Effect of a High-Fat Ketogenic Diet on Plasma Levels of Lipids, Lipoproteins, and Apolipoproteins in Children
Context Little prospective long-term information is available on the effect of a ketogenic diet on plasma lipoproteins in children with difficult-to-control seizures.
Objective To determine the effect in children with intractable seizures of a high-fat ketogenic diet on plasma levels of the major apolipoprotein B (apoB)???containing lipoproteins, low-density lipoprotein (LDL) and very LDL (VLDL); and the major apolipoprotein A-I (apoA-I)???containing lipoprotein, high-density lipoprotein (HDL).
Design, Setting, and Patients A 6-month prospective cohort study of 141 children (mean [SD] age, 5.2 [3.8] years for 70 boys and 6.1 [4.4] years for 71 girls) with difficult-to-treat seizures who were hospitalized for initiation of a high-fat ketogenic diet and followed up as outpatients. This cohort constituted a subgroup of the 371 patients accepted into the ketogenic diet program between 1994 and 2001. A subset of the cohort was also studied after 12 (n = 59) and 24 (n = 27) months.
Intervention A ketogenic diet consisting of a high ratio of fat to carbohydrate and protein combined (4:1 [n = 102], 3.5:1 [n = 7], or 3:1 [n = 32]). After diet initiation, the calories and ratio were adjusted to maintain ideal body weight for height and maximal urinary ketosis for seizure control.
Main Outcome Measures Differences at baseline and 6-month follow-up for levels of total, VLDL, LDL, HDL, and non-HDL cholesterol; triglycerides; total apoB; and apoA-I.
Results At 6 months, the high-fat ketogenic diet significantly increased the mean plasma levels of total (58 mg/dL [1.50 mmol/L]), LDL (50 mg/dL [1.30 mmol/L]), VLDL (8 mg/dL [0.21 mmol/L]), and non-HDL cholesterol (63 mg/dL [1.63 mmol/L]) (P<.001 vs baseline for each); triglycerides (58 mg/dL [0.66 mmol/L]) (P<.001); and total apoB (49 mg/dL) (P<.001). Mean HDL cholesterol decreased significantly (P<.001), although apoA-I increased (4 mg/dL) (P = .23). Significant but less marked changes persisted in children observed after 12 and 24 months.
Conclusions A high-fat ketogenic diet produced significant increases in the atherogenic apoB???containing lipoproteins and a decrease in the antiatherogenic HDL cholesterol. Further studies are necessary to determine if such a diet adversely affects endothelial vascular function and promotes inflammation and formation of atherosclerotic lesions.
asked byAgingHippie (614)
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on March 27, 2013
at 07:36 PM
I am always concerned reading modern research about the lack of awareness of the general deficiency status in modern humans with regard to Vitamin D3, Magnesium, potassium omega 3 and melatonin compared to the optimal levels typical of those living now as hunter gatherers in East Africa.
It seems to me a total disregard for the lack of anti-inflammatory reserves is tantamount to medical negligence. We would regard as idiots anyone managing a racing cars if no regard was paid to fundamentals like optimal tyre pressures or coolant levels.
We know Statins mimic the actions of Vitamin D and work in a way similar to magnesium, we know omega 3 reduces triglycerides and that melatonin has a role in metabolic syndrome and plays a major role as a natural anti inflammatory agent.
If we are about to embark on a long and difficult journey wouldn't it be common sense to start by making sure your tyre pressures and coolant levels met makers recommended settings?
If you are going to embark on a diet with the potential to raise inflammatory status isn't it common sense, before starting, to ensure the optimal natural levels of natural anti-inflammatory agents are equivalent to those human DNA evolved with?
on March 27, 2013
at 07:17 PM
I'm pretty sure it can be dangerous if done recklessly.
Dangerous or not, though, I'm quite positive that scheduled carbloading will greatly improve results.
on March 27, 2013
at 07:03 PM
As I said in my comment above, I think this study has some strong points -- especially the use of detailed lipid testing and a long follow-up period. The authors note that these findings are probably not generalizable to adults on a ketogenic diet for weightloss:
Adults losing weight are eating a hypocaloric diet, which might have different effects from growing kids who want to meet or exceed their caloric needs.
Adults losing weight tend to improve their lipid profile as a result of losing excess fat, which would compensate for negative influences from the diet.
Adults losing weight tend to stay on a ketogenic diet for a relatively short time, in comparison to severely epileptic kids who will be on a ketogenic diet for years or longer.
However, they may well be applicable to people who are healthy and without excess fat, but intending to maintain ketosis indefinitely.