648:(patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free. At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.
469:, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.
1370:(MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate, leading to more food choices and larger portion sizes. The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil. Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant. The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by
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achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.
1107:
1135:, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil, or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas, and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower, and green beans are all equivalent. Fresh, canned, or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic
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started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or
1499:
310:
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three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions. This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.
1515:
1569:). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.
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996:" restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.
568:, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research. A multicentre prospective study began in 1994; the results were presented to the American Epilepsy Society in 1996 and were published in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV drama film,
663:
of diets or ways of introducing them to make them more tolerable. In the largest trial of the ketogenic diet with a non-diet control, nearly 38% of the children and young people had half or fewer seizures with the diet compared to 6% with the group not assigned to the diet. Two large trials of the
Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.
542:
into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children. The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.
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29:
515:
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must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory, so calculating macronutrients such as fat, protein and carbohydrates can be difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.
5010:
5040:
688:
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866:, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone. About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as
1007:(which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks. The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness. The level of parental education and commitment required is higher than with medication.
1771:
5020:
1757:
1647:, but cannot do this by using fatty acids. Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the
94:. Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists after discontinuing the diet. Some evidence shows that adults with epilepsy may benefit from the diet and that a less strict regimen, such as a modified
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fat content. Although it is also a high-fat diet (with approximately 60% calories from fat), the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day. However, the types of carbohydrates consumed are restricted to those that have a
1697:, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet. This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.
1123:
require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be
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About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether. Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or
1030:
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are
972:
The Johns
Hopkins Hospital protocol for initiating the classic ketogenic diet has been widely adopted. It involves a consultation with the patient and their caregivers and, later, a short hospital admission. Because of the risk of complications during ketogenic diet initiation, most centres begin the
963:
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging
662:
systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures. Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types
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devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated
1451:
In theory, there are no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people
1408:
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009)
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levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet, which occurs because the absorption of the limited carbohydrates is slowed by the high
1386:
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients. While the strength of evidence is low for the modified Atkins, it has been known to show seizure freedom in some infants. Few adverse effects have been reported,
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for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet).
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in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis
1021:
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the
666:
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, and the side effects relatively mild. However, many patients gave up the diet,
353:
The first modern study of fasting as a treatment for epilepsy was in France in 1911. Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with
300:
to treat epilepsy. Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs. Most individuals with epilepsy can successfully control their seizures with medication. However, 25–30% fail to achieve such control despite trying a number of different drugs.
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lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary
1603:
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for
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First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns
Hopkins Hospital modified the Atkins diet by removing the aim of
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convention. He had seen
Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite having studied the patients for only a short time. Further studies in the 1920s indicated that seizures generally returned after the fast.
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Kossoff EH, Zupec-Kania BA, Auvin S, Ballaban-Gil KR, Christina
Bergqvist AG, Blackford R, Buchhalter JR, Caraballo RH, Cross JH, Dahlin MG, Donner EJ, Guzel O, Jehle RS, Klepper J, Kang HC, Lambrechts DA, Liu YMC, Nathan JK, Nordli DR Jr, Pfeifer HH, Rho JM, Scheffer IE, Sharma S, Stafstrom CE,
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Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a
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do not eat root vegetables. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in
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Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and
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A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several
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In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit, and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a
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By 2007, the ketogenic diet was available from around 75 centres in 45 countries, and less restrictive variants, such as the modified Atkins diet, were in use, particularly among older children and adults. The ketogenic diet was also under investigation for the treatment of a wide variety of
878:) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone. The stones are treatable and do not justify discontinuation of the diet. Around half of clinics give oral
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The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients. Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been
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containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an
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In Asia, the traditional diet includes rice and noodles as the main source of energy, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: for instance, Hindus
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seen more frequently, with the initial visit held after just two to four weeks. A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital
632:, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions. Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.
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Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%. The diet is recommended earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include
1681:, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the
830:, holistic, or all-natural treatment. As with any serious medical therapy, it may result in complications, although these are generally less severe and less frequent than with anticonvulsant medication or surgery. Common but easily treatable short-term side effects include
462:) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.
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powdered formula, such as KetoCal, into a liquid feed. Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula. Some studies have found this liquid feed to be more efficacious and associated with lower total
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artificially sweetened vanilla flavour and is suitable for tube or oral feeding. Other formula products include KetoVolve and
Ketonia. Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.
805:
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the
1628:). Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.
587:
ineffective. Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug. Adolescents and adults may also benefit from the diet, though compliance with oral diet (vs tube fed) remains a problem.
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to all ketogenic diet patients, with some evidence that this reduces the incidence of stone formation. However, this has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
777:, which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication. However, it is absolutely
991:
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal. On admission, only calorie- and caffeine-free fluids are allowed until dinner, which consists of
850:
by around 30%. This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio. Supplements are necessary to counter the dietary deficiency of many
125:
to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective
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though cholesterol is increased and the diet has not been studied long term. Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favorably with the traditional ketogenic diet.
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treatment and the modified Atkins diet—are more appropriate for adolescents and adults, mainly due to better adherence. A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and others who are
793:. Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to
2290:
Cai QY, Zhou ZJ, Luo R, Gan J, Li SP, Mu DZ, Wan CM. Safety and tolerability of the ketogenic diet used for the treatment of refractory childhood epilepsy: a systematic review of published prospective studies. World J Pediatr. 2017 Dec;13(6):528–536.
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are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect. This is performed using ketone test strips containing
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patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected. Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.
1713:) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.
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30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an
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Experts on the ketogenic diet recommend it be strongly considered for children with uncontrolled epilepsy who have tried and failed two anticonvulsant drugs; most children who start the ketogenic diet have failed at least three times this
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Musa-Veloso K, Cunnane SC. Measuring and interpreting ketosis and fatty acid profiles in patients on a high-fat ketogenic diet. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. pp. 129–141.
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are more likely to become seizure-free with surgery than with the ketogenic diet. About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. The two less restrictive dietary variants—the low
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Kossoff E. Is there a role for the ketogenic diet beyond childhood? In: Freeman J, Veggiotti P, Lanzi G, Tagliabue A, Perucca E. The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res. 2006 Feb;68(2):145–180.
159:, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.
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Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants
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accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.
655:. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients. It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.
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levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight. Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as
529:(MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides). MCTs are more efficiently absorbed and are rapidly transported to the liver via the
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Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet – 1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–1363.
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Zupec-Kania B, Werner RR, Zupanc ML. Clinical Use of the
Ketogenic Diet – The Dietitian's Role. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. pp. 63–81.
501:
in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time, restricted to difficult cases such as
406:, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $ 5,000 to study "the ketosis of starvation". As professor of paediatrics at
130:
medications. This classic ketogenic diet contains a 4:1 ketogenic ratio or ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and
608:, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a
560:. The two-year-old had epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to
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drugs have failed to control it. About 60% of patients achieve control of their epilepsy with the first drug they use, whereas around 30% do not achieve control with drugs. When drugs fail, other options include
1989:
Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg,
1994:
and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1). The eggnog may also be cooked to make a custard, or frozen to make ice
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The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely,
595:
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a
338:. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis. In the same collection, the author of
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Muzykewicz DA, Lyczkowski DA, Memon N, Conant KD, Pfeifer HH, Thiele EA. Efficacy, safety, and tolerability of the low glycemic index treatment in pediatric epilepsy. Epilepsia. 2009 May;50(5):1118–1126.
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and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.
604:) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from
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On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through
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Kossoff EH, Freeman JM. The ketogenic diet – the physician's perspective. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. pp. 53–61.
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Temkin O. The falling sickness: a history of epilepsy from the Greeks to the beginnings of modern neurology. 2nd ed. Baltimore: Johns
Hopkins University Press; 1971. pp. 33, 57, 66–67, 71, 78.
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1018:, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.
612:(the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as
2623:
Thiele EA, Turner Z, Vaccarezza MM, van der Louw EJTM, Veggiotti P, Wheless JW, Wirrell EC; Charlie
Foundation; Matthew's Friends; Practice Committee of the Child Neurology Society.
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Porta N, Vallée L, Lecointe C, Bouchaert E, Staels B, Bordet R, Auvin S. Fenofibrate, a peroxisome proliferator-activated receptor-alpha agonist, exerts anticonvulsive properties.
3165:. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K, Amemiya A, editors. GeneReviews. Seattle (WA): University of Washington, Seattle; 1993–2018. 2002 Jul 30 .
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Bergqvist AGC. Indications and
Contraindications of the Ketogenic diet. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004. pp. 53–61.
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Henderson CB, Filloux FM, Alder SC, Lyon JL, Caplin DA. Efficacy of the ketogenic diet as a treatment option for epilepsy: meta-analysis. J Child Neurol. 2006 Mar;21(3):193–198.
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and calcium with vitamin D. A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:
960:
who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.
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inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.
1093:). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
651:
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as
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537:. The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971,
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reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.
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267:(spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic
2774:
Hemingway C, Freeman JM, Pillas DJ, Pyzik PL. The ketogenic diet: a 3- to 6-year follow-up of 150 children enrolled prospectively. Pediatrics. 2001 Oct;108(4):898–905.
3130:
Mastriani KS, Williams VC, Hulsey TC, Wheless JW, Maria BL. Evidence-based versus reported epilepsy management practices. J Child Neurol. 2008 Feb 15;23(5):507–514.
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988:
is obtained and the parameters of the diet selected: the ketogenic ratio of fat to combined protein and carbohydrate, the calorie requirements and the fluid intake.
2337:
3581:
2381:, Marie A. La lutte contre l'epilepsie par la desintoxication et par la reeducation alimentaire. Rev Ther med-Chirurg. 1911; 78: 8–13. As cited by Bailey (2005).
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shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an
2100:
2065:
2625:
Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group
1068:. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.
2249:
Stafstrom CE. An introduction to seizures and epilepsy. In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004.
916:
Many institutions traditionally restricted the water intake of patients on the diet to 80% of normal daily needs; this practice is no longer encouraged.
377:, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the
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number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment
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2711:
2137:
370:
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describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink. The royal physician
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190:. The foundation sponsored a research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.
2995:
3388:
2802:
450:), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet. Dr.
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166:, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation for Ketogenic Therapies to further promote
3723:
3513:
3485:
3281:
393:
claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent
86:, the latter passing into the brain and replacing glucose as an energy source. An elevated level of ketone bodies in the blood (a state called
3984:
3849:
Broom GM, et al. The ketogenic diet as a potential treatment and prevention strategy for Alzheimer's disease. Nutrition. 2019 Apr;60:118–121.
3603:
3337:
2759:
1612:
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include
458:, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (
20:
1128:
must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.
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3666:
2177:
Zupec-Kania BA, Spellman E. An overview of the ketogenic diet for pediatric epilepsy. Nutr Clin Pract. 2008 Dec–2009 Jan;23(6):589–596.
1585:
2916:
19:
This article is about a dietary therapy for epilepsy. For information on ketogenic diets as a lifestyle choice or for weight loss, see
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Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group.
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2511:
3183:
2627:
790:
770:
3797:
3762:
3099:
2474:. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008 Jun;7(6):500–506.
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followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the
1035:
and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.
1457:
2659:
Husari KS, Cervenka MC. The ketogenic diet all grown up-Ketogenic diet therapies for adults. Epilepsy Res. 2020 May;162:106319.
5077:
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Kossoff EH, Zupec-Kania BA, Rho JM. Ketogenic diets: an update for child neurologists. J Child Neurol. 2009 Aug;24(8):979–988.
782:
3682:
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2923:. National Institute for Health and Care Excellence (NICE). Published January 2012. Updated February 2016. Cited March 2018.
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2349:
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must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a
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for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of
4405:
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Römer M, et al. The use of ketogenic diets in cancer patients: a systematic review. Clin Exp Med. 2021 Nov;21(4):501–536.
3076:
2334:
1726:
867:
561:
202:
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The ketogenic diet has been studied for potential therapeutic use in various neurological disorders other than epilepsy:
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1573:
902:
Hypocitraturia: the urine has an abnormally low concentration of citrate, which normally helps to dissolve free calcium.
863:
766:
398:
3569:
3158:
503:
4970:
4950:
4082:
2439:
Huttenlocher PR, Wilbourn AJ, Signore JM. Medium-chain triglycerides as a therapy for intractable childhood epilepsy.
1131:
A computer program such as KetoCalculator may be used to help generate recipes. The meals often have four components:
621:
613:
255:, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the
3242:
Bergqvist AG. Long-term monitoring of the ketogenic diet: Do's and Don'ts. Epilepsy Res. 2011 Aug 18;100(3):261–266.
2415:
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also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.
858:
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and
574:, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.
296:
dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of
271:, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three
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Bailey EE, Pfeifer HH, Thiele EA. The use of diet in the treatment of epilepsy. Epilepsy Behav. 2005 Feb;6(1):4–8.
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739:
735:
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of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.
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de Boer HM, Mula M, Sander JW. The global burden and stigma of epilepsy. Epilepsy Behav. 2008 May;12(4):540–546.
2097:
1044:, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).
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526:
518:
144:
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Guideline 81, Diagnosis and management of epilepsies in children and young people. A national clinical guideline
2762: – JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
1014:
clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of
354:
the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication,
4955:
3026:
Kossoff EH, McGrogan JR, Freeman JM. Benefits of an all-liquid ketogenic diet. Epilepsia. 2004 Sep;45(9):1163.
2062:
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Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics. 2007 Mar;119(3):535–543.
1655:
1593:
1504:
609:
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1648:
240:, affecting around 50 million people worldwide. It is diagnosed in a person having recurrent, unprovoked
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For this group, and for children in particular, the diet has once again found a role in epilepsy management.
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140:
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in Scotland, England, and Wales and reimbursed by nearly all US insurance companies. Children with a focal
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The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with
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427:
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210:
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Kim DY, Rho JM. The ketogenic diet and epilepsy. Curr Opin Clin Nutr Metab Care. 2008 Mar;11(2):113–120.
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4873:
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Optimal management of seizures associated with tuberous sclerosis complex: current and emerging options.
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Ketogenic diet for treatment of intractable epilepsy in adults: A meta-analysis of observational studies
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953:
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466:
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declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."
327:
194:
48:
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2344:(PDF). In: Stafstrom CE, Rho JM, editors. Epilepsy and the ketogenic diet. Totowa: Humana Press; 2004.
135:, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts,
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Grimes DR, O'Riordan E (November 2023). "Starving cancer and other dangerous dietary misconceptions".
4903:
4878:
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Decreased relative efficacy of the ketogenic diet for children with surgically approachable epilepsy.
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1286:
1082:
977:
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451:
118:
111:
103:
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4908:
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51:
dietary therapy that in conventional medicine is used mainly to treat hard-to-control (refractory)
5039:
1922:
of 9 and 4 kcal/g for fat and combined carbohydrate and water respectively. The equation is:
1421:
Measuring KetoCal – a powdered formula for administering the classic ketogenic diet
940:
that involves participants from various disciplines. Team members include a registered paediatric
708:(a single point of brain abnormality causing the epilepsy) who would make suitable candidates for
309:
4843:
4549:
4318:
4290:
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4158:
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Kossoff EH, McGrogan JR. Worldwide use of the ketogenic diet. Epilepsia. 2005 Feb;46(2):280–289.
1613:
1558:
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1125:
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762:
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497:(Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of
486:
403:
322:
321:
treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the
167:
3334:
378:
1745:. As of 2022 there is no clinical evidence that a ketogenic diet is effective to treat cancer.
1514:
5067:
4913:
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3888:
3857:
3833:
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3497:
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3365:
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3251:
3221:
3195:
3166:
3139:
3115:
3059:
3035:
3011:
2948:
2924:
2894:
2877:
2858:
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2817:
2783:
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2584:
2527:
2483:
2452:
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2300:
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2250:
2224:
2186:
2153:
2115:
2081:
2039:
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896:
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701:
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and followed-up by a report published in 2001. As with most studies of the ketogenic diet, no
478:
415:
362:
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132:
91:
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3698:
3624:
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3517:
3489:
3440:
3392:
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3310:
3285:
3243:
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3131:
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3027:
3003:
2913:
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2834:
2810:
2775:
2743:
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2635:
2576:
2519:
2475:
2444:
2391:
2378:
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2267:
2216:
2178:
2145:
2108:
2073:
2031:
1554:
1520:
1371:
949:
895:) occurs due to increased bone demineralisation with acidosis. Bones are mainly composed of
778:
743:
731:
709:
640:
A study with an intent-to-treat prospective design was published in 1998 by a team from the
534:
498:
366:
277:
245:
183:
67:
2508:
1685:
to remain stable in the face of increased energy demand during a seizure, and may confer a
1010:
Variations on the Johns Hopkins protocol are common. The initiation can be performed using
920:
In adolescents and adults, common side effects reported include weight loss, constipation,
350:
believed an "attenuating diet" might afford a cure in mild cases and be helpful in others.
4606:
4574:
4491:
4420:
4415:
4270:
4237:
4181:
4042:
3801:
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3654:
3610:
3436:
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3162:
3103:
3083:
2999:
2979:
2920:
2865:
2806:
2715:
2631:
2515:
2422:
2341:
2212:
2141:
2104:
2069:
1762:
1686:
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1600:(such as a neurotransmitter). These channels are another target for anticonvulsant drugs.
1439:
1401:
1310:
1168:
985:
883:
774:
727:
714:
550:
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's
75:
2624:
1827:
in this article refers to going without food while maintaining calorie-free fluid intake.
3885:
3774:
3543:
Kossoff EH, Dorward JL. The modified Atkins diet. Epilepsia. 2008 Nov;49 Suppl 8:37–41.
3096:
1553:. The propagation of this impulse from one neuron to another is typically controlled by
1106:
5013:
4975:
4698:
4559:
4308:
4303:
4019:
3794:
3759:
3731:
3486:
Discontinuing the ketogenic diet in seizure-free children: recurrence and risk factors.
1919:
1742:
1710:
1674:
1136:
981:
892:
843:
605:
318:
272:
214:
193:
Possible therapeutic uses for the ketogenic diet have been studied for many additional
127:
3917:
2479:
1561:
between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by
1003:
are checked several times daily and the patient is monitored for signs of symptomatic
556:
television programme reported the case of Charlie Abrahams, son of Hollywood producer
5061:
4688:
4648:
4638:
4584:
4501:
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4265:
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4247:
4163:
3829:
3702:
3628:
3548:
3521:
3493:
3444:
3396:
3314:
3247:
3031:
2723:
2664:
2149:
1784:
1706:
1652:
1625:
1621:
1577:
1550:
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1396:
1144:
1041:
852:
839:
815:
652:
645:
482:
447:
394:
260:
83:
5033:
4011:
1951:. For example, a 4:1 diet derives 90% of calories from fat. The inverse equation is
4430:
4380:
4275:
4046:
2077:
1678:
1659:
1636:
1530:
1426:
1164:
1053:
925:
921:
859:
831:
794:
719:
597:
557:
551:
490:
439:
411:
343:
187:
171:
163:
148:
99:
56:
3424:
Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R,
3007:
1110:
The ratio of calorific contributions from food components of four diets, by weight
485:(1912), the ketogenic diet was widely used and studied. This changed in 1938 when
3361:
899:. The phosphate reacts with the acid, and the calcium is excreted by the kidneys.
477:
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative
5043:
4802:
4526:
4516:
4352:
4107:
2523:
2395:
2271:
1776:
1734:
1694:
1589:
1435:
1417:
1304:
1000:
945:
676:
672:
629:
455:
206:
156:
122:
95:
3877:
2814:
155:. A variant of the classic diet known as the MCT ketogenic diet uses a form of
4898:
4888:
4778:
4754:
4713:
4683:
4668:
4633:
4615:
4521:
4455:
3854:
3191:
3155:
2296:
1752:
1640:
1347:
1152:
1120:
1011:
957:
875:
871:
811:
754:
and clinical practice. One major factor may be the lack of adequately trained
687:
79:
3647:
3289:
3135:
2580:
2205:
2182:
2112:
1894:
reduction is defined here to mean a 50–90% decrease in seizure frequency. An
4990:
4883:
4825:
4820:
4815:
4810:
4741:
4708:
4663:
4653:
4592:
4569:
4564:
4506:
4496:
4460:
4097:
4077:
2838:
2747:
2503:
Vining EP, Freeman JM, Ballaban-Gil K, Camfield CS, Camfield PR, Holmes GL,
1991:
1702:
1651:. However, the liver can use long-chain fatty acids to synthesise the three
1572:
The nerve impulse is characterised by a great influx of sodium ions through
1566:
1395:
The low glycemic index treatment (LGIT) is an attempt to achieve the stable
1160:
1115:
1036:
1032:
941:
906:
827:
786:
755:
494:
459:
410:, John E. Howland used the money to fund research undertaken by neurologist
386:
229:
152:
33:
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3738:
3710:
3636:
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3501:
3452:
3404:
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3322:
3297:
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3170:
3143:
3119:
3039:
3015:
2881:
2846:
2821:
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2730:
2672:
2647:
2588:
2487:
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2403:
2304:
2279:
2228:
2190:
2157:
2119:
2085:
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2035:
1047:
A short-lived increase in seizure frequency may occur during illness or if
514:
3809:
2755:
2531:
2456:
4918:
4853:
4848:
4746:
4718:
4643:
4628:
4541:
4252:
4132:
3724:
The modified Atkins diet: a potential treatment for developing countries.
1086:
1065:
1057:
952:
who is familiar with childhood epilepsy. Additional help may come from a
835:
624:
has changed. In older protocols, the diet was initiated with a prolonged
431:
268:
233:
225:
107:
52:
2220:
1592:
is governed by a "gate" which is opened by either a voltage change or a
1565:, or GABA) or they can excite the neuron into firing (primarily done by
121:
provides just enough protein for body growth and repair, and sufficient
4985:
4945:
4835:
4733:
4693:
4673:
4658:
4623:
4227:
4117:
4102:
4072:
4067:
3111:
2873:
2639:
1807:
1663:
1536:
1465:
1156:
1004:
625:
443:
297:
241:
87:
63:
44:
1770:
910:
369:, popularised the use of fasting to restore health. His disciple, the
28:
4893:
4858:
4794:
4786:
4723:
4703:
4678:
4087:
3988:
3943:
The Ketogenic Diet: A Treatment for Children and Others with Epilepsy
3685:. Keto News. Epilepsy.com. Updated July 2009. Cited 29 November 2009.
3568:
Treadwell, Jonathan R.; Wu, Mingche; Tsou, Amy Y. (25 October 2022).
2470:
Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G,
1730:
1682:
1061:
1048:
993:
705:
248:
237:
3999:
1366:
Normal dietary fat contains mostly long-chain triglycerides (LCTs).
3383:
Kossoff EH, Laux LC, Blackford R, Morrison PF, Pyzik PL, Hamdy RM,
313:
A news report of Dr Hugh Conklin's "water diet" treatment from 1922
3993:
1639:(the energy-producing parts of the cell). Humans can convert some
1469:
America and Europe. However, they appear to be just as effective.
1416:
1132:
1105:
686:
513:
347:
308:
256:
136:
71:
70:. However, if only a little carbohydrate remains in the diet, the
27:
3282:
Kidney stones and the ketogenic diet: risk factors and prevention
2982:(PDF). Pract Gastroenterol. 2006 Jun;29(6):53, 56, 58, 61–62, 64.
814:, and that the diet may be less successful in children receiving
761:
Because the ketogenic diet alters the body's metabolism, it is a
4923:
4280:
4232:
4092:
66:, which is then transported around the body and is important in
4015:
2061:
Martin-McGill KJ, Jackson CF, Bresnahan R, Levy RG, Cooper PN.
1147:
and only contains tiny portions of fresh fruit and vegetables,
55:
in children. The diet forces the body to burn fats rather than
3514:
KetoCalculator: a web-based calculator for the ketogenic diet.
3572:(Report). Agency for Healthcare Research and Quality (AHRQ).
2800:
Ketogenic diets: evidence for short- and long-term efficacy.
1089:
shows focal abnormalities (for example, as in children with
389:
in mainstream practice. In 1916, a Dr McMurray wrote to the
3613:. Epilepsy Foundation. 22 August 2013. Cited 31 March 2018.
2973:
The ketogenic and Atkins diets: recipes for seizure control
139:, and butter. Most dietary fat is made of molecules called
2509:
A multicenter study of the efficacy of the ketogenic diet.
1283:
4 g strawberries (about half of one small strawberry)
3389:
When do seizures usually improve with the ketogenic diet?
2857:
Liu H, Yang Y, Wang Y, Tang H, Zhang F, Zhang Y, Zhao Y.
2206:
Ketogenic diets, mitochondria, and neurological diseases.
948:
who is experienced in offering the ketogenic diet; and a
758:
who are needed to administer a ketogenic diet programme.
3795:
Fasting: the history, pathophysiology and complications.
3186:(PDF). Curr Neurol Neurosci Rep. 2006 Jul;6(4):332–340.
3958:
The Ketogenic Bible: The Authoritative Guide to Ketosis
3280:
Sampath A, Kossoff EH, Furth SL, Pyzik PL, Vining EP.
2416:
Do ketogenic diets work for adults with epilepsy? Yes!
1429:
can also be given a ketogenic diet. Parents make up a
973:
diet under close medical supervision in the hospital.
3981:, from the Harvard University School of Public Health
2947:(PDF). Edinburgh: Royal College of Physicians; 2005.
1914:
can be converted to the portion of calories from fat
4006:
Epilepsy.com: Dietary Therapies & Ketogenic News
3793:
Kerndt PR, Naughton JL, Driscoll CE, Loxterkamp DA.
3106:
Neuropsychiatr Dis Treat. 2014 Oct 23;10:2021–2030.
2072:
Cochrane Database Syst Rev. 2018 Nov 7;11:CD001903.
1670:
substitute for blood glucose as a source of energy.
1151:
cereals, and calcium-rich foods. In particular, the
397:
Henry Rawle Geyelin reported his experiences to the
259:, consciousness, or a combination. A seizure can be
4936:
4834:
4732:
4614:
4605:
4583:
4540:
4474:
4366:
4345:
4317:
4289:
4246:
4195:
4172:
4146:
4125:
4116:
3086:
Guardian. 2008 Aug 15;Sect. Health & wellbeing.
2435:
2433:
2431:
909:from dissolving, leading to crystals that act as a
98:, is similarly effective. Side effects may include
62:Normally, carbohydrates in food are converted into
3215:
3213:
3211:
3209:
3207:
2991:Stainman RS, Turner Z, Rubenstein JE, Kossoff EH.
2173:
2171:
2169:
2167:
2165:
2135:Medium-chain triglyceride (MCT) ketogenic therapy.
2057:
2055:
2053:
2051:
434:. He reported that three water-soluble compounds,
2425:epilepsy.com. 2007, March. Cited 24 October 2009.
944:who coordinates the diet programme; a paediatric
750:possible explanations exist for this gap between
600:of patients recently treated by the physician (a
3722:Kossoff EH, Dorward JL, Molinero MR, Holden KR.
3238:
3236:
3234:
2770:
2768:
2703:
2701:
2571:
2569:
2567:
2565:
2563:
2561:
2559:
1866:De venae sect. adv. Erasistrateos Romae degentes
4008:, information and regular research news updates
3539:
3537:
3480:
3478:
3420:
3418:
3416:
3414:
3412:
3379:
3377:
3284:(PDF). J Child Neurol. 2007 Apr;22(4):375–378.
3054:
3052:
3050:
3048:
2699:
2697:
2695:
2693:
2691:
2689:
2687:
2685:
2683:
2681:
2618:
2616:
2557:
2555:
2553:
2551:
2549:
2547:
2545:
2543:
2541:
2539:
2245:
2243:
2241:
2239:
2237:
1211:9 g slice of apple (about 5% of one apple)
3941:Freeman JM, Kossoff EH, Freeman JB, Kelly MT.
3758:Hartman AL, Gasior M, Vining EP, Rogawski MA.
3754:
3752:
3750:
3748:
3746:
3693:
3691:
3276:
3274:
3272:
3270:
3268:
3266:
3264:
3156:Glucose Transporter Type 1 Deficiency Syndrome
2614:
2612:
2610:
2608:
2606:
2604:
2602:
2600:
2598:
2596:
2329:
2327:
2325:
2323:
2321:
2319:
2317:
2315:
2313:
263:(confined to a specific part of the brain) or
4027:
3677:
3675:
2967:
2965:
2963:
2961:
2943:Scottish Intercollegiate Guidelines Network.
2499:
2497:
2495:
2026:
2024:
2022:
2020:
2018:
2016:
2014:
2012:
2010:
8:
3760:The neuropharmacology of the ketogenic diet.
3657:. Nutricia North America. Cited 8 June 2018.
2634:. Epilepsia Open. 2018 May 21;3(2):175–192.
2063:Ketogenic diets for drug-resistant epilepsy.
1119:Highly active children or those with muscle
170:. Publicity included an appearance on NBC's
3979:Diet Review: Ketogenic Diet for Weight Loss
2466:
2464:
1810:as a unit of measure (4.1868 kJ), and
781:in the treatment of other diseases such as
4611:
4122:
4034:
4020:
4012:
3391:(PDF). Epilepsia. 2008 Feb;49(2):329–333.
3184:State of the ketogenic diet(s) in epilepsy
2809:Neurotherapeutics. 2009 Apr;6(2):406–414.
2200:
2198:
1666:. These ketone bodies enter the brain and
1438:than a solid ketogenic diet. KetoCal is a
976:At the initial consultation, patients are
147:(MCTs)—made from fatty acids with shorter
3960:. 1st ed. Victory Belt Publishing; 2017.
2868:. Epilepsia Open. 2018 Feb 19;3(1):9–17.
2129:
2127:
775:glucose transporter 1 deficiency syndrome
385:Conklin's fasting therapy was adopted by
3769:Pediatr Neurol. 2007 May;36(5):281–292.
2518:Arch Neurol. 1998 Nov;55(11):1433–1437.
2335:History and origin of the ketogenic diet
2215:J Lipid Res. 2014 Nov;55(11):2211–2228.
1173:
4002:, a US charity and information resource
3996:, a UK charity and information resource
3669:. Solace Nutrition. Cited 17 June 2013.
2939:
2937:
2909:
2907:
2709:Clinical aspects of the ketogenic diet.
2006:
1906:
1904:
1795:
826:The ketogenic diet is not considered a
3516:Epilepsia. 2008 Nov;49 Suppl 8:14–16.
2144:Epilepsia. 2008 Nov;49 Suppl 8:33–36.
1545:The brain is composed of a network of
1114:The ketogenic diet is calculated by a
771:pyruvate dehydrogenase (E1) deficiency
3804:West J Med. 1982 Nov;137(5):379–399.
3726:Epilepsia. 2008 Sep;49(9):1646–1647.
1343:25 g of 36% heavy whipping cream
1319:38 g of 36% heavy whipping cream
1277:18 g of 36% heavy whipping cream
1256:36 g of 36% heavy whipping cream
1205:37 g of 36% heavy whipping cream
90:) eventually lowers the frequency of
16:High-fat dietary therapy for epilepsy
7:
5019:
2914:Epilepsies: diagnosis and management
1616:(high levels of acid in the blood),
1466:strict vegetarians of the Jain faith
1353:Pure, unsweetened vanilla flavouring
1325:11 g green beans (one spoonful)
1202:11 g bacon (about half a slice)
1143:The classic ketogenic diet is not a
905:The urine has a low pH, which stops
844:Raised levels of lipids in the blood
331:, covers the disease; it dates from
21:Very low-carbohydrate ketogenic diet
4961:Fruits & Veggies – More Matters
3775:10.1016/j.pediatrneurol.2007.02.008
3683:The Ketogenic Diet ... in a bottle?
3488:Epilepsia. 2007 Jan;48(1):187–190.
3484:Martinez CC, Pyzik PL, Kossoff EH.
3439:Epilepsia. 2009 Feb;50(2):304–317.
2107:Biomed J. 2013 Jan–Feb;36(1):2–8.
1322:10 g lettuce (one medium leaf)
791:genetic disorders of fat metabolism
3732:10.1111/j.1528-1167.2008.01580_6.x
3570:Management of Infantile Epilepsies
1823:Unless otherwise stated, the term
1460:not to be killed and eaten, Islam
1259:15 g lettuce (one large leaf)
842:if an initial fast is undertaken.
465:Wilder's colleague, paediatrician
430:reviewed the research on diet and
117:The original therapeutic diet for
14:
3945:. 4th ed. New York: Demos; 2007.
3077:The diet that can treat epilepsy.
3002:Seizure. 2007 Oct;16(7):615–619.
2718:Epilepsia. 2007 Jan;48(1):31–42.
1643:into glucose by a process called
1405:dietary therapy for adolescents.
1199:28 g egg (about half an egg)
846:affect up to 60% of children and
797:, and eventually coma and death.
683:Indications and contraindications
5038:
5028:
5018:
5009:
5008:
3830:10.1111/j.1528-1167.2008.01901.x
3703:10.1111/j.0013-9580.2005.42704.x
3629:10.1111/j.1528-1167.2008.01959.x
3584:from the original on 5 July 2023
3549:10.1111/j.1528-1167.2008.01831.x
3522:10.1111/j.1528-1167.2008.01824.x
3494:10.1111/j.1528-1167.2006.00911.x
3445:10.1111/j.1528-1167.2008.01765.x
3397:10.1111/j.1528-1167.2007.01417.x
3315:10.1016/j.eplepsyres.2005.10.003
3248:10.1016/j.eplepsyres.2011.05.020
3032:10.1111/j.0013-9580.2004.18504.x
2724:10.1111/j.1528-1167.2007.00914.x
2665:10.1016/j.eplepsyres.2020.106319
2150:10.1111/j.1528-1167.2008.01830.x
1769:
1755:
1584:), which is mediated by another
1529:
1513:
1497:
1337:(serving size: 1.2 ounces)
1271:(serving size: 1.3 ounces)
956:who works with the family and a
3154:Wang D, Pascual JM, De Vivo D.
2098:Dietary therapies for epilepsy.
1898:reduction is a 90–99% decrease.
1673:The ketone bodies are possibly
1425:Infants and patients fed via a
1223:(serving size: 0.5 ounce)
848:cholesterol levels may increase
783:pyruvate carboxylase deficiency
578:disorders other than epilepsy.
2078:10.1002/14651858.CD001903.pub4
1814:stands for "energy" from food.
1:
3918:10.1016/S1470-2045(23)00483-7
3008:10.1016/j.seizure.2007.04.010
2480:10.1016/S1474-4422(08)70092-9
2443:. 1971 Nov;21(11):1097–1103.
1727:amyotrophic lateral sclerosis
1547:neurons that transmit signals
1175:Sample meal plan for one day
891:Excess calcium in the urine (
868:carbonic anhydrase inhibitors
862:. The diet reduces levels of
767:congenital metabolic diseases
700:. It is approved by national
332:
203:amyotrophic lateral sclerosis
3604:Low glycemic index treatment
3362:10.1097/MCO.0b013e3282f44c06
3335:Epilepsy's Big, Fat Miracle.
1458:consider cows sacred animals
1391:Low glycemic index treatment
913:for calcium stone formation.
864:insulin-like growth factor 1
399:American Medical Association
373:Dr. Hugh William Conklin of
162:In 1994, Hollywood producer
4971:Latin American Diet Pyramid
4951:Dairy Council of California
4406:Gluten-free and casein-free
3667:KetoVOLVE: 4:1 Ratio Powder
3648:KetoCal Product Information
2524:10.1001/archneur.55.11.1433
2396:10.1016/j.yebeh.2004.10.006
2272:10.1016/j.yebeh.2007.12.019
1462:forbids consumption of pork
1440:nutritionally complete food
473:Anticonvulsants and decline
5094:
4981:Mediterranean Diet Pyramid
4436:Low-fiber/low-residue diet
3878:10.1007/s10238-021-00710-2
3824:. 2009 Apr;50(4):943–948.
2815:10.1016/j.nurt.2009.01.005
2204:Gano LB, Patel M, Rho JM.
1717:Other medical applications
1368:Medium-chain triglycerides
740:tuberous sclerosis complex
736:myoclonic-astatic epilepsy
527:medium-chain triglycerides
365:, an American exponent of
284:, and the ketogenic diet.
228:is one of the most common
145:medium-chain triglycerides
18:
5047:Health and fitness portal
5004:
4053:
3855:10.1016/j.nut.2018.10.003
3192:10.1007/s11910-006-0027-6
3161:30 September 2016 at the
2297:10.1007/s12519-017-0053-2
1588:. The flow through these
938:medical nutrition therapy
765:in children with certain
628:, designed to lose 5–10%
519:Medium-chain triglyceride
358:, which dulled the mind.
197:, some of which include:
4327:Bodybuilding supplements
3435:13 February 2018 at the
3290:10.1177/0883073807301926
3136:10.1177/0883073807309785
2978:11 December 2019 at the
2630:20 November 2022 at the
2581:10.1177/0883073809337162
2183:10.1177/0884533608326138
2113:10.4103/2319-4170.107152
2068:20 November 2020 at the
1557:, though there are also
1313:(half a slice of cheese)
980:for conditions that may
936:The ketogenic diet is a
742:and for children fed by
614:intent-to-treat analysis
391:New York Medical Journal
292:The ketogenic diet is a
184:made-for-television film
141:long-chain triglycerides
43:is a high-fat, adequate-
4996:Vegetarian Diet Pyramid
4299:Ovo-lacto vegetarianism
3800:27 October 2017 at the
3182:Huffman J, Kossoff EH.
3102:10 January 2020 at the
2864:31 January 2020 at the
2839:10.2310/7010.2006.00044
2748:10.1542/peds.102.6.1358
2707:Hartman AL, Vining EP.
1413:Prescribed formulations
698:drug-resistant epilepsy
669:low-density lipoprotein
504:Lennox–Gastaut syndrome
446:(known collectively as
282:vagus nerve stimulation
5078:Low-carbohydrate diets
4966:Healthy eating pyramid
4512:Time Restricted Eating
4396:Fluid restriction diet
4000:The Charlie Foundation
3578:10.23970/ahrqepccer252
2971:Turner Z, Kossoff EH.
2780:10.1542/peds.108.4.898
2714:13 August 2017 at the
2449:10.1212/wnl.21.11.1097
2140:22 August 2017 at the
2036:10.1542/peds.2006-2447
1422:
1298:Cheeseburger (no bun)
1229:6 g peanut butter
1111:
999:When in the hospital,
808:vagus nerve stimulator
693:
642:Johns Hopkins Hospital
566:Johns Hopkins Hospital
522:
487:H. Houston Merritt Jr.
481:(discovered 1857) and
428:Rollin Turner Woodyatt
408:Johns Hopkins Hospital
375:Battle Creek, Michigan
314:
195:neurological disorders
68:fueling brain function
36:
34:ketone bodies in urine
4466:Specific carbohydrate
4358:Very-low-calorie diet
3609:27 April 2018 at the
2919:22 April 2019 at the
2421:27 April 2018 at the
2096:Kossoff EH, Wang HS.
1839:On the Sacred Disease
1420:
1346:9 g egg (half a
1109:
1037:Urinary ketone levels
954:medical social worker
690:
531:hepatic portal system
517:
467:Mynie Gustav Peterman
371:osteopathic physician
328:On the Sacred Disease
312:
31:
4411:Intermittent fasting
3956:Lowery R, Wilson J.
3653:12 June 2018 at the
3340:1 April 2018 at the
3082:1 April 2018 at the
2805:1 April 2018 at the
2798:Kossoff EH, Rho JM.
2514:25 July 2011 at the
1920:Atwater coefficients
1910:The ketogenic ratio
1633:fatty-acid oxidation
1305:minced (ground) beef
1287:artificial sweetener
1280:17 g sour cream
1250:30 g mayonnaise
1133:heavy whipping cream
1083:electroencephalogram
984:the diet. A dietary
506:, declined further.
452:Russell Morse Wilder
4376:Calorie restriction
3765:1 June 2018 at the
2998:21 May 2020 at the
2340:5 June 2011 at the
2221:10.1194/jlr.R048975
2211:19 May 2019 at the
2103:1 June 2018 at the
1879:De victu attenuante
1739:Parkinson's disease
1723:Alzheimer's disease
1649:blood–brain barrier
1618:electrolyte changes
1563:γ-aminobutyric acid
1559:electrical pathways
1477:Mechanism of action
1372:insurance companies
1247:28 g tuna fish
1221:Peanut butter ball
1176:
702:clinical guidelines
602:retrospective study
571:...First Do No Harm
244:. These occur when
211:Parkinson's disease
199:Alzheimer's disease
179:...First Do No Harm
151:than LCTs—are more
119:paediatric epilepsy
4291:Semi-vegetarianism
3602:Pfeifer, Heidi H.
3345:The New York Times
3112:10.2147/NDT.S51789
3095:Wang S, Fallah A.
2874:10.1002/epi4.12098
2640:10.1002/epi4.12225
1855:, VII, 46; vol. 5.
1594:chemical messenger
1423:
1174:
1112:
1091:tuberous sclerosis
763:first-line therapy
694:
610:prospective cohort
539:Peter Huttenlocher
523:
521:(MCT) oil emulsion
414:and his assistant
404:Charles P. Howland
361:Around this time,
323:Hippocratic Corpus
315:
294:mainstream medical
253:hypersynchronously
251:fire excessively,
106:, growth slowing,
92:epileptic seizures
37:
5055:
5054:
4932:
4931:
4601:
4600:
4174:Sustainable diets
3994:Matthew's Friends
3912:(11): 1177–1178.
1842:, ch. 18; vol. 6.
1802:In this article,
1791:Explanatory notes
1656:β-hydroxybutyrate
1614:systemic acidosis
1586:potassium channel
1582:refractory period
1555:neurotransmitters
1505:β-hydroxybutyrate
1482:Seizure pathology
1359:
1358:
897:calcium phosphate
880:potassium citrate
810:or with the drug
789:, and other rare
436:β-hydroxybutyrate
416:William G. Lennox
363:Bernarr Macfadden
356:potassium bromide
143:(LCTs). However,
5085:
5042:
5032:
5022:
5021:
5012:
5011:
4612:
4446:Monotrophic diet
4426:Low-carbohydrate
4391:Elimination diet
4337:Therapeutic food
4332:Meal replacement
4319:Supplement diets
4187:Planetary health
4123:
4059:
4036:
4029:
4022:
4013:
3930:
3929:
3901:
3895:
3870:
3864:
3847:
3841:
3818:
3812:
3791:
3785:
3756:
3741:
3720:
3714:
3695:
3686:
3679:
3670:
3664:
3658:
3645:
3639:
3620:
3614:
3600:
3594:
3593:
3591:
3589:
3565:
3559:
3541:
3532:
3510:
3504:
3482:
3473:
3461:
3455:
3422:
3407:
3381:
3372:
3354:
3348:
3331:
3325:
3306:
3300:
3278:
3259:
3240:
3229:
3217:
3202:
3180:
3174:
3152:
3146:
3128:
3122:
3093:
3087:
3073:
3067:
3056:
3043:
3024:
3018:
2989:
2983:
2969:
2956:
2941:
2932:
2911:
2902:
2891:
2885:
2855:
2849:
2831:
2825:
2796:
2790:
2772:
2763:
2739:
2733:
2705:
2676:
2657:
2651:
2620:
2591:
2573:
2534:
2501:
2490:
2468:
2459:
2437:
2426:
2412:
2406:
2388:
2382:
2376:
2370:
2359:
2353:
2331:
2308:
2288:
2282:
2264:
2258:
2247:
2232:
2202:
2193:
2175:
2160:
2131:
2122:
2094:
2088:
2059:
2046:
2028:
1996:
1987:
1981:
1979:
1978:
1976:
1975:
1968:
1965:
1950:
1949:
1947:
1946:
1939:
1936:
1917:
1913:
1908:
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1875:
1869:
1868:, c. 8; vol. 11.
1862:
1856:
1849:
1843:
1834:
1828:
1821:
1815:
1800:
1779:
1774:
1773:
1765:
1760:
1759:
1758:
1576:in the neuron's
1533:
1521:acetoacetic acid
1517:
1501:
1427:gastrostomy tube
1316:26 g butter
1266:Afternoon snack
1253:10 g celery
1208:23 g butter
1177:
950:registered nurse
924:, and in women,
744:gastrostomy tube
732:infantile spasms
535:lymphatic system
533:rather than the
499:sodium valproate
367:physical culture
337:
334:
278:epilepsy surgery
232:disorders after
104:high cholesterol
49:low-carbohydrate
5093:
5092:
5088:
5087:
5086:
5084:
5083:
5082:
5058:
5057:
5056:
5051:
5000:
4938:
4928:
4830:
4806:
4798:
4790:
4782:
4774:
4766:
4758:
4750:
4728:
4597:
4579:
4536:
4470:
4368:
4362:
4346:Non-solid diets
4341:
4313:
4285:
4271:Milk substitute
4250:
4242:
4196:Religious diets
4191:
4168:
4142:
4112:
4057:
4049:
4043:Human nutrition
4040:
3975:
3938:
3936:Further reading
3933:
3903:
3902:
3898:
3871:
3867:
3848:
3844:
3819:
3815:
3802:Wayback Machine
3792:
3788:
3767:Wayback Machine
3757:
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3721:
3717:
3696:
3689:
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3673:
3665:
3661:
3655:Wayback Machine
3646:
3642:
3621:
3617:
3611:Wayback Machine
3601:
3597:
3587:
3585:
3567:
3566:
3562:
3542:
3535:
3512:Zupec-Kania B.
3511:
3507:
3483:
3476:
3462:
3458:
3437:Wayback Machine
3423:
3410:
3382:
3375:
3355:
3351:
3342:Wayback Machine
3332:
3328:
3307:
3303:
3279:
3262:
3241:
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3218:
3205:
3181:
3177:
3163:Wayback Machine
3153:
3149:
3129:
3125:
3104:Wayback Machine
3094:
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3084:Wayback Machine
3074:
3070:
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3000:Wayback Machine
2990:
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2980:Wayback Machine
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2921:Wayback Machine
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2892:
2888:
2866:Wayback Machine
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2828:
2807:Wayback Machine
2797:
2793:
2773:
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2716:Wayback Machine
2706:
2679:
2658:
2654:
2632:Wayback Machine
2621:
2594:
2574:
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2516:Wayback Machine
2502:
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2423:Wayback Machine
2413:
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2342:Wayback Machine
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2213:Wayback Machine
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2142:Wayback Machine
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2105:Wayback Machine
2095:
2091:
2070:Wayback Machine
2060:
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2008:
2004:
1999:
1988:
1984:
1969:
1966:
1960:
1959:
1957:
1952:
1940:
1937:
1931:
1930:
1928:
1923:
1915:
1911:
1909:
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1885:
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1872:
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1850:
1846:
1835:
1831:
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1818:
1801:
1797:
1793:
1775:
1768:
1763:Medicine portal
1761:
1756:
1754:
1751:
1743:sleep disorders
1719:
1711:benzodiazepines
1687:neuroprotective
1645:gluconeogenesis
1610:
1608:Seizure control
1549:by propagating
1543:
1542:
1541:
1540:
1539:
1534:
1525:
1524:
1523:
1518:
1509:
1508:
1507:
1502:
1493:
1492:
1484:
1479:
1449:
1415:
1402:glycaemic index
1393:
1380:
1378:Modified Atkins
1364:
1311:American cheese
1232:9 g butter
1194:Egg with bacon
1104:
1099:
1074:
1072:Discontinuation
1028:
970:
934:
824:
822:Adverse effects
803:
779:contraindicated
728:Dravet syndrome
715:glycaemic index
685:
638:
593:
584:
562:John M. Freeman
548:
512:
475:
424:
395:endocrinologist
379:Peyer's patches
335:
307:
290:
223:
215:sleep disorders
24:
17:
12:
11:
5:
5091:
5089:
5081:
5080:
5075:
5073:High-fat diets
5070:
5060:
5059:
5053:
5052:
5050:
5049:
5036:
5026:
5016:
5005:
5002:
5001:
4999:
4998:
4993:
4988:
4983:
4978:
4976:French paradox
4973:
4968:
4963:
4958:
4953:
4948:
4942:
4940:
4934:
4933:
4930:
4929:
4927:
4926:
4921:
4916:
4911:
4906:
4901:
4896:
4891:
4886:
4881:
4876:
4871:
4866:
4861:
4856:
4851:
4846:
4840:
4838:
4832:
4831:
4829:
4828:
4823:
4818:
4813:
4808:
4804:
4800:
4796:
4792:
4788:
4784:
4780:
4776:
4772:
4768:
4764:
4760:
4756:
4752:
4748:
4744:
4738:
4736:
4730:
4729:
4727:
4726:
4721:
4716:
4711:
4706:
4701:
4699:Selenocysteine
4696:
4691:
4686:
4681:
4676:
4671:
4666:
4661:
4656:
4651:
4646:
4641:
4636:
4631:
4626:
4620:
4618:
4609:
4603:
4602:
4599:
4598:
4596:
4595:
4589:
4587:
4581:
4580:
4578:
4577:
4572:
4567:
4562:
4560:Master Cleanse
4557:
4552:
4546:
4544:
4538:
4537:
4535:
4534:
4529:
4524:
4519:
4514:
4509:
4504:
4499:
4494:
4489:
4484:
4478:
4476:
4472:
4471:
4469:
4468:
4463:
4458:
4453:
4448:
4443:
4438:
4433:
4428:
4423:
4418:
4413:
4408:
4403:
4398:
4393:
4388:
4383:
4378:
4372:
4370:
4364:
4363:
4361:
4360:
4355:
4349:
4347:
4343:
4342:
4340:
4339:
4334:
4329:
4323:
4321:
4315:
4314:
4312:
4311:
4306:
4301:
4295:
4293:
4287:
4286:
4284:
4283:
4278:
4273:
4268:
4263:
4257:
4255:
4244:
4243:
4241:
4240:
4235:
4230:
4225:
4220:
4215:
4210:
4205:
4199:
4197:
4193:
4192:
4190:
4189:
4184:
4178:
4176:
4170:
4169:
4167:
4166:
4161:
4156:
4150:
4148:
4147:Regional diets
4144:
4143:
4141:
4140:
4135:
4129:
4127:
4120:
4114:
4113:
4111:
4110:
4105:
4100:
4095:
4090:
4085:
4080:
4075:
4070:
4065:
4060:
4054:
4051:
4050:
4041:
4039:
4038:
4031:
4024:
4016:
4010:
4009:
4003:
3997:
3991:
3985:Ketogenic diet
3982:
3974:
3973:External links
3971:
3970:
3969:
3966:978-1628601046
3954:
3937:
3934:
3932:
3931:
3896:
3865:
3842:
3813:
3786:
3742:
3715:
3687:
3671:
3659:
3640:
3615:
3595:
3560:
3533:
3505:
3474:
3456:
3408:
3373:
3349:
3347:. 2010 Nov 17.
3333:Vogelstein F.
3326:
3301:
3260:
3230:
3203:
3175:
3147:
3123:
3088:
3068:
3044:
3019:
2984:
2957:
2933:
2929:978-1473117907
2903:
2886:
2850:
2826:
2791:
2764:
2734:
2677:
2652:
2592:
2535:
2491:
2460:
2427:
2407:
2383:
2371:
2354:
2309:
2283:
2259:
2233:
2194:
2161:
2123:
2089:
2047:
2005:
2003:
2000:
1998:
1997:
1982:
1900:
1883:
1870:
1857:
1844:
1829:
1816:
1794:
1792:
1789:
1788:
1787:
1781:
1780:
1766:
1750:
1747:
1718:
1715:
1675:anticonvulsant
1635:in the cell's
1609:
1606:
1551:nerve impulses
1535:
1528:
1527:
1526:
1519:
1512:
1511:
1510:
1503:
1496:
1495:
1494:
1488:
1487:
1486:
1485:
1483:
1480:
1478:
1475:
1448:
1445:
1414:
1411:
1392:
1389:
1379:
1376:
1363:
1360:
1357:
1356:
1355:
1354:
1351:
1344:
1339:
1333:
1332:Evening snack
1329:
1328:
1327:
1326:
1323:
1320:
1317:
1314:
1307:
1299:
1296:
1292:
1291:
1290:
1289:
1284:
1281:
1278:
1273:
1267:
1263:
1262:
1261:
1260:
1257:
1254:
1251:
1248:
1243:
1240:
1236:
1235:
1234:
1233:
1230:
1225:
1219:
1218:Morning snack
1215:
1214:
1213:
1212:
1209:
1206:
1203:
1200:
1195:
1192:
1188:
1187:
1184:
1181:
1103:
1100:
1098:
1095:
1073:
1070:
1027:
1024:
1001:glucose levels
982:contraindicate
969:
966:
933:
932:Implementation
930:
918:
917:
914:
903:
900:
893:hypercalciuria
853:micronutrients
823:
820:
802:
799:
684:
681:
637:
634:
606:selection bias
592:
589:
583:
580:
547:
544:
525:In the 1960s,
511:
508:
474:
471:
423:
420:
319:ancient Greece
317:Physicians of
306:
303:
289:
286:
273:anticonvulsant
222:
219:
128:anticonvulsant
41:ketogenic diet
15:
13:
10:
9:
6:
4:
3:
2:
5090:
5079:
5076:
5074:
5071:
5069:
5066:
5065:
5063:
5048:
5045:
5041:
5037:
5035:
5031:
5027:
5025:
5017:
5015:
5007:
5006:
5003:
4997:
4994:
4992:
4989:
4987:
4984:
4982:
4979:
4977:
4974:
4972:
4969:
4967:
4964:
4962:
4959:
4957:
4954:
4952:
4949:
4947:
4944:
4943:
4941:
4935:
4925:
4922:
4920:
4917:
4915:
4912:
4910:
4907:
4905:
4902:
4900:
4897:
4895:
4892:
4890:
4887:
4885:
4882:
4880:
4877:
4875:
4872:
4870:
4867:
4865:
4862:
4860:
4857:
4855:
4852:
4850:
4847:
4845:
4842:
4841:
4839:
4837:
4833:
4827:
4824:
4822:
4819:
4817:
4814:
4812:
4809:
4807:
4801:
4799:
4793:
4791:
4785:
4783:
4777:
4775:
4769:
4767:
4761:
4759:
4753:
4751:
4745:
4743:
4740:
4739:
4737:
4735:
4731:
4725:
4722:
4720:
4717:
4715:
4712:
4710:
4707:
4705:
4702:
4700:
4697:
4695:
4692:
4690:
4689:Phenylalanine
4687:
4685:
4682:
4680:
4677:
4675:
4672:
4670:
4667:
4665:
4662:
4660:
4657:
4655:
4652:
4650:
4649:Glutamic acid
4647:
4645:
4642:
4640:
4639:Aspartic acid
4637:
4635:
4632:
4630:
4627:
4625:
4622:
4621:
4619:
4617:
4613:
4610:
4608:
4604:
4594:
4591:
4590:
4588:
4586:
4585:List of diets
4582:
4576:
4573:
4571:
4568:
4566:
4563:
4561:
4558:
4556:
4553:
4551:
4548:
4547:
4545:
4543:
4539:
4533:
4532:U.S. military
4530:
4528:
4525:
4523:
4520:
4518:
4515:
4513:
4510:
4508:
4505:
4503:
4500:
4498:
4495:
4493:
4490:
4488:
4485:
4483:
4480:
4479:
4477:
4473:
4467:
4464:
4462:
4459:
4457:
4454:
4452:
4449:
4447:
4444:
4442:
4439:
4437:
4434:
4432:
4429:
4427:
4424:
4422:
4419:
4417:
4414:
4412:
4409:
4407:
4404:
4402:
4399:
4397:
4394:
4392:
4389:
4387:
4386:Diabetic diet
4384:
4382:
4379:
4377:
4374:
4373:
4371:
4365:
4359:
4356:
4354:
4351:
4350:
4348:
4344:
4338:
4335:
4333:
4330:
4328:
4325:
4324:
4322:
4320:
4316:
4310:
4307:
4305:
4302:
4300:
4297:
4296:
4294:
4292:
4288:
4282:
4279:
4277:
4274:
4272:
4269:
4267:
4266:Meat analogue
4264:
4262:
4261:Fruitarianism
4259:
4258:
4256:
4254:
4249:
4248:Vegetarianism
4245:
4239:
4236:
4234:
4231:
4229:
4226:
4224:
4221:
4219:
4216:
4214:
4211:
4209:
4206:
4204:
4201:
4200:
4198:
4194:
4188:
4185:
4183:
4180:
4179:
4177:
4175:
4171:
4165:
4162:
4160:
4159:Mediterranean
4157:
4155:
4152:
4151:
4149:
4145:
4139:
4136:
4134:
4131:
4130:
4128:
4124:
4121:
4119:
4115:
4109:
4106:
4104:
4101:
4099:
4096:
4094:
4091:
4089:
4086:
4084:
4081:
4079:
4076:
4074:
4071:
4069:
4066:
4064:
4061:
4058:Main articles
4056:
4055:
4052:
4048:
4047:healthy diets
4044:
4037:
4032:
4030:
4025:
4023:
4018:
4017:
4014:
4007:
4004:
4001:
3998:
3995:
3992:
3990:
3986:
3983:
3980:
3977:
3976:
3972:
3967:
3963:
3959:
3955:
3952:
3948:
3944:
3940:
3939:
3935:
3927:
3923:
3919:
3915:
3911:
3907:
3900:
3897:
3894:
3890:
3887:
3883:
3879:
3875:
3869:
3866:
3863:
3859:
3856:
3852:
3846:
3843:
3839:
3835:
3831:
3827:
3823:
3817:
3814:
3811:
3807:
3803:
3799:
3796:
3790:
3787:
3784:
3780:
3776:
3772:
3768:
3764:
3761:
3755:
3753:
3751:
3749:
3747:
3743:
3740:
3736:
3733:
3729:
3725:
3719:
3716:
3712:
3708:
3704:
3700:
3694:
3692:
3688:
3684:
3678:
3676:
3672:
3668:
3663:
3660:
3656:
3652:
3649:
3644:
3641:
3638:
3634:
3630:
3626:
3619:
3616:
3612:
3608:
3605:
3599:
3596:
3583:
3579:
3575:
3571:
3564:
3561:
3558:
3554:
3550:
3546:
3540:
3538:
3534:
3531:
3527:
3523:
3519:
3515:
3509:
3506:
3503:
3499:
3495:
3491:
3487:
3481:
3479:
3475:
3471:
3467:
3460:
3457:
3454:
3450:
3446:
3442:
3438:
3434:
3431:
3427:
3421:
3419:
3417:
3415:
3413:
3409:
3406:
3402:
3398:
3394:
3390:
3386:
3380:
3378:
3374:
3371:
3367:
3363:
3359:
3353:
3350:
3346:
3343:
3339:
3336:
3330:
3327:
3324:
3320:
3316:
3312:
3305:
3302:
3299:
3295:
3291:
3287:
3283:
3277:
3275:
3273:
3271:
3269:
3267:
3265:
3261:
3257:
3253:
3249:
3245:
3239:
3237:
3235:
3231:
3227:
3223:
3216:
3214:
3212:
3210:
3208:
3204:
3201:
3197:
3193:
3189:
3185:
3179:
3176:
3172:
3168:
3164:
3160:
3157:
3151:
3148:
3145:
3141:
3137:
3133:
3127:
3124:
3121:
3117:
3113:
3109:
3105:
3101:
3098:
3092:
3089:
3085:
3081:
3078:
3072:
3069:
3065:
3061:
3055:
3053:
3051:
3049:
3045:
3041:
3037:
3033:
3029:
3023:
3020:
3017:
3013:
3009:
3005:
3001:
2997:
2994:
2988:
2985:
2981:
2977:
2974:
2968:
2966:
2964:
2962:
2958:
2954:
2950:
2946:
2940:
2938:
2934:
2930:
2926:
2922:
2918:
2915:
2910:
2908:
2904:
2900:
2896:
2890:
2887:
2883:
2879:
2875:
2871:
2867:
2863:
2860:
2854:
2851:
2848:
2844:
2840:
2836:
2830:
2827:
2823:
2819:
2816:
2812:
2808:
2804:
2801:
2795:
2792:
2789:
2785:
2781:
2777:
2771:
2769:
2765:
2761:
2757:
2753:
2749:
2745:
2738:
2735:
2732:
2728:
2725:
2721:
2717:
2713:
2710:
2704:
2702:
2700:
2698:
2696:
2694:
2692:
2690:
2688:
2686:
2684:
2682:
2678:
2674:
2670:
2666:
2662:
2656:
2653:
2649:
2645:
2641:
2637:
2633:
2629:
2626:
2619:
2617:
2615:
2613:
2611:
2609:
2607:
2605:
2603:
2601:
2599:
2597:
2593:
2590:
2586:
2582:
2578:
2572:
2570:
2568:
2566:
2564:
2562:
2560:
2558:
2556:
2554:
2552:
2550:
2548:
2546:
2544:
2542:
2540:
2536:
2533:
2529:
2525:
2521:
2517:
2513:
2510:
2506:
2500:
2498:
2496:
2492:
2489:
2485:
2481:
2477:
2473:
2467:
2465:
2461:
2458:
2454:
2450:
2446:
2442:
2436:
2434:
2432:
2428:
2424:
2420:
2417:
2411:
2408:
2405:
2401:
2397:
2393:
2387:
2384:
2380:
2375:
2372:
2368:
2364:
2358:
2355:
2351:
2347:
2343:
2339:
2336:
2330:
2328:
2326:
2324:
2322:
2320:
2318:
2316:
2314:
2310:
2306:
2302:
2298:
2294:
2287:
2284:
2281:
2277:
2273:
2269:
2263:
2260:
2256:
2252:
2246:
2244:
2242:
2240:
2238:
2234:
2230:
2226:
2222:
2218:
2214:
2210:
2207:
2201:
2199:
2195:
2192:
2188:
2184:
2180:
2174:
2172:
2170:
2168:
2166:
2162:
2159:
2155:
2151:
2147:
2143:
2139:
2136:
2130:
2128:
2124:
2121:
2117:
2114:
2110:
2106:
2102:
2099:
2093:
2090:
2087:
2083:
2079:
2075:
2071:
2067:
2064:
2058:
2056:
2054:
2052:
2048:
2045:
2041:
2037:
2033:
2027:
2025:
2023:
2021:
2019:
2017:
2015:
2013:
2011:
2007:
2001:
1993:
1986:
1983:
1973:
1964:
1955:
1944:
1935:
1926:
1921:
1907:
1905:
1901:
1897:
1893:
1887:
1884:
1880:
1874:
1871:
1867:
1861:
1858:
1854:
1851:Hippocrates,
1848:
1845:
1841:
1840:
1836:Hippocrates,
1833:
1830:
1826:
1820:
1817:
1813:
1809:
1805:
1799:
1796:
1790:
1786:
1785:List of diets
1783:
1782:
1778:
1772:
1767:
1764:
1753:
1748:
1746:
1744:
1740:
1736:
1732:
1728:
1724:
1716:
1714:
1712:
1708:
1707:levetiracetam
1704:
1698:
1696:
1690:
1688:
1684:
1680:
1679:animal models
1676:
1671:
1669:
1665:
1661:
1657:
1654:
1653:ketone bodies
1650:
1646:
1642:
1638:
1634:
1629:
1627:
1626:blood glucose
1623:
1622:hypoglycaemia
1619:
1615:
1607:
1605:
1601:
1599:
1595:
1591:
1587:
1583:
1579:
1578:cell membrane
1575:
1570:
1568:
1564:
1560:
1556:
1552:
1548:
1538:
1532:
1522:
1516:
1506:
1500:
1491:
1490:Ketone bodies
1481:
1476:
1474:
1470:
1467:
1463:
1459:
1453:
1446:
1444:
1441:
1437:
1432:
1428:
1419:
1412:
1410:
1406:
1403:
1398:
1397:blood glucose
1390:
1388:
1384:
1377:
1375:
1373:
1369:
1361:
1352:
1349:
1345:
1342:
1341:
1340:
1338:
1335:Keto custard
1334:
1331:
1330:
1324:
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1318:
1315:
1312:
1308:
1306:
1302:
1301:
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1297:
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1293:
1288:
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1282:
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1196:
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1185:
1182:
1179:
1178:
1172:
1170:
1166:
1162:
1158:
1154:
1150:
1146:
1145:balanced diet
1141:
1138:
1134:
1129:
1127:
1122:
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1108:
1101:
1096:
1094:
1092:
1088:
1084:
1078:
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1069:
1067:
1063:
1059:
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1050:
1045:
1043:
1042:nitroprusside
1038:
1034:
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1019:
1017:
1013:
1008:
1006:
1002:
997:
995:
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987:
983:
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961:
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915:
912:
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904:
901:
898:
894:
890:
889:
888:
885:
881:
877:
873:
869:
865:
861:
860:kidney stones
856:
854:
849:
845:
841:
840:hypoglycaemia
837:
833:
829:
821:
819:
817:
816:phenobarbital
813:
809:
800:
798:
796:
792:
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764:
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680:
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674:
671:, high total
670:
664:
661:
656:
654:
653:meta-analysis
649:
647:
646:control group
643:
635:
633:
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617:
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520:
516:
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505:
500:
496:
492:
488:
484:
483:phenobarbital
480:
472:
470:
468:
463:
461:
457:
453:
449:
448:ketone bodies
445:
441:
437:
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400:
396:
392:
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383:
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336: 400 BC
330:
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295:
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285:
283:
279:
274:
270:
266:
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250:
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243:
239:
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231:
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218:
216:
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200:
196:
191:
189:
185:
181:
180:
175:
174:
169:
165:
160:
158:
154:
150:
149:carbon chains
146:
142:
138:
134:
129:
124:
120:
115:
113:
112:kidney stones
109:
105:
101:
97:
93:
89:
85:
84:ketone bodies
81:
77:
73:
69:
65:
60:
58:
57:carbohydrates
54:
50:
46:
42:
35:
30:
26:
22:
5044:Food portal,
4956:Food pyramid
4937:Nutritional
4381:Cardiac diet
4369:restrictions
4353:Liquid diets
3957:
3942:
3909:
3906:Lancet Oncol
3905:
3899:
3868:
3845:
3821:
3816:
3789:
3718:
3681:Kossoff EH.
3662:
3643:
3618:
3598:
3588:30 September
3586:. Retrieved
3563:
3508:
3459:
3425:
3384:
3352:
3344:
3329:
3304:
3178:
3150:
3126:
3091:
3075:Spendiff S.
3071:
3022:
2987:
2889:
2853:
2829:
2794:
2737:
2655:
2504:
2471:
2440:
2414:Kossoff EH.
2410:
2386:
2374:
2357:
2333:Wheless JW.
2286:
2262:
2092:
1985:
1971:
1962:
1953:
1942:
1933:
1924:
1895:
1891:
1886:
1878:
1873:
1865:
1860:
1852:
1847:
1837:
1832:
1824:
1819:
1811:
1803:
1798:
1733:, headache,
1720:
1699:
1691:
1672:
1667:
1660:acetoacetate
1637:mitochondria
1630:
1611:
1602:
1590:ion channels
1571:
1544:
1471:
1454:
1450:
1424:
1407:
1394:
1385:
1381:
1365:
1336:
1270:
1269:Keto yogurt
1222:
1186:Ingredients
1165:multivitamin
1142:
1130:
1113:
1079:
1075:
1054:maltodextrin
1046:
1029:
1020:
1009:
998:
990:
975:
971:
962:
935:
926:dysmenorrhea
922:dyslipidemia
919:
882:supplements
857:
834:, low-grade
832:constipation
825:
804:
801:Interactions
795:ketoacidosis
760:
748:
724:
695:
665:
657:
650:
639:
618:
594:
591:Trial design
585:
576:
569:
558:Jim Abrahams
552:
549:
524:
491:Tracy Putnam
476:
464:
440:acetoacetate
425:
412:Stanley Cobb
390:
387:neurologists
384:
360:
352:
344:Erasistratus
339:
326:
316:
291:
230:neurological
224:
205:, headache,
192:
188:Meryl Streep
177:
176:program and
172:
168:diet therapy
164:Jim Abrahams
161:
116:
100:constipation
61:
40:
38:
32:Testing for
25:
4616:Amino acids
4555:Macrobiotic
4527:Raw foodism
4517:Liquid diet
4487:Cotton ball
4482:Entomophagy
4475:Other diets
4441:Low-protein
4401:Gluten-free
4309:Pollotarian
4304:Pescetarian
4138:Plant-based
4126:Basic types
4108:Staple food
2760:Lay summary
1806:stands for
1777:Food portal
1735:neurotrauma
1695:fenofibrate
1641:amino acids
1596:known as a
1436:cholesterol
1242:Tuna salad
1126:supplements
1026:Maintenance
946:neurologist
884:empirically
677:weight loss
673:cholesterol
630:body weight
493:discovered
456:Mayo Clinic
265:generalised
207:neurotrauma
157:coconut oil
96:Atkins diet
80:fatty acids
5062:Categories
4899:Phosphorus
4889:Molybdenum
4714:Tryptophan
4684:Methionine
4669:Isoleucine
4634:Asparagine
4522:Ninja diet
4456:Renal diet
4421:Low-FODMAP
4416:Low-sodium
4182:Low carbon
3951:1932603182
3470:1588292959
3226:1588292959
3064:1588292959
2953:1899893245
2899:1588292959
2367:0801848490
2350:1588292959
2255:1588292959
2002:References
1918:using the
1431:prescribed
1348:tablespoon
1309:10 g
1303:22 g
1191:Breakfast
1183:Menu idea
1153:B vitamins
1121:spasticity
1012:outpatient
968:Initiation
958:pharmacist
876:zonisamide
872:topiramate
812:zonisamide
756:dietitians
182:(1997), a
133:vegetables
4991:MyPyramid
4904:Potassium
4884:Manganese
4879:Magnesium
4826:Vitamin K
4821:Vitamin E
4816:Vitamin D
4811:Vitamin C
4803:Vitamin B
4795:Vitamin B
4787:Vitamin B
4779:Vitamin B
4771:Vitamin B
4763:Vitamin B
4755:Vitamin B
4747:Vitamin B
4742:Vitamin A
4709:Threonine
4664:Histidine
4654:Glutamine
4607:Nutrition
4593:Diet food
4575:Slow-Carb
4570:Superfood
4565:Junk food
4550:Cambridge
4542:Fad diets
4461:Soft diet
4367:Specific
4276:Raw vegan
4233:Rastafari
4208:Christian
4098:Nutrition
4078:Dietitian
3822:Epilepsia
2441:Neurology
1992:saccharin
1896:excellent
1853:Epidemics
1741:(PD) and
1703:valproate
1668:partially
1567:glutamate
1447:Worldwide
1161:vitamin D
1149:fortified
1116:dietitian
1033:dietitian
942:dietitian
907:uric acid
787:porphyria
495:phenytoin
460:ketonemia
454:, at the
426:In 1921,
340:Epidemics
269:syndromes
186:starring
153:ketogenic
74:converts
5068:Epilepsy
5034:Cookbook
5014:Category
4919:Vanadium
4909:Selenium
4854:Chromium
4849:Chlorine
4836:Minerals
4734:Vitamins
4719:Tyrosine
4644:Cysteine
4629:Arginine
4253:veganism
4203:Buddhist
4164:Atlantic
4133:Omnivore
3926:37922928
3893:33813635
3862:30554068
3838:19054409
3798:Archived
3783:17509459
3763:Archived
3739:18782218
3711:15679509
3651:Archived
3637:19220406
3607:Archived
3582:Archived
3557:19049584
3530:19049577
3502:17241227
3453:18823325
3433:Archived
3405:18028405
3370:18301085
3338:Archived
3323:16523530
3298:17621514
3256:21855296
3200:16822355
3171:20301603
3159:Archived
3144:18281618
3120:25364257
3100:Archived
3080:Archived
3040:15329084
3016:17544706
2996:Archived
2976:Archived
2917:Archived
2882:29588983
2862:Archived
2847:16901419
2822:19332337
2803:Archived
2788:11581442
2731:17241206
2712:Archived
2673:32199222
2648:29881797
2628:Archived
2589:19535814
2512:Archived
2488:18456557
2419:Archived
2404:15652725
2379:Guelpa G
2338:Archived
2305:28702868
2280:18280210
2229:24847102
2209:Archived
2191:19033218
2158:19049583
2138:Archived
2133:Liu YM.
2120:23515147
2101:Archived
2086:30403286
2066:Archived
2044:17332207
1812:calories
1808:calories
1749:See also
1737:, pain,
1689:effect.
1574:channels
1169:minerals
1097:Variants
1087:MRI scan
1066:fructose
1058:sorbitol
1016:acidosis
978:screened
836:acidosis
769:such as
752:evidence
720:tube-fed
660:Cochrane
636:Outcomes
622:protocol
582:Efficacy
553:Dateline
510:MCT diet
479:bromides
432:diabetes
246:cortical
242:seizures
234:migraine
226:Epilepsy
221:Epilepsy
209:, pain,
173:Dateline
123:calories
108:acidosis
53:epilepsy
5024:Commons
4986:MyPlate
4946:5 A Day
4844:Calcium
4694:Proline
4674:Leucine
4659:Glycine
4624:Alanine
4431:Low-fat
4218:Islamic
4154:Western
4118:Dieting
4103:Obesity
4073:Cuisine
4068:Dieting
3886:8505380
3810:6758355
2756:9832569
2532:9823827
2457:5166216
1977:
1970:9 (1 -
1958:
1948:
1929:
1881:, c. 1.
1877:Galen,
1864:Galen,
1825:fasting
1729:(ALS),
1683:neurons
1664:acetone
1537:acetone
1362:MCT oil
1295:Dinner
1157:calcium
1102:Classic
1005:ketosis
986:history
710:surgery
692:number.
546:Revival
444:acetone
305:Fasting
298:fasting
288:History
249:neurons
88:ketosis
64:glucose
45:protein
4939:advice
4914:Sodium
4894:Nickel
4869:Iodine
4864:Copper
4859:Cobalt
4724:Valine
4704:Serine
4679:Lysine
4228:Jewish
4088:Leptin
4083:Hunger
3989:Curlie
3964:
3949:
3924:
3891:
3884:
3860:
3836:
3808:
3781:
3737:
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3635:
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2253:
2227:
2189:
2156:
2118:
2084:
2042:
1995:cream.
1731:autism
1725:(AD),
1598:ligand
1464:, and
1239:Lunch
1159:, and
1064:, and
1062:starch
1049:ketone
994:eggnog
838:, and
828:benign
706:lesion
675:, and
598:cohort
442:, and
257:senses
238:stroke
213:, and
110:, and
4502:Inuit
4213:Hindu
3426:et al
3385:et al
2505:et al
2472:et al
1677:; in
1624:(low
1180:Meal
1167:with
1137:scale
911:nidus
348:Galen
261:focal
137:cream
78:into
72:liver
4924:Zinc
4874:Iron
4507:MIND
4497:DASH
4492:Pica
4281:Tofu
4251:and
4238:Sikh
4223:Jain
4093:Meal
4063:Diet
4045:and
3962:ISBN
3947:ISBN
3922:PMID
3889:PMID
3858:PMID
3834:PMID
3806:PMID
3779:PMID
3735:PMID
3707:PMID
3633:PMID
3590:2023
3553:PMID
3526:PMID
3498:PMID
3466:ISBN
3449:PMID
3401:PMID
3366:PMID
3319:PMID
3294:PMID
3252:PMID
3222:ISBN
3196:PMID
3167:PMID
3140:PMID
3116:PMID
3060:ISBN
3036:PMID
3012:PMID
2949:ISBN
2925:ISBN
2895:ISBN
2878:PMID
2843:PMID
2818:PMID
2784:PMID
2752:PMID
2727:PMID
2669:PMID
2644:PMID
2585:PMID
2528:PMID
2484:PMID
2453:PMID
2400:PMID
2363:ISBN
2346:ISBN
2301:PMID
2276:PMID
2251:ISBN
2225:PMID
2187:PMID
2154:PMID
2116:PMID
2082:PMID
2040:PMID
1892:good
1804:kcal
1709:and
1662:and
1620:and
773:and
626:fast
489:and
422:Diet
236:and
82:and
39:The
4451:NPO
3987:at
3914:doi
3882:PMC
3874:doi
3851:doi
3826:doi
3771:doi
3728:doi
3699:doi
3625:doi
3574:doi
3545:doi
3518:doi
3490:doi
3441:doi
3393:doi
3358:doi
3311:doi
3286:doi
3244:doi
3188:doi
3132:doi
3108:doi
3028:doi
3004:doi
2870:doi
2835:doi
2811:doi
2776:doi
2744:doi
2720:doi
2661:doi
2636:doi
2577:doi
2520:doi
2476:doi
2445:doi
2392:doi
2293:doi
2268:doi
2217:doi
2179:doi
2146:doi
2109:doi
2074:doi
2032:doi
1945:+ 4
616:).
564:at
76:fat
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2009:^
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1956:=
1941:9
1932:9
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