Carnitine, nutritional supplementation and discontinuation of ketogenic diet therapies
Section snippets
Carnitine
The ketogenic diet (KD) is a high fat, low carbohydrate dietary regimen used since the 1920s (Wilder, 1921). It is designed to imitate the metabolic changes occurring during fasting and has been shown to be successful in treating intractable epilepsy (Freeman et al., 1998, Lefevre and Aronson, 2000, Henderson et al., 2006, Neal et al., 2008). The classical KD is usually prescribed at a ratio of 3 or 4 g of fat to every 1 g of carbohydrate and protein combined, thus providing 87–90% of total
Nutritional supplementation
General nutritional supplementation for the KD is less controversial and well established within clinical implementation. The KD restricts intake of dairy products, fruit, vegetables, cereals and grain products. These high carbohydrate foods contain many of the 28 known essential micronutrients. The KD is deficient in major nutrients when compared to the Dietary Reference Intakes (DRIs). The DRIs are micronutrient standards established by the United States Food and Nutrition Board of the
Diet discontinuation: an international survey
A frequently asked question is what is the optimal duration of KD therapy? Doctors and dietitians have traditionally recommended that the KD be used for no longer than two years due to potential long term side effects, such as dyslipidemia, kidney stones, and decreased growth velocity (Groesbeck et al., 2006). Over the past 90 years of clinical use, the implementation of the diet has changed with the liberalization of calories and fluid restriction as well as vitamin and mineral supplementation
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