�Elevated cholesterol levels return to normal or near normal levels over time in four-spot out of 10 children with uncontrollable epilepsy treated with the high-fat ketogenic diet, according to results of a Johns Hopkins Children's Center study reported in the Journal of Child Neurology. The bailiwick appears online ahead of print here.
In the four-year study, the Hopkins Children's team followed 121 epileptic children with intractable seizures on the high-fat, low-carbohydrate ketogenic diet designed to control such seizures. While most children developed high cholesterol after starting the diet, cholesterin gradually improved in about half of them, reverting to normal or near-normal levels, with or without modifications to their diet to decoct fat intake.
In fact, researchers point out, diet modifications-including reducing total fat content or certain types of fats called saturated fats and adding nutritional supplements-reduced high cholesterol just as much as doing naught. High cholesterol is defined as tote up cholesterol greater than two hundred mg per deciliter of blood, bad or LDL (low-density lipoprotein) cholesterol greater than 130, triglycerides greater than cxxx, and good or HDL (high-density lipoprotein) lower than 35.
Researchers prescribed dietary modifications to increment "good," polyunsaturated fats in the diets of 15 children with elevated cholesterol. Dietary modifications decreased cholesterol by 20 percent in 9 tabu of the 15 (60 percent) children whose diets were limited. Surprisingly, cholesterin also dropped by at least 20 percent in 41 pct of the 37 children whose diets remained unchanged. The findings, while encouraging overall, besides mean that relying on diet changes alone may not do much for those children in whom cholesterol stiff persistently exalted, and that new approaches for these patients are needed, researchers say.
The findings should come as consoling news to pediatric neurologists, general pediatricians and parents of children treated with the ketogenic diet, and reassure them that, in most patients, increases in cholesterol may be short-lived, researchers say. Previous semipermanent studies by the Hopkins group of children world Health Organization were on the diet between six and 12 years echoed these findings. The ketogenic diet, believed to work by triggering biochemical changes that winnow out seizure-provoking short-circuits in the brain's sign system, is used in many children with hard-to-control epilepsy and in those whose seizures do non respond to traditional anticonvulsant drug medications.
"We are greatly bucked up by our findings because the near half of the children on the diet were either able-bodied to preserve healthy cholesterin or bit by bit metabolized the extra fat and returned to somewhat normal cholesterol levels," says senior detective Eric Kossoff, M.D., a pediatric brain doctor at Hopkins Children's. "This means the benefits of the diet-a diet that is lifesaving in many children and therapeutic in most of them-continue to outweigh the risks."
Noting that 40 per centum of children maintained normal cholesterol even after starting the diet, researchers found that children fed a formula-based, liquid-only ketogenic diet were nearly three times less likely to break high cholesterol. Researches property this finding to the nearly zero fat content in commonly used ketogenic diet formulas.
In the group with normal cholesterol, 78 percent of children (31 out of 40) were fed formula-based ketogenic diet. This determination, while requiring further study, points to another possible treatment for high cholesterol, Kossoff says, by shift children with persistently raised cholesterol to formula-based ketogenic diets at least some of the time. The formula-based ketogenic diet contains only tierce the amount of pure fats-the worst kind in terms of cholesterol-of the solid nutrient version of the ketogenic diet. Because doctors hindquarters tweak the ratio of fat vs. carbohydrates depending on each child's severeness of seizures, the investigators examined whether higher-fat versions of the ketogenic diet raised cholesterin additionally, merely found that higher-fat ratio did non make cholesterin worse than a lower-fat ratio.
Some of the other findings:
One-fourth of 121 children had elevated tot up cholesterol before starting the diet, which increased to 60 per centum (59 out of 99 children at follow-up) after the initiation of the diet.
18 percent (22 out of 119) had triglycerides all over 130 before the diet, which increased to 51 percent (49 out of 96) after starting the diet.
19 percent (21 out cx) had bad cholesterol over 130 earlier the diet, which increased to 53 percent (48 out of 93) subsequently starting the diet.
The research was funded in part by the National Institutes of Health. Other Hopkins investigators in the study: Juniad Nizamuddin, B.S., Zahava Turner, R.D., James Rubenstien, M.D., Paula Pyzik, B.A.
Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the virtually comprehensive pediatric medical programs in the country, treating more than 90,000 children each year. Hopkins Children's is consistently stratified among the top children's hospitals in the nation. Hopkins Children's is Maryland's largest children's hospital and the exclusively state-designated Trauma Service and Burn Unit for paediatric patients. It has recognized Centers of Excellence in 20 paediatric subspecialties, including allergy, cardiology, transplant, neurology, neurosurgery, cystic fibrosis, pulmonary, nephrology, gastroenterology and oncology. For more information, please visit http://www.hopkinschildrens.org/
Source: Katerina Pesheva
Johns Hopkins Medical Institutions
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