Author(s): Whiteley V.J.; Martin-Mcgill K.J.; Schoeler N.E.
Source: Developmental Medicine and Child Neurology; Jan 2019; vol. 61 ; p. 57
Publication Date: Jan 2019
Publication Type(s): Conference Abstract
Available at Developmental Medicine and Child Neurology – from Wiley Online Library Full Collection
Abstract:Objective: To investigate the changes in the types of ketogenic diets (KD) used in the management of refractory epilepsy in the UK and Ireland since 2000. Method(s): An online questionnaire consisting of mixed open and closed questions devised by a consensus group of ketogenic dietitians was circulated to centres across the UK and Ireland and compared to surveys from 2000 and 2010. Result(s): Prior to 2010, only the classical (CKD) and Medium Chain Triglyceride (MCT) KDs were used. In 2000, 59% of patients (from 20 centres) followed the CKD, increasing to 74% in 2010 (22 centres), of which 67% were orally fed. In 2016, 27 centres responded to the survey, with 55.5% of patients following CKD, 32.3% following Modified ketogenic diet (MKD), 9.7% MCT KD and 2.2% Low Glycaemic Index treatment (LGIT). Of those orally feeding; 48.4% MKD, 37.6% CKD, 10.6% MCT and 3.4% LGIT. No centres reported use of The Modified Atkins diet (MAD). Conclusion(s): Despite the lack of published evidence for effectiveness of MKD for epilepsy, almost half of all orally fed patients in this survey are following MKD. Whilst trials have shown CKD and MCT to be of comparable efficacy, and MAD has been shown to be effective, there is a lack of evidence for MKD. MKD is within the scope of ketogenic therapy, as the dietary aim is to induce ketosis. Since 2000, there has been a significant reduction in the use of the CKD. MKD use may have increased as it is viewed to be easier to implement by dietitians, reducing dietetic time required to calculate and educate patients. There is also a perception that a less rigid dietary plan can improve compliance and tolerability. Further research into the effectiveness of MKD would be of benefit to support its ongoing use.