Ketogenic Diets in Children With Intractable Epilepsy and its Effects on Gastrointestinal Function, Gut Microbiome, Inflammation, and Quality of Life

Study information

Needs review

study design

case-control

Citation

PMID PubMed identifier for scientific articles.

37679873

DOI Digital object identifier for electronic documents.

10.1097/MPG.0000000000003928

URI

Authors

Menzies J, Sundararaj A, Cardamone M, McHarg A, Leach S, Krishnan U

Journal

Journal of pediatric gastroenterology and nutrition

Year

2023

OBJECTIVES: The ketogenic diet (KD) is a treatment for children with intractable epilepsy (IE), can cause gastrointestinal symptoms, and have an adverse effect on growth, nutrition and quality of life (QOL). This study investigated the extent of these side effects by comparing children with IE on KDs to their counterparts on normal diets. METHODS: Patients with IE were categorized into patients with KD or control groups. Gastrointestinal side effects and QOL were assessed using the PedsQL Gastrointestinal Symptoms Module. Cross sectional growth, gut microbiome compositions, and inflammation levels were also analyzed. RESULTS: Fourteen patients on the KD and 13 control patients were enrolled. Patients had been on KD for a median duration of 15 months (interquartile range: 9.8-60 months). The patients on the KD reported a trend to lower total gastrointestinal symptoms scores (more symptoms) compared to control patients, at 71.1 and 84.9, respectively ( P = 0.06, not significant). Patients on the KD had significantly lower QOL scores compared to control patients ( P = 0.01). Patients on the KD were found to have consistently lower median height/length, weight, and body mass index z scores compared to the controls although these were not statistically significant. Patients on the KD had a lower microbial diversity, Both groups had a normal level of S100A12, a marker of gut inflammation. CONCLUSIONS: Patients on the KD reported a trend to more gastrointestinal symptoms and more QOL concerns compared to controls. Although microbial differences were noted in patients on the KD, this did not result in detectable gut inflammation.

Experiment 1

Edit History Delete

Mark reviewed

Your review change was submittedDuplicate this Experiment Add a new Signature

Needs review

Curated date: 2024/12/11

Curator: Kavyaayala

Revision editor(s): Kavyaayala

Subjects

Location of subjects: Australia

Host species Species from which microbiome was sampled. Contact us to have more species added.: Homo sapiens

Body site Anatomical site where microbial samples were extracted from according to the Uber Anatomy Ontology: Feces Cow dung,Cow pat,Droppings,Dung,Excrement,Excreta,Faeces,Fecal material,Fecal matter,Fewmet,Frass,Guano,Matières fécales@fr,Merde@fr,Ordure,Partie de la merde@fr,Piece of shit,Porción de mierda@es,Portion of dung,Portion of excrement,Portion of faeces,Portion of fecal material,Portion of fecal matter,Portion of feces,Portion of guano,Portion of scat,Portionem cacas,Scat,Spoor,Spraint,Stool,Teil der fäkalien@de,Feces,feces

Condition The experimental condition / phenotype studied according to the Experimental Factor Ontology: Ketogenic diet Ketogenic diet,ketogenic diet

Group 0 name Corresponds to the control (unexposed) group for case-control studies: Non-Ketogenic Diet Group

Group 1 name Corresponds to the case (exposed) group for case-control studies: Ketogenic Diet Group

Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group: children between 0 and 17 diagnosed with intractable epilepsy (IE) by their treating neurologist and undergoing ketogenic diet (KD) treatment

Group 0 sample size Number of subjects in the control (unexposed) group: 12

Group 1 sample size Number of subjects in the case (exposed) group: 14

Lab analysis

Sequencing type: 16S

16S variable region One or more hypervariable region(s) of the bacterial 16S gene: V4

Sequencing platform Manufacturer and experimental platform used for quantifying microbial abundance: Illumina

Statistical Analysis

Data transformation Data transformation applied to microbial abundance measurements prior to differential abundance testing (if any).: relative abundances

Statistical test: ANOSIM

Significance threshold p-value or FDR threshold used for differential abundance testing (if any): 0.05

Alpha Diversity

Shannon Estimator of species richness and species evenness: more weight on species richness: unchanged

Simpson Estimator of species richness and species evenness: more weight on species evenness: unchanged

Signature 1

Edit History Delete

Mark reviewed

Your review change was submitted

Needs review

Curated date: 2024/12/11

Curator: Kavyaayala

Revision editor(s): Kavyaayala

Source: Supplemental Digital Content 4

Description: Comparison of IE group receiving ketogenic diet treatment vs IE group undergoing traditional treatment

Abundance in Group 1: increased abundance in Ketogenic Diet Group

NCBI	Quality Control	Links
Bacteroidia

Revision editor(s): Kavyaayala

Signature 2

Edit History Delete

Mark reviewed

Your review change was submitted

Needs review

Curated date: 2024/12/11

Curator: Kavyaayala

Revision editor(s): Kavyaayala

Source: Supplemental Digital Content 4

Description: Comparison of IE group receiving ketogenic diet treatment vs IE group undergoing traditional treatment

Abundance in Group 1: decreased abundance in Ketogenic Diet Group

NCBI	Quality Control	Links
Actinomycetota

Revision editor(s): Kavyaayala