Effectiveness of Ketogenic Diet in Children with Epileptic Disorders: A Meta-Analysis and Systematic Review

Duha Janahi1, Feras Alhussainy1, Fatimah Al Hassan1, Taiba Alhumaidi1, Deema Altamimi1, Saad Alharbi1, Omar Zainal1, Haitham Jahrami1, 2*, Mo’ez Al-Islam Faris3
1College of Medicine and Medical Sciences, Arabian Gulf University; 2Ministry of Health, Kingdom of Bahrain; 3Department of Clinical Nutrition and Dietetics, College of Health Sciences/Sharjah Institute for Medical Research (SIMR), University of Sharjah, Sharjah, United Arab Emirates
*Corresponding Author Email Address: hjahrami@health.gov.bh

ABSTRACT
Background: Epilepsy is a central nervous disorder that affects children at great magnitude. Cognitive, emotional, and behavioral symptoms are common. The ketogenic diet (KD) is a dietary treatment option, particularly for intractable seizures. The effectiveness of KD in the management of epileptic disorders (ED) varies between studies. Objective: The aim of this meta-analysis and systematic review is to determine the effectiveness of KD in the management of ED in children. Methods: A literature search was performed using relevant key terms to identify studies published from 1998 to 2017 on KD, ED, and children. Studies were identified through an electronic search of Embase, MEDLINE, and ProQuest databases. The main outcomes and measures were ≤ 50% reduction of seizure episodes at one month, three months, six months and twelve months of treatment. Data were pooled using random effects meta-analysis technique. Results: Fourteen studies were included in the meta-analysis and systematic review including 1276 participants. Reductions of seizure episodes by ≥50% (which is clinically relevant) using KD were 22.9%, 49.9%, 37.9% and 30.8% after one month, three months, six months and twelve months of treatment, respectively. Conclusion: There is some evidence that KD is effective in the management of some cases of ED. Reduction of ≥ 50% seizure episodes is seen mainly at the first three months and declines thereafter, possibly due to the side effects or non-adherence with KD. The decision to adopt this type of diet should be based on both short-term and long-term goals, taking into consideration the cost, safety and efficacy of the treatment. Effectiveness in the first three months appears to be an indicator of the outcomes of interest.

Keywords: Ketogenic Diet, Epileptic Disorder, Children, Meta-analysis, Systematic Review

Citation: Janahi D, Alhussainy F, Al-Hassan F, Alhumaidi T, Altamimi D, Alharbi S, Zainal O, Jahrami H, Faris MAI. Effectiveness of Ketogenic Diet in Children with Epileptic Disorders: A Meta-Analysis and Systematic Review. Canad J Clin Nutr 2018; 6 (2): 105-125.

DOI: http://dx.doi.org/10.14206/canad.j.clin.nutr.2018.02.09

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