The effect of olive oil-based ketogenic diet on serum lipid levels in epileptic children

Abstract

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.

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References

  1. 1.

    Vidali S, Aminzadeh S, Lambert B, Rutherford T, Sperl W, Kofler B, Feichtinger RG (2015) Mitochondria: the ketogenic diet—a metabolism-based therapy. Int J Biochem Cell Biol 63:55–59

    CAS  PubMed  Article  Google Scholar 

  2. 2.

    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):193–198

    PubMed  Google Scholar 

  3. 3.

    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):1030–1036

    PubMed  Article  Google Scholar 

  4. 4.

    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):29–36

    PubMed  Article  Google Scholar 

  5. 5.

    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 37:77–81

    PubMed  Article  Google Scholar 

  6. 6.

    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):898–904

    PubMed  PubMed Central  Article  Google Scholar 

  7. 7.

    Nei M, Ngo L, Sirven JI, Sperling MR (2014) Ketogenic diet in adolescents and adults with epilepsy. Seizure 23(6):439–442

    PubMed  Article  Google Scholar 

  8. 8.

    Sirikonda NS, Patten WD, Phillips JR, Mullett CJ (2012) Ketogenic diet: rapid onset of selenium deficiency-induced cardiac decompensation. Pediatr Cardiol 33(5):834–838

    PubMed  Article  Google Scholar 

  9. 9.

    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):978–981

    PubMed  Article  Google Scholar 

  10. 10.

    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):912–920

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    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):758–761

    PubMed  Article  Google Scholar 

  12. 12.

    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):260–265

    PubMed  Article  Google Scholar 

  13. 13.

    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)

  14. 14.

    Kapetanakis M, Liuba P, Odermarsky M, Lundgren J, Hallbook T (2014) Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 18(4):489–494

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    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):402–408

    CAS  PubMed  Article  Google Scholar 

  16. 16.

    Kossoff E, Shields WD (2014) Nonpharmacologic care for patients with Lennox-Gastaut syndrome: ketogenic diets and vagus nerve stimulation. Epilepsia 55(Suppl 4):29–33

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    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):834–840

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    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):112

    Article  Google Scholar 

  19. 19.

    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):290–297

    Article  Google Scholar 

  20. 20.

    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):633–638

    CAS  PubMed  Article  Google Scholar 

  21. 21.

    Visioli F, Bellomo G, Modedoro G, Galli C (1995) Low density lipoprotein oxidation is inhibited in vitro by olive oil constituents. Atherosclerosis 117(1):25–32

    CAS  PubMed  Article  Google Scholar 

  22. 22.

    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):1167–1174

    CAS  PubMed  Article  Google Scholar 

  23. 23.

    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):499–502

    CAS  PubMed  Google Scholar 

  24. 24.

    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):742–748

    CAS  PubMed  Article  Google Scholar 

  25. 25.

    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):659–669

    CAS  PubMed  Article  Google Scholar 

  26. 26.

    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):479–483

    PubMed  Article  Google Scholar 

  27. 27.

    Cervenka MC, Patton K, Eloyan A, Henry B, Kossoff EH (2014) The impact of the modified Atkins diet on lipid profiles in adults with epilepsy. Nutr Neurosci. doi:10.1179/1476830514Y.0000000162 (in press)

    PubMed  Google Scholar 

  28. 28.

    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):367–369

    CAS  PubMed  Article  Google Scholar 

  29. 29.

    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):364–367

    CAS  PubMed  Article  Google Scholar 

  30. 30.

    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):70–74

    PubMed  Article  Google Scholar 

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Acknowledgments

We thank all the patients and parents who contributed to this study.

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Correspondence to Nur Arslan.

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The authors declare that they have no conflict of interest.

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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).

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Güzel, O., Yılmaz, U., Uysal, U. et al. The effect of olive oil-based ketogenic diet on serum lipid levels in epileptic children. Neurol Sci 37, 465–470 (2016). https://doi.org/10.1007/s10072-015-2436-2

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Keywords

  • Children
  • Epilepsy
  • Olive oil
  • Ketogenic diet
  • Cholesterol
  • Triglyceride