J Clin Neurol.  2015 Jan;11(1):26-31. 10.3988/jcn.2015.11.1.26.

Efficacy of and Patient Compliance with a Ketogenic Diet in Adults with Intractable Epilepsy: A Meta-Analysis

• Ye F
• Li XJ
• Jiang WL
• Sun HB
• Liu J

• KMID: 2179569
• DOI: http://doi.org/10.3988/jcn.2015.11.1.26

Abstract

BACKGROUND AND PURPOSE
Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice.
METHODS
Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes.
RESULTS
In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%.
CONCLUSIONS
The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet.

Keyword

ketogenic diet; adult; intractable epilepsy; efficacy; compliance

MeSH Terms

Adult*
Compliance
Diet, Carbohydrate-Restricted
Epilepsy*
Humans
Ketogenic Diet*
Patient Compliance*

Figure

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  Fig. 1 Flowchart of studies included and excluded. KD: ketogenic diet.

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  Fig. 2 The forest and funnel plots of the combined efficacy rates of ketogenic diet and its variants. CI: confidence interval, CKD: classical ketogenic diet, MAD: modified Atkins diet, MCT: medium-chain triglycerides diet, N: number of total subjects, n: number of patients achieving success in total subjects, % weight: percentage that each study counts in the results of the meta-analysis.

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  Fig. 3 The forest and funnel plots of the combined compliance rates of ketogenic diet and its variants. CI: confidence interval, CKD: classical ketogenic diet, MAD: modified Atkins diet, MCT: medium-chain triglycerides diet, % weight: percentage that each study counts in the results of the meta-analysis.

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