ABSTRACT
ABSTRACT The ketogenic diet (KD), a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. The KD was developed in 1921 and even though it has been increasingly used worldwide in the past decade, many neurologists are not familiar with this therapeutic approach. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients. This review summarizes the history of the KD and the principles and efficacy of the classic ketogenic diet, medium-chain triglyceride(s) (MCT) ketogenic diet, modified Atkins diet, and low glycemic index treatment.
RESUMO A dieta cetogênica, rica em gorduras, adequada em proteínas e pobre em carboidratos é uma opção de tratamento efetiva e bem estabelecida para epilepsia de difícil controle na infância. Foi desenvolvida em 1921 e nos últimos 20 anos tem sido utilizada em diferentes países e culturas, porém ainda é desconhecida entre muitos neurologistas e outras especialidades. Recentemente, no esforço de tornar a dieta mais palatável, de fácil administração e com menos efeitos adversos, dietas cetogênicas alternativas foram criadas, possibilitando a sua administração a um maior número de pacientes. Nesta revisão abordaremos a história, príncipios e eficácia da dieta cetogênica, da dieta com triglicérides de cadeia média, da dieta modificada de Atkins e da dieta com baixos índices glicêmicos.
Subject(s)
Humans , Epilepsy/diet therapy , Diet, Ketogenic/methods , Triglycerides/therapeutic use , Treatment Outcome , Glycemic Index , Diet, Carbohydrate-Restricted/methodsABSTRACT
Laurence-Moon-Bardet-Biedl syndrome is a rare, genetically heterogeneous, autosomal recessive inherited disorder with wide variability in expression. We report a case of Laurence-Moon-Bardet-Biedl syndrome with typical phenotype in conjunction with nonalcoholic steatohepatitis. The diagnosis had been missed until the patient presented at our hospital.
Subject(s)
Bardet-Biedl Syndrome/complications , Child , Diagnosis, Differential , Diet, Carbohydrate-Restricted/methods , Exercise Therapy/methods , Fatty Liver/diagnosis , Follow-Up Studies , Humans , MaleABSTRACT
Obesity in the past was only seen in great numbers in Western countries but is now gaining prevalence in India with a growing Indian economy. Historically a favourable phenotype, obesity has been associated with multiple diseases affecting almost all organ systems. In addition, the cost of obesity to a health care system is enormous. Weight loss improves many of the outcomes and yet is a difficult process for most patients with even the medical community baffled about methods for weight loss. Our group and others have looked at weight loss in obese individuals using a low carbohydrate diet and have shown some success at six months and one year. Many studies have also shown a decrease in insulin resistance and improvement in lipid profiles when obese individuals are placed on a low carbohydrate diet. The reason for weight loss on this diet was initially thought to be diuresis from increased ketone production but it may be due to decreased insulin concentrations causing a decrease in appetite. In addition, lowering carbohydrates limits food choice and in the process decreases overall calorie consumption. In the United States, an increase in calories, predominantly from carbohydrates, appears to parallel the obesity epidemic. However, it is not known if guidelines or policies lowering carbohydrates in normal or slightly overweight individuals may help prevent obesity and its complications. Equally less known, is the applicability of a low carbohydrate diet to populations like India where many main dishes are carbohydrate-based.