Ketogenic diet (KD) is one of the most effective therapies for intractable epilepsy. Olive oil is rich in monounsaturated fatty acids and antioxidant molecules and has some beneficial effects on lipid profile, inflammation and oxidant status. The aim of this study was to evaluate the serum lipid levels of children who were receiving olive oil-based KD for intractable seizures at least 1 year. 121 patients (mean age 7.45 ± 4.21 years, 57 girls) were enrolled. At baseline and post-treatment 1, 3, 6, and 12 months body mass index-SDS, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol and triglyceride levels were measured. Repeated measure ANOVA with post hoc Bonferroni correction was used for data analysis. The mean duration of KD was 15.4 ± 4.1 months. Mean total cholesterol, LDL-cholesterol and triglyceride levels were significantly higher at 1st, 3rd, 6th and 12th months of the KD treatment, compared to pre-treatment levels (p = 0.001), but showed no difference among during-treatment measurements. Mean body mass index-SDS and HDL-cholesterol levels were not different among the baseline and follow-up time points (p = 0.113 and p = 0.067, respectively). No child in this study discontinued the KD because of dyslipidemia. Even if rich in olive oil, high-fat KD causes significant increase in LDL-cholesterol and triglyceride levels. More studies are needed to determine the effect of KD on serum lipids in children using different fat sources in the diet.
Children Epilepsy Olive oil Ketogenic diet Cholesterol Triglyceride
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We thank all the patients and parents who contributed to this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study protocol was designed in compliance with the 1964 Declaration of Helsinki. Informed consent was obtained from parents on enrollment in the study. The study was started and data collection began after the approval of the Ethics Committee of the Dokuz Eylul University Faculty of Medicine (Number of ethical approval: 2015/10-38).
Henderson CB, Filloux FM, Alder SC, Lyon JL, Caplin DA (2006) Efficacy of the ketogenic diet as a treatment option for epilepsy: meta-analysis. J Child Neurol 21(3):193–198PubMedGoogle Scholar
Wibisono C, Rowe N, Beavis E, Kepreotes H, Mackie FE, Lawson JA, Cardamone M (2015) Ten-year single-center experience of the ketogenic diet: factors influencing efficacy, tolerability, and compliance. J Pediatr 166(4):1030–1036PubMedCrossRefGoogle Scholar
Hallböök T, Sjölander A, Åmark P, Miranda M, Bjurulf B, Dahlin M (2015) Effectiveness of the ketogenic diet used to treat resistant childhood epilepsy in Scandinavia. Eur J Paediatr Neurol 19(1):29–36PubMedCrossRefGoogle Scholar
Schoeler NE, Wood S, Aldridge V, Sander JW, Cross JH, Sisodiya SM (2014) Ketogenic dietary therapies for adults with epilepsy: feasibility and classification of response. Epilepsy Behav 37:77–81PubMedCrossRefGoogle Scholar
Groleau V, Schall JI, Stallings VA, Bergqvist CA (2014) Long-term impact of the ketogenic diet on growth and resting energy expenditure in children with intractable epilepsy. Dev Med Child Neurol 56(9):898–904PubMedPubMedCentralCrossRefGoogle Scholar
Nei M, Ngo L, Sirven JI, Sperling MR (2014) Ketogenic diet in adolescents and adults with epilepsy. Seizure 23(6):439–442PubMedCrossRefGoogle Scholar
Groesbeck DK, Bluml RM, Kossoff EH (2006) Long-term use of the ketogenic diet in the treatment of epilepsy. Dev Med Child Neurol 48(12):978–981PubMedCrossRefGoogle Scholar
Kwiterovich PO, Vining EP, Pyzik P, Skolasky R, Freeman JM (2003) Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and apolipoproteins in children. JAMA 290(7):912–920PubMedCrossRefGoogle Scholar
Nizamuddin J, Turner Z, Rubenstein JE, Pyzik PL, Kossoff EH (2008) Management and risk factors for dyslipidemia with the ketogenic diet. J Child Neurol 23(7):758–761PubMedCrossRefGoogle Scholar
Coppola G, Natale F, Torino A, Capasso R, D’Aniello A, Pironti E, Santoro E, Calabrò R, Verrotti A (2014) The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 23(4):260–265PubMedCrossRefGoogle Scholar
Doksöz O, Güzel O, Yılmaz U, İşgüder R, Çeleğen K, Meşe T, Uysal U. The short-term effect of ketogenic diet on carotid intima-media thickness and elastic properties of the carotid artery and the aorta in epileptic children. J Child Neurol (pii: 0883073815576793; in press)Google Scholar
Kapetanakis M, Liuba P, Odermarsky M, Lundgren J, Hallbook T (2014) Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 18(4):489–494PubMedCrossRefGoogle Scholar
El-Rashidy OF, Nassar MF, Abdel-Hamid IA, Shatla RH, Abdel-Hamid MH, Gabr SS, Mohamed SG, El-Sayed WS, Shaaban SY (2013) Modified Atkins diet vs classic ketogenic formula in intractable epilepsy. Acta Neurol Scand 128(6):402–408PubMedCrossRefGoogle Scholar
Kossoff E, Shields WD (2014) Nonpharmacologic care for patients with Lennox-Gastaut syndrome: ketogenic diets and vagus nerve stimulation. Epilepsia 55(Suppl 4):29–33PubMedCrossRefGoogle Scholar
Venturini D, Simão AN, Urbano MR, Dichi I (2015) Effects of extra virgin olive oil and fish oil on lipid profile and oxidative stress in patients with metabolic syndrome. Nutrition 31(6):834–840PubMedCrossRefGoogle Scholar
Paoli A, Cenci L, Grimaldi KA (2011) Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. Nutr J 12(10):112CrossRefGoogle Scholar
Peñalvo JL, Oliva B, Sotos-Prieto M, Uzhova I, Moreno-Franco B, León-Latre M, Ordovás JM (2015) Greater adherence to a Mediterranean dietary pattern is associated with improved plasma lipid profile: the Aragon Health Workers Study cohort. Rev Esp Cardiol (Engl Ed) 68(4):290–297CrossRefGoogle Scholar
Fito M, Covas MI, Lamuela-Raventos RM, Vila J, Torrents L, de la Torre C, Marrugat J (2000) Protective effect of olive oil and its phenolic compounds against low density lipoprotein oxidation. Lipids 35(6):633–638PubMedCrossRefGoogle Scholar
Visioli F, Bellomo G, Modedoro G, Galli C (1995) Low density lipoprotein oxidation is inhibited in vitro by olive oil constituents. Atherosclerosis 117(1):25–32PubMedCrossRefGoogle Scholar
Zamora-Ros R, Serafini M, Estruch R et al (2013) Mediterranean diet and non enzymatic antioxidant capacity in the PREDIMED study: evidence for a mechanism of antioxidant tuning. Nutr Metab Cardiovasc Dis 23(12):1167–1174PubMedCrossRefGoogle Scholar
Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18(6):499–502PubMedGoogle Scholar
Buil-Cosiales P, Irimia P, Berrade N, Garcia-Arellano A, Riverol M, Murie-Fernández M, Martínez-Vila E, Martínez-González MA, Serrano-Martínez M (2008) Carotid intima-media thickness is inversely associated with olive oil consumption. Atherosclerosis 196(2):742–748PubMedCrossRefGoogle Scholar
Mente A, de Koning L, Shannon HS, Anand SS (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169(7):659–669PubMedCrossRefGoogle Scholar
Liu YM, Lowe H, Zak MM, Kobayashi J, Chan VW, Donner EJ (2013) Can children with hyperlipidemia receive ketogenic diet for medication resistant epilepsy? J Child Neurol 28(4):479–483PubMedCrossRefGoogle Scholar
Aynaci FM, Orhan F, Orem A, Yildirmis S, Gedik Y (2001) Effect of antiepileptic drugs on plasma lipoprotein (a) and other lipid levels in childhood. J Child Neurol 16(5):367–369PubMedCrossRefGoogle Scholar
Verrotti A, Basciani F, Domizio S, Sabatino G, Morgese G, Chiarelli F (1998) Serum lipids and lipoproteins in patients treated with antiepileptic drugs. Pediatr Neurol 19(5):364–367PubMedCrossRefGoogle Scholar
Sonmez FM, Demir E, Orem A, Yildirmis S, Orhan F, Aslan A, Topbas M (2006) Effect of antiepileptic drugs on plasma lipids, lipoprotein (a), and liver enzymes. J Child Neurol 21(1):70–74PubMedCrossRefGoogle Scholar