Wpływ stanu odżywienia na skuteczność diety ketogennej u dzieci z epilepsją oporną na leki
Influence of baseline nutritional status on ketogenic diet efficacy in children with drug-resistant epilepsy
W skrócie
Badanie wykazało, że stan odżywienia dziecka przed rozpoczęciem diety ketogennej ma wpływ na to, jak dobrze ta dieta będzie działać na zmniejszenie napadów. Dzieci, które przed dietą miały wystarczające spożycie pewnych tłuszczy i minerałów, takich jak magnez, cynk i witamina E, osiągały lepsze wyniki w zmniejszeniu liczby napadów. Naukowcy stwierdzili, że prawidłowe odżywienie na początku leczenia diety ketogennej może poprawiać jej skuteczność u dzieci z epilepsją, która nie reaguje na zwykłe leki.
Oryginalny abstract (angielski)
BACKGROUND: Nutritional status may influence the efficacy of ketogenic diet (KD) therapy in children with drug-resistant epilepsy. METHODS: This study enrolled 43 children (25 girls, 18 boys) with drug-resistant epilepsy. Pre-KD nutritional status was assessed using 24-h diet recalls and 3-day food records compared against Dietary Reference Intakes (DRIs). Seizure reduction (≥70% vs. <70%) at 3 and 6 months was analyzed using Fisher's exact test and Mann-Whitney U test. RESULTS: KD was initiated at 5.41 ± 4.65 years. At 3 months, children with ≥70% seizure reduction (n = 11) had significantly higher mean energy intake from n-3 polyunsaturated fatty acids (PUFA) (2.23% vs. 0.78%, p = 0.021) and n-6 PUFA (8.98% vs. 5.87%, p = 0.018), and lower phosphorus insufficiency (0% vs. 31.25%, p = 0.043) compared to those with <70% reduction. At 6 months, the ≥70% reduction group (n = 17) exhibited lower rates of insufficient magnesium (86.7% vs. 47.1%, p = 0.019), zinc (53.3% vs. 11.8%, p = 0.021), and vitamin E (53.3% vs. 17.6%, p = 0.034) intake. CONCLUSION: Baseline nutritional status, particularly adequate n-3/n-6 PUFA, phosphorus, magnesium, zinc, and vitamin E intake, may enhance KD efficacy in children with drug-resistant epilepsy. Further study with bigger population may be mandatory to lead to more conclusive results. IMPACT: Children under 2 years often respond better to ketogenic diet possibly due to elevated fatty acid oxidation rates. Nutritional status may also influence the efficacy of ketogenic diet therapy in children with drug-resistant epilepsy. Adolescents with drug-resistant epilepsy show the highest rates of insufficient phosphorus, zinc, and vitamin E intake. The ≥70% seizure reduction group exhibited lower rates of insufficient magnesium, zinc, and vitamin E intake. Baseline nutritional status, particularly adequate n-3/n-6 PUFA, phosphorus, magnesium, zinc, and vitamin E intake, showed a positive association with enhanced KD efficacy in children with drug-resistant epilepsy.