The impact of ketogenic diet on drug-resistant epilepsy in children: A comprehensive review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 38315271 · doi:10.1007/s11845-024-03622-8
What was done
Systematic review and meta-analysis searching Cochrane, Embase, Medline, and PubMed to assess the efficacy and safety of ketogenic dietary interventions (including modified Atkins and low glycemic index diets) in pediatric drug-resistant epilepsy. The authors included 11 randomized controlled trials comprising 788 participants using predefined criteria and quality assessment.
What was found
Dietary interventions significantly increased the odds of achieving >50% seizure reduction (OR 6.68, 96% CI 3.52 to 12.67), >90% seizure reduction (OR 4.37, 95% CI 2.04 to 9.37), and complete seizure freedom (OR 4.13, 95% CI 1.61 to 10.60). Commonly reported adverse effects were constipation (39.07%) and vomiting (10%).
Why it matters
This meta-analysis aggregates randomized trial evidence confirming that ketogenic diets substantially improve seizure control and can achieve seizure freedom in children with treatment-resistant epilepsy who fail pharmacotherapy.
Limits
The total sample size across 11 trials is modest (788 participants, averaging ~72 per trial). The abstract does not break down efficacy by specific diet type (e.g., classic KD vs. MAD vs. LGID), does not report treatment duration, and notes a lack of long-term outcome data. Constipation and vomiting were frequent side effects.
Cited by
- supports Ketogenic metabolic therapy has been used clinically in children for decades to manage epilepsy.