Manipulation of Types of Fats and Cholesterol Intake Can Successfully Improve the Lipid Profile While Maintaining the Efficacy of the Ketogenic Diet

Abstract

The ketogenic diet (KD) is a dietary therapy that effectively treats intractable epilepsy in children. Hyperlipidemias are common side effects of KD and have been reported in approximately 30% to 50% of patients on this diet. Fats comprise 90% of the calories, and saturated fats are often used as 50% of the fat intake. The purpose of this study was to investigate whether alterations of the dietary fat sources can improve the lipid profiles while maintaining seizure control in the ketogenic diet. Using a retrospective chart review, the authors evaluated their practices of treating hyperlipidemias in 6 children on the KD who developed elevated lipid profiles. All had normal or mildly elevated lipid profiles before beginning the KD. The elevated lipid levels were detected after an average of 7 months of KD treatment. Changing the dietary fat types to mainly oils (polyunsaturated fats) and decreasing the use of protein foods high in saturated fats and cholesterol resulted in a normalized or baseline lipid profile in all 3 months later. Seizure control was unaffected. Hyperlipidemia is not a cause for discontinuing the KD and can be managed by changing the dietary fat sources.