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The effects of ketogenic diet on beta-hydroxybutyrate, arachidonic acid, and oxidative stress in pediatric epilepsy.

Epilepsy & behavior : E&B
March 1, 2023
Bita Poorshiri et al. (8 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to evaluate whether a ketogenic diet (KD) reduces oxidative stress by increasing Arachidonic Acid (ARA) and beta-hydroxybutyrate (BHB) as a potential mechanism for alleviating seizures in children with drug-resistant epilepsy (DRE).

Results Summary

The study found that serum levels of ARA and BHB significantly increased after KD therapy, correlating with reduced oxidative stress markers (MDA and 8-OHdG) and a 61.76% responder rate (≥50% seizure reduction). BHB's role in reducing oxidative stress and seizures appeared more pronounced than ARA's.

Population

Forty children with refractory epilepsy (34 completed the study).

Effective Dosage

Not specified

Duration

3 months

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
ketogenic diet (KD) therapy
decrease
seizure frequency
children with drug-resistant epilepsy (DRE)
more than 50%
more than a 50% reduction
#1
ketogenic diet (KD) therapy
increase
serum levels of Arachidonic acid (ARA)
children with drug-resistant epilepsy (DRE)
-
significantly increased
#2
ketogenic diet (KD) therapy
increase
serum levels of beta-hydroxybutyrate (BHB)
children with drug-resistant epilepsy (DRE)
-
significantly increased
#3
ketogenic diet (KD) therapy
decrease
serum levels of malondialdehyde (MDA)
children with drug-resistant epilepsy (DRE)
-
significantly higher before than after
#4
ketogenic diet (KD) therapy
decrease
serum levels of 8-hydroxyl-deoxyguanosine (8-OHdG)
children with drug-resistant epilepsy (DRE)
-
significantly higher before than after
#5
ketogenic diet (KD) therapy
increase
serum levels of beta-hydroxybutyrate (BHB)
responders (children with DRE)
-
higher in responders than non-responders
#6
ketogenic diet (KD) therapy
decrease
serum levels of malondialdehyde (MDA)
responders (children with DRE)
-
lower in responders than non-responders
#7
ketogenic diet (KD)
decrease
brain oxidative stress (OS)
-
-
might reduce
#8
ketogenic diet (KD)
increase
beta-hydroxybutyrate (BHB)
-
-
by increasing
#9
ketogenic diet (KD)
increase
Arachidonic acid (ARA)
-
-
by increasing
#10
beta-hydroxybutyrate (BHB)
decrease
oxidative stress (OS)
-
-
role in diminishing
#11
beta-hydroxybutyrate (BHB)
decrease
seizure
-
-
role in diminishing
#12
Abstract

The exact mechanism of a ketogenic diet (KD) as a suitable alternative therapeutic approach for drug-resistant epilepsy (DRE) in alleviating seizures is not yet fully understood. The present study aimed to evaluate the role of the KD in reducing oxidative stress (OS) by increasing the ketone body beta-hydroxybutyrate (BHB) and Arachidonic acid (ARA), an essential polyunsaturated fatty acid, as a possible mechanism in relieving seizure attacks in children with DRE. Forty children with refractory epilepsy were included in the present study. The serum levels of BHB, ARA, and OS markers, malondialdehyde (MDA), and 8-hydroxyl-deoxyguanosine (8-OHdG), were evaluated in children with DRE and compared before and after the three months of KD therapy. Thirty-four of 40 included children could complete the three-month KD therapy. Twenty-one (61.76%) patients had more than a 50% reduction in seizure frequency after the KD (responders). The remaining 13 children were considered non-responders to the diet. The serum levels of ARA and BHB significantly (p < 0.05) increased after the KD therapy. The serum levels of OS parameters MDA and 8-OHdG before the diet therapy were significantly (p < 0.05) higher than those after the administration. The serum levels of BHB and MDA after the KD therapy in the responders were respectively higher and lower than those in the non-responders (p < 0.001). Ketogenic diet might reduce brain OS by increasing BHB and ARA. The role of BHB in diminishing OS and seizure might be more remarkable than ARA.

Medical Subject Headings (MeSH)
ChildHumansDiet, Ketogenic3-Hydroxybutyric AcidArachidonic AcidEpilepsySeizuresDrug Resistant EpilepsyTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations10
Citations/Year5.0
Relative Citation Ratio2.83
NIH Percentile83.7%
Research Impact Scores
APT Score0.75
Weight Score2.82
Normalized Score0.66
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