Herlev University Hospital, Herlev, Denmark.
Epilepsy Res. 2012 Jul;100(3):278-85. doi: 10.1016/j.eplepsyres.2012.06.007. Epub 2012 Jul 6.
The ketogenic diet (KD), a high-fat, adequate protein, low-carbohydrate diet has been used since 1921 for the treatment of severe medically refractory epilepsy. In the past 15 years, the use of the KD has expanded enormously and a huge amount of clinical evidence of its efficacy is available. The classical KD is however restrictive and therefore alternative more liberal varieties of the classical KD have been developed within the last 8 years. The purpose of this report is to summarise the principles and evidence of effectiveness of the alternative ketogenic diets: Medium Chain Triglyceride (MCT)-KD, modified Atkins diet (MAD) and low glycaemic index treatment (LGIT), compared to the classical KD. The clinical evidence to date suggests that the more liberal versions of the classical KD such as MCT KD, MAD and LGIT have an efficacy close to the classical KD; however, no RCT data are available for MAD and LGIT. This evidence suggests that factors such as age, epilepsy type, lifestyle and resources are important factors in deciding which diet we should start a patient on. This report intends to summarise guidelines based on the evidence available.
生酮饮食（KD）是一种高脂肪、适量蛋白质、低碳水化合物的饮食，自 1921 年以来一直用于治疗严重的医学难治性癫痫。在过去的 15 年中，KD 的应用已经大大扩展，并且有大量关于其疗效的临床证据。然而，经典 KD 是有限制性的，因此在过去 8 年中已经开发出了更宽松的经典 KD 替代方案。本报告的目的是总结替代生酮饮食的原则和有效性证据：中链甘油三酯（MCT）-KD、改良的阿特金斯饮食（MAD）和低血糖指数治疗（LGIT），与经典 KD 相比。迄今为止的临床证据表明，经典 KD 的更宽松版本，如 MCT KD、MAD 和 LGIT，与经典 KD 具有相近的疗效；然而，MAD 和 LGIT 尚无 RCT 数据。这一证据表明，年龄、癫痫类型、生活方式和资源等因素是决定我们应该给患者开始哪种饮食的重要因素。本报告旨在根据现有证据总结指南。
