Liu Yeou-Mei Christiana, Williams Shelley, Basualdo-Hammond Carlota, Stephens Derek, Curtis Rosalind
The Hospital for Sick Children, Room 6D47 Atrium, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
J Am Diet Assoc. 2003 Jun;103(6):707-12. doi: 10.1053/jada.2003.50136.
To assess the nutritional status of children treated with the classic and medium-chain triglyceride (MCT) ketogenic diets.
A prospective, nonrandomized study design was used to measure nutrient intakes, growth, and biochemical indexes of children, age 1 to 16 years, with intractable epilepsy before and after 4 months' treatment with the classic and MCT ketogenic diets. None of the children had been on earlier dietary regimens.
Of 58 children asked to participate in the study between September 1998 and July 2000, consent was obtained for 30 children. Fourteen children on the classic diet and 11 children on the MCT diet completed the study (83% completed). Statistical analysis performed Paired t tests were done on anthropometric and biochemical indexes. Nutrient intakes were compared with Dietary Reference Intakes (DRIs).
Both groups had statistically significant height increases of 2 to 3 cm (P<.05), but did not have significant increases in height/age percentiles. Weight percentiles decreased by approximately 10 percentiles for both diets; P=.043 for classic diet and.051 for MCT diet. Nutrient intakes from the diet and vitamin and mineral supplements met the DRIs except for phosphorus (both diets) and folate (classic diet). All biochemical indexes, including albumin, remained within the normal range. For the MCT diet, there was a 0.7 decrease in the ratio of total cholesterol to high-density lipoprotein ratios (P<.0009) at 4 months.
When treating children on a ketogenic diet, clinicians should recommend adequate intake of energy and protein, a higher proportion of unsaturated to saturated dietary fats, and consider vitamin and mineral supplements.
评估采用经典生酮饮食和中链甘油三酯（MCT）生酮饮食治疗的儿童的营养状况。
采用前瞻性、非随机研究设计，测量1至16岁难治性癫痫儿童在接受经典生酮饮食和MCT生酮饮食治疗4个月前后的营养摄入、生长情况和生化指标。所有儿童此前均未采用过其他饮食方案。
在1998年9月至2000年7月期间邀请参与研究的58名儿童中，30名儿童同意参与。14名采用经典饮食的儿童和11名采用MCT饮食的儿童完成了研究（完成率83%）。对人体测量和生化指标进行配对t检验统计分析。将营养摄入量与膳食参考摄入量（DRIs）进行比较。
两组儿童身高均有统计学意义的增加，增加幅度为2至3厘米（P<0.05），但身高/年龄百分位数无显著增加。两种饮食方案的体重百分位数均下降了约10个百分位数；经典饮食组P = 0.043，MCT饮食组P = 0.051。饮食及维生素和矿物质补充剂中的营养摄入量均达到DRIs标准，但磷（两种饮食方案）和叶酸（经典饮食方案）除外。所有生化指标，包括白蛋白，均保持在正常范围内。对于MCT饮食方案，4个月时总胆固醇与高密度脂蛋白的比率下降了0.7（P<0.0009）。
在采用生酮饮食治疗儿童时，临床医生应建议摄入充足的能量和蛋白质，不饱和脂肪与饱和脂肪的膳食比例应更高，并考虑补充维生素和矿物质。
