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将营养性酮症作为治愈小儿大脑的一种选择提出来讨论。

Bringing nutritional ketosis to the table as an option for healing the pediatric brain.

作者信息

Gertler Tracy S, Blackford Robyn

机构信息

Division of Pediatric Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.

Division of Clinical Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.

出版信息

Front Nutr. 2024 Jun 12;11:1408327. doi: 10.3389/fnut.2024.1408327. eCollection 2024.

Abstract

Our core premise is that personalized variations of a ketogenic diet are likely to benefit pediatric patients with neuropsychiatric symptoms across multiple domains. Although pediatric epilepsy is currently a well-accepted indication for a strict ketogenic diet, there is a dearth of knowledge and therefore clinical guidelines upon which to recommend nutritional ketosis for pervasive pediatric conditions such as autism spectrum disorder and ADHD, even when comorbid epilepsy is present. However, there are published cohort studies and current clinical trials implementing medical ketogenic therapies for cognitive impairment, psychiatric comorbidities, motor disability, and even neuroinflammation. As holistic practitioners, it is imperative that we consider the health of a child in its entirety - and additionally offer the ketogenic diet as a therapeutic option when it may be synergistic in treating extra-neurologic diseases such as obesity. While there are uniquely pediatric potential adverse side effects such as linear growth deceleration and micronutrient deficiencies, previous trials in epilepsy and our center's experience have already proven the ketogenic diet to be a low-risk intervention when optimized with appropriate patient monitoring and support.

摘要

我们的核心前提是,生酮饮食的个性化变体可能会在多个领域使患有神经精神症状的儿科患者受益。虽然儿科癫痫目前是严格生酮饮食的一个被广泛认可的适应症,但对于自闭症谱系障碍和注意力缺陷多动障碍等普遍存在的儿科疾病,即便存在合并癫痫的情况,在推荐营养性酮症方面仍缺乏相关知识,因此也没有临床指南。然而,有已发表的队列研究以及当前正在进行的临床试验,针对认知障碍、精神共病、运动残疾甚至神经炎症实施医学生酮疗法。作为整体治疗从业者,我们必须全面考虑儿童的健康状况——此外,当生酮饮食在治疗肥胖等神经外疾病时可能具有协同作用时,应将其作为一种治疗选择提供给患者。虽然存在如线性生长减速和微量营养素缺乏等独特的儿科潜在不良副作用,但先前在癫痫方面的试验以及我们中心的经验已经证明,通过适当的患者监测和支持进行优化后,生酮饮食是一种低风险的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/11199727/d9f0591c20e0/fnut-11-1408327-g001.jpg

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