Dietary-Induced Ketogenesis: Adults Are Not Children
Abstract
:1. Introduction
2. Materials and Methods
- (1)
- A retrospective sample of children treated with a long-term KD in the pediatric neurological department during the years 2009–2016 for either epilepsy or metabolic disorders: GLUT1 deficiency syndrome (GLUT1DS) and pyruvate dehydrogenase deficiency (PDHD). Inclusion criteria were children who received the KD between the ages of six months to 18 years diagnosed with epilepsy who did not respond to at least two types of medication, with a frequency of seizures at least once a day or at least seven seizures per week; treatment with the KD was for over three months. Exclusion criteria included children with refractory epilepsy who had received treatment with KD for less than three months; patients for whom there was a lack of relevant information from the medical records; and children with known metabolic disease associated with lipid metabolism.
- (2)
- A prospective single-institution clinical trial (NCT02149459) [10] amongst adults with newly diagnosed or recurrent high-grade glioma, in which patients received the KD (for a total of eight weeks) prior to, during, and following two or six weeks of radiation therapy. Patients in cohort one received dietary treatment alone, whereas those in cohorts two and three received metformin in addition. Inclusion criteria were patients above the age of 18 years suffering from high-grade glioma (brain tumor). Exclusion criteria included patients with known metabolic disease associated with lipid metabolism, diabetes mellitus, and known severe dyslipidemia.
2.1. Dietary Intervention
2.2. Ketogenic Ratio
2.3. Ketone Bodies
2.4. Statistical Methods
2.5. Ethical Consideration
3. Results
3.1. Subject’s Characteristics
3.2. Dietary Intake Prior and during Diet Intervention
3.3. Anthropometric and Metabolic Parameters
3.4. Associations with Blood Ketone Levels
3.5. Children versus Adults
3.6. Multivariant Mixed-Model Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Parameter | Children (n = 15) | Adults (n = 13) |
---|---|---|
Sex: | ||
Male | 7 (47%) | 8 (61.5%) |
Female | 8 (53%) | 5 (38.5%) |
Mean age (years), SD | 3.0 ± 3.3 | 61.4 ± 5.3 |
Diagnosis: | ||
Epilepsy | 13 (87%) | - |
Metabolic disorder | 2 (13%) | - |
Brain tumor | - | 13 (100%) |
Diet Type: | ||
Classical ketogenic diet | 11 (73%) | |
Modified Atkins diet | 1 (7%) | 13 (100%) |
Combined | 3 (20%) |
Variable | Coefficient | p-Value | CI 95% |
---|---|---|---|
Fat intake (%) | 0.05 | <0.0001 | 0.04, 0.06 |
Carbohydrate intake (%) | −0.05 | <0.0001 | −0.067, −0.04 |
Protein intake (%) | −0.09 | <0.0001 | −0.12, 0.06 |
Calories (kcal) per kg | 0.30 | <0.0001 | 0.02, 0.04 |
Ketogenic ratio | 0.93 | <0.0001 | 0.78, 1.08 |
MCT (ml) per kg | 0.86 | 0.016 | 0.15, 1.5 |
Weight (kg) | −0.03 | <0.0001 | −0.04, −0.02 |
BMI | −0.16 | <0.0001 | −0.21, −0.11 |
Population type, (Adults = 0, Children = 1) | 2.62 | <0.0001 | 2.09, 3.15 |
Variable | Coefficient | p-Value | CI 95% |
---|---|---|---|
Fat intake (%) | 0.05 | 0.006 | 0.014, 0.086 |
Carbohydrate intake (%) | 0.04 | 0.20 | −0.02, 0.11 |
Total calories (kcal per kg) | 0.004 | 0.52 | −0.009, 0.018 |
MCT (mL per kg) | −0.42 | 0.18 | −1.03, 0.20 |
Population type (Adults = 0, Children = 1) | 1.7 | 0.001 | 0.7, 2.68 |
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Porper, K.; Zach, L.; Shpatz, Y.; Ben-Zeev, B.; Tzadok, M.; Jan, E.; Talianski, A.; Champ, C.E.; Symon, Z.; Anikster, Y.; et al. Dietary-Induced Ketogenesis: Adults Are Not Children. Nutrients 2021, 13, 3093. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093093
Porper K, Zach L, Shpatz Y, Ben-Zeev B, Tzadok M, Jan E, Talianski A, Champ CE, Symon Z, Anikster Y, et al. Dietary-Induced Ketogenesis: Adults Are Not Children. Nutrients. 2021; 13(9):3093. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093093
Chicago/Turabian StylePorper, Keren, Leor Zach, Yael Shpatz, Bruria Ben-Zeev, Michal Tzadok, Elisheva Jan, Alisa Talianski, Colin E. Champ, Zvi Symon, Yair Anikster, and et al. 2021. "Dietary-Induced Ketogenesis: Adults Are Not Children" Nutrients 13, no. 9: 3093. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093093