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Nutritional factors and anticonvulsant therapies: effect on growth in children with epilepsy
H L Kurowski1, S M Gospe, F J Zeman
1Department of Nutrition, University of California, Davis 95616.
Insights
Epileptic children taking carbamazepine or valproic acid showed normal linear growth. Low dietary zinc intake did not impact height, and medication duration did not affect weight in this study.
Area of Science:
- Pediatric Endocrinology
- Neurodevelopmental Disorders
- Clinical Nutrition
Background:
- Epilepsy affects children's growth and development.
- Anticonvulsant medications like carbamazepine and valproic acid may influence growth parameters.
- Nutritional factors, including zinc intake, are crucial for child development.
Purpose of the Study:
- To investigate the factors influencing growth in epileptic children before puberty.
- To compare growth and nutritional status between children taking carbamazepine versus valproic acid.
- To assess the impact of dietary zinc intake and anticonvulsant therapy on linear growth and weight.
Main Methods:
- Cross-sectional study of 32 epileptic children, divided into carbamazepine and valproic acid groups.
- Assessment of dietary intake (energy, iron, zinc), hemoglobin, and serum zinc.
- Comparison of height and weight with National Center for Health Statistics growth charts.
- Statistical analyses including Student's t test, ANCOVA, and stepwise regression.
Main Results:
- No significant differences in height or weight were observed between the two drug groups.
- Linear growth was within normal ranges for all participants.
- Low dietary zinc intake (64-87% RDA) was not associated with reduced height.
- Neither duration nor total intake of anticonvulsants significantly affected weight, contrary to expectations for valproic acid.
Conclusions:
- Carbamazepine and valproic acid did not significantly impact linear growth or weight in this cohort of epileptic children.
- Dietary zinc intake, even when below recommendations, did not impede height.
- Further research is needed to understand the weight-regulating mechanisms of valproic acid in pediatric epilepsy.
Abstract:
Factors influencing growth before puberty were examined in a group of 32 epileptic children in a cross-sectional investigation. Participants in the study were divided into two groups according to what anticonvulsant drug, carbamazepine or valproic acid, they were currently taking. Dietary intakes of energy, iron, and zinc were assessed and hemoglobin and serum zinc concentrations were evaluated. Measurements of height and weight were compared with standard growth charts prepared by the National Center for Health Statistics, Hyattsville, MD. A Student's t test comparison was made along with analyses of covariance and stepwise regression, and no significant differences were found between the two groups of children in terms of height or weight. Linear growth was normal. We found that low dietary zinc intake, 64-87% of the recommended dietary allowance, was not associated with reduced height in children. In addition, neither the number of years taking anticonvulsant medication nor the total amount of drug intake had a significant effect on weight. This was an unanticipated result because valproic acid has been associated with weight gain because of increased appetite.
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