Related Experiment Videos
Growth of children on the ketogenic diet
Eileen P G Vining1, Paula Pyzik, Jane McGrogan
1The Johns Hopkins Medical Institutions, Baltimore, MD, USA. evining@jhmi.edu
Insights
The ketogenic diet can impact growth in children with epilepsy. While generally providing sufficient nutrition, very young children require careful, long-term monitoring for growth parameters.
Area of Science:
- Pediatrics
- Neurology
- Nutritional Science
Background:
- Intractable epilepsy in children often necessitates specialized dietary interventions.
- The ketogenic diet is a recognized treatment for drug-resistant epilepsy.
- Understanding the impact of the ketogenic diet on pediatric growth is crucial for long-term management.
Purpose of the Study:
- To prospectively evaluate the effects of the ketogenic diet on height and weight z scores in children with intractable epilepsy.
- To identify potential differences in growth patterns based on age, sex, or initial weight status.
- To assess the long-term nutritional adequacy of the ketogenic diet for pediatric growth.
Main Methods:
- Prospective cohort study of 237 children with intractable epilepsy commencing the ketogenic diet.
- Regular measurements of height and weight, converted to age- and sex-appropriate z scores.
- Follow-up data collected over a 2-year period, analyzing changes in z scores.
Main Results:
- Initial rapid drop in weight z scores within the first 3 months, followed by stabilization in some children.
- Weight z scores continued to decrease in children initially above the median weight.
- Small initial decrease in height z scores, with larger changes observed by 2 years; no sex-based differences noted.
Conclusions:
- The ketogenic diet can support growth within normal parameters for a defined period.
- Very young children (< 3 years 8 months) may experience poorer growth on the diet.
- Close, long-term monitoring of growth is essential for pediatric patients on the ketogenic diet.
Abstract:
This is a prospective cohort study of 237 children (130 males, 107 females) placed on the ketogenic diet for control of intractable epilepsy (mean age at starting diet 3 years 8 months; age range 2 months to 9 years 10 months); average length of follow-up was 308 days. There were 133 children on the diet at 1 year and 76 at 2 years. Height and weight measurements were converted into age- and sex-appropriate z scores. There was a rapid drop in weight z scores in the first 3 months. After this initial period, the weight z score remained constant in children who started the diet below the median weight for their age and sex, although z scores continued to decrease in children starting above the median. There was a small decrease in height z scores in the first 6 months (<0.5); however, there were larger changes by 2 years. There was no difference based on sex for either height or weight. The ketogenic diet generally provides sufficient nutrition to maintain growth within normal parameters over a defined period. Very young children grow poorly on the diet and should be followed-up carefully over long periods of use.