Ketogenic diet therapies as a non-pharmacological adjuvant in resistant epilepsy: retrospective analysis of adult outpatients in Colombia

ABSTRACT

Twelve patients between 18 and 53 years of age were included. MAD plus nutritional supplementation was administered to 75% (n = 10) of the participants, one (8.3%) received MAD alone, and 16.7 (n = 2) received Classic Ketogenic Diet (cKD) plus nutritional supplementation. Oral nutritional supplementation, administered in the outpatient setting, provided patients with between 31 and 55% of the total caloric value. In the first month of KDT treatment, 83.3% (n = 10) of patients reduced the number of weekly seizures by 40% (median). At six months of treatment, 75% of patients had at least halved the number of weekly seizures. At 12 months of treatment, the number of weekly seizures had been reduced by 85.7% (median). KDT was well tolerated, and there was no need to discontinue treatment. This study provides real-world information on the use of KDT, particularly MAD in adults, in developing countries. Future studies in larger cohorts will provide further information on different types of KDT, adherence, and patient-reported outcomes.

KEYWORDS:

• Drug resistant epilepsy
• ketogenic diet therapies
• modified atkins diet
• Latin America
• diet
• carbohydrate-restricted
• adult
• epilepsy and observational study

Acknowledgements

We thanked all members of Project Huitaca (www.projecthuitaca.org) for contributing with the scientific advice for this paper. Its effort to contribute to scientific writing by women in Latin America is remarkable. We also thank EpiThink Health Consulting for data analysis, medical writing, and editorial support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

AM evaluated and treated the included patients in her epileptology consultation. DC and JB collected the data. All authors reviewed and approved the final manuscript.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Ethical aspects

As a retrospective study of routine patient care, according to Colombian legislation, it did not require an Institutional Review Board approval. The study was performed in accordance to the Helsinki Declaration of 1964 and its later amendments. According to local policies, it is classified as a risk-free research study because it is exclusively documentary-based.

Additional information

Funding

The authors did not receive any funding for this study. Danone Baby Nutrition Colombia supported this publication's data analysis and medical writing, performed by Epithink Health Consulting.

Notes on contributors

Jennifer Katherine Ballesteros Tapias

Jennifer Katherine Ballesteros Tapias, Medical doctor pursuing a geriatrics specialisation at Hospital Universitario San Ignacio, Bogotá Colombia.

Diana Isabel Conde Hurtado

Diana Isabel Conde Hurtado, Medical doctor and clinical epidemiologist. Current general practitioner at hospital Universitario de Santander.

Luz Helena Castaño

Luz Helena Castaño, Nutritionist and dietitian, certified training in inborn metabolic errors and ketogenic therapies for neurological disorders. Current medical advisor at Danone Nutricia Colombia.

Adriana Martínez Pérez

Adriana Martínez Pérez, Neurologist with advanced education in epilepsy and a Master's Degree in Neuroimmunology. Active member of the Colombian Association of Neurology since 2009, being part of the Board of Directors from 2018 to 2020. Professor at the Autonomous University of Bucaramanga.