Abstract
Data on the impact of the ketogenic diet (KD) on children’s growth remain controversial. Here, we retrospectively investigated the occurrence of linear growth retardation in 34 children (47% males; age range: 2−17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20) who had been treated with the KD for 12 months. The general characteristics of children with and without growth retardation were also compared. All participants received a full-calorie, traditional KD supplemented with vitamins, minerals, and citrate. Most children (80%; 11/14 in the DRE subgroup and 16/20 in the GLUT1-DS subgroup) treated with the KD did not show growth retardation at 12 months. Although participants with and without delay of growth did not differ in terms of baseline clinical characteristics, dietary prescriptions, or supplementation patterns, marked ketosis at 12 months tended to occur more frequently in the latter group. Altogether, our results indicate that growth retardation may occur in a minority of children treated with the KD. However, further research is required to identify children at risk and to clarify how increased ketones levels may affect endocrine pathways regulating growth during KD administration.
Highlights
The ketogenic diet (KD) is considered a valuable non-pharmacological therapeutic option for children with drug-resistant epilepsy (DRE) [1] but it represents the mainstay of treatment for glucose transporter type 1 deficiency syndrome (GLUT1-DS, OMIM 606777) [2]
Because patients with GLUT1-DS are expected to require a lifelong assumption of the KD, data on its potential consequences on children’s growth in this clinical population are eagerly awaited. Starting from these premises, we retrospectively investigated the occurrence of linear growth retardation in 34 children diagnosed with DRE (n = 14) or GLUT1-DS
Ten patients with DRE were on multiple anti-epileptic drugs (AEDs) and their pharmacological treatment was not modified throughout the study
Summary
The ketogenic diet (KD) is considered a valuable non-pharmacological therapeutic option for children with drug-resistant epilepsy (DRE) [1] but it represents the mainstay of treatment for glucose transporter type 1 deficiency syndrome (GLUT1-DS, OMIM 606777) [2]. Among the potential long-term consequences, recent years have witnessed a remarkable interest on the possible effects of the KD on children’s growth. Both retrospective [5,6] and prospective [7,8] investigations with follow-up periods up to six months failed to identify a negative impact on growth percentiles. Such discrepancies clearly indicate that this issue deserves further scrutiny
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