C2 - 9832569

AN - SCOPUS:0031773486

VL - 102

SP - 1358

EP - 1363

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6

ER -