scholarly journals The Feasibility and Tolerability of Medium Chain Triglycerides in Women with a Catamenial Seizure Pattern on the Modified Atkins Diet

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2261
Author(s):  
Elizabeth A. Felton ◽  
Bobbie J. Henry-Barron ◽  
Amanda K. Jan ◽  
Abigail Shegelman ◽  
Kelly Faltersack ◽  
...  
Keyword(s):  
Medium Chain Triglyceride ◽  
Diet Therapy ◽  
Adherence Rate ◽  
Medium Chain Triglycerides ◽  
Future Studies ◽  
Medium Chain ◽  
Modified Atkins Diet ◽  
Atkins Diet ◽  
High Adherence ◽  
Intervention Adherence

Ketogenic diet therapy (KDT), particularly modified Atkins diet (MAD), is increasingly recognized as a treatment for adults with epilepsy. Women with epilepsy (WWE) comprise 50% of people with epilepsy and approximately one in three have catamenial epilepsy. The purpose of this study was to determine whether adding a medium chain triglyceride emulsion to MAD to target catamenial seizures was feasible and well-tolerated. This was a prospective two-center study of pre-menopausal WWE with a catamenial seizure pattern on MAD. After a 1-month baseline interval with no changes in treatment, participants consumed betaquik® (Vitaflo International Ltd.) for 10 days each menstrual cycle starting 2 days prior to and encompassing the primary catamenial seizure pattern for five cycles. Participants recorded seizures, ketones, and menses, and completed surveys measuring tolerability. Sixteen women aged 20–50 years (mean 32) were enrolled and 13 (81.2%) completed the study. There was 100% adherence for consuming betaquik® in the women who completed the study and overall intervention adherence rate including the participants that dropped out was 81.2%. The most common side effects attributed to MAD alone prior to starting betaquik® were constipation and nausea, whereas abdominal pain, diarrhea, and nausea were reported after adding betaquik®. The high adherence rate and acceptable tolerability of betaquik® shows feasibility for future studies evaluating KDT-based treatments for catamenial seizures.

The Ketogenic and Modified Atkins Diet Therapy for Children With Refractory Epilepsy of Genetic Etiology

2019 ◽  
Vol 94 ◽  
pp. 32-37 ◽  
Author(s):  
Spoorthi Jagadish ◽  
Eric T. Payne ◽  
Lily Wong-Kisiel ◽  
Katherine C. Nickels ◽  
Susan Eckert ◽  
...  
Keyword(s):  
Refractory Epilepsy ◽  
Diet Therapy ◽  
Genetic Etiology ◽  
Modified Atkins Diet ◽  
Atkins Diet

Ketogenic diet, seizure control, and cardiometabolic risk in adult patients with pharmacoresistant epilepsy: a review

2020 ◽  
Author(s):  
Gabriela S Neves ◽  
Mariana S Lunardi ◽  
Katia Lin ◽  
Débora Kurrle Rieger ◽  
Letícia C Ribeiro ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Cardiometabolic Risk ◽  
Medium Chain Triglyceride ◽  
General Term ◽  
Adult Patients ◽  
Pharmacoresistant Epilepsy ◽  
Medium Chain ◽  
Modified Atkins Diet ◽  
Comprehensive Information ◽  
Cholesterol Intake

Abstract Pharmacoresistant epilepsy causes serious deleterious effects on the patient’s health and quality of life. For this condition, a ketogenic diet (KD) is a treatment option. The KD is a general term for a set of diets that contain high amounts of fat and low content of carbohydrates. The most prominent KD treatments are classical KD (4:1 ratio of fat to carbohydrate), modified Atkins diet (2:1 to 1:1 ratio), medium-chain triglycerides KD (with medium-chain triglyceride as a part of the fat content), and low glycemic index KD (using low glycemic carbohydrates). KD has been widely prescribed for children with epilepsy but not for adult patients. One of the main concerns about adult use of KD is its cardiovascular risk associated with high-fat and cholesterol intake. Therefore, this narrative review provides comprehensive information of the current literature on the effects of KD on lipid profile, glycemic-control biomarkers, and other cardiometabolic risk factors in adult patients with pharmacoresistant epilepsy.

scholarly journals Is Modified Atkins Diet Therapy Applicable for Adults with Intractable Epilepsy Patients? - A Short Trial in Adult Volunteers

2011 ◽  
Vol 4 (1) ◽  
pp. 7-14
Author(s):  
Miyako Oguni ◽  
Noriyo Inoue ◽  
Kyoya Takahata ◽  
Masamichi Koseki
Keyword(s):  
Intractable Epilepsy ◽  
Diet Therapy ◽  
Modified Atkins Diet ◽  
Atkins Diet ◽  
Adult Volunteers

scholarly journals Exploring the Viability of Exogenous Ketones as Weight Loss Supplements (P21-017-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Angela Poff ◽  
Andrew Koutnik ◽  
Sara Moss ◽  
Sahith Mandala ◽  
Dominic D'Agostino
Keyword(s):  
Weight Loss ◽  
Caloric Restriction ◽  
Ketone Bodies ◽  
Standard Diet ◽  
Medium Chain Triglycerides ◽  
Future Studies ◽  
Medium Chain ◽  
Funding Sources ◽  
Beta Hydroxybutyrate ◽  
Main Strategy

Abstract Objectives 70.7% of Americans over 20 years of age are overweight or obese. Currently, the main strategy for weight loss is caloric restriction. Ketone bodies have been shown to facilitate voluntary caloric restriction through altering the appetite stimulating hormone ghrelin. However, these non-toxic ketone bodies have not been evaluated as weight loss supplements. C57BL6J mice were used to determine the weight loss efficacy of exogenous ketones by adding synthetic (R/S 1,3-Butanediol Acetoacetate Diester and 1,3-Butanediol) and natural (Beta-hydroxybutyrate and Beta-hydroxybutyrate + Medium Chain Triglycerides) ketogenic agents to standard rodent chow ab-libitum. Methods Six groups (R/S 1,3-butanediol acetoacetate diester, 1,3-butanediol, beta-hydroxybutyrate, beta-hydroxybutyrate + medium chain triglycerides, caloric restriction, standard diet ad-libitum) were housed 2–5 animals per cage and monitored to ensure appropriate acclimation prior to intervention. Mice were treated for two weeks with ketogenic agents, adjusting % of agent daily to ensure 20% weight loss was achieved. Results All ketogenic agents induced weight loss and voluntary caloric restriction. Weight loss for beta-hydroxybutyrate and beta-hydroxybutyrate + medium chain triglycerides was explained by caloric restriction alone. However, R/S 1,3-butanediol acetoacetate diester induced weight loss at lower dosages which could not be explained by caloric restriction alone. Conclusions Taken together, all ketogenic agents may assist in weight loss. However, R/S 1,3-butanediol acetoacetate diester appears to be a more potent non-toxic ketogenic supplement that facilitates weight loss via both voluntary caloric restriction and caloric restriction-independent mechanisms. Future studies should explore caloric-restriction independent weight loss mechanisms of R/S 1,3-butanediol acetoacetate diester. Funding Sources Disruptive Nutrition.

scholarly journals Efficacy and Safety of a Ketogenic Diet in Children and Adolescents with Refractory Epilepsy—A Review

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1809 ◽  
Author(s):  
Jana Wells ◽  
Arun Swaminathan ◽  
Jenna Paseka ◽  
Corrine Hanson
Keyword(s):  
Ketogenic Diet ◽  
Medium Chain Triglyceride ◽  
Epileptic Seizures ◽  
Diet Therapy ◽  
Direct Result ◽  
Individual Response ◽  
Modified Atkins Diet ◽  
Patients With Epilepsy ◽  
The Brain

Epilepsy in the pediatric and adolescent populations is a devastating condition where individuals are prone to recurrent epileptic seizures or changes in behavior or movement that is the direct result of a primary change in the electrical activity in the brain. Although many children with epilepsy will have seizures controlled with antiseizure medications (ASMs), a large percentage of patients are refractory to drug therapy and may consider initiating a ketogenic diet. The term Ketogenic Diet or Ketogenic Diet Therapy (KDT) refers to any diet therapy in which dietary composition results in a ketogenic state of human metabolism. Currently, there are 4 major Ketogenic diet therapies—the classic ketogenic diet (cKD), the modified Atkins diet (MAD), the medium chain triglyceride ketogenic diet (MCTKD) and the low glycemic index treatment (LGIT). The compositions of the 4 main KDTs differ and limited evidence to distinguish the efficacy among different diets currently exists. Although it is apparent that more randomized controlled trials (RCTs) and long-term studies are needed to evaluate efficacy, side effects and individual response to the diet, it is imperative to study and understand the metabolic profiles of patients with epilepsy in order to isolate which dietary restrictions are necessary to maximize clinical benefit.

scholarly journals Ketogenic diet for epilepsy treatment

2016 ◽  
Vol 74 (10) ◽  
pp. 842-848 ◽  
Author(s):  
Letícia Pereira de Brito Sampaio
Keyword(s):  
Ketogenic Diet ◽  
Refractory Epilepsy ◽  
Medium Chain Triglyceride ◽  
Modified Atkins Diet ◽  
The Past ◽  
Atkins Diet ◽  
Low Carbohydrate ◽  
History Of ◽  
Index Treatment ◽  
Low Glycemic Index

ABSTRACT The ketogenic diet (KD), a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. The KD was developed in 1921 and even though it has been increasingly used worldwide in the past decade, many neurologists are not familiar with this therapeutic approach. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients. This review summarizes the history of the KD and the principles and efficacy of the classic ketogenic diet, medium-chain triglyceride(s) (MCT) ketogenic diet, modified Atkins diet, and low glycemic index treatment.

scholarly journals Positive Impact of a Modified Atkins Diet on Cognition, Seizures Control and Abnormal Movements in an Adult With Glucose Transporter Type 1 Deficiency Syndrome Deficiency Syndrome

2021 ◽  
Author(s):  
Luisa A. Diaz-Arias ◽  
Bobbie J. Henry-Barron ◽  
Alison Buchholz ◽  
Mackenzie C. Cervenka
Keyword(s):  
Ketogenic Diet ◽  
Glucose Transporter ◽  
Diet Therapy ◽  
Deficiency Syndrome ◽  
Newly Diagnosed ◽  
Modified Atkins Diet ◽  
Abnormal Movements ◽  
Atkins Diet ◽  
The Brain

Glucose is the primary energy fuel used by the brain and is transported across the blood-brain barrier (BBB) by the glucose transporter type 1 and 2.[1] A GLUT1 genetic defect is responsible for glucose transporter type 1 deficiency syndrome (GLUT1DS). Patients with GLUT1DS may present with pharmaco-resistant epilepsy, developmental delay, microcephaly, and/or abnormal movements, with tremendous phenotypic variability. Diagnosis is made by the presence of specific clinical features, hypoglycorrhachia and an SLC2A1 gene mutation. Treatment with a ketogenic diet therapy (KDT) is the standard of care as it results in production of ketone bodies which can readily cross the BBB and provide an alternate energy source to the brain in the absence of glucose. KDTs have been shown to reduce seizures and abnormal movements in children diagnosed with GLUT1DS. However, little is known about the impact of KDT on cognitive function, seizures and movement disorders in adults newly diagnosed with GLUT1DS and started on a KDT in adulthood, or the appropriate ketogenic diet therapy to administer. This case report demonstrates the potential benefits of using a modified Atkins diet (MAD), a less restrictive ketogenic diet therapy on cognition, seizure control and motor function in an adult with newly-diagnosed GLUT1SD.

scholarly journals Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 508
Author(s):  
Gregory Guthrie ◽  
Douglas Burrin
Keyword(s):  
Fatty Acid Composition ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Lipid Emulsion ◽  
Medium Chain Triglyceride ◽  
Cholestatic Liver Disease ◽  
Lipid Emulsions ◽  
Medium Chain Triglycerides ◽  
Medium Chain ◽  
Life Saving

Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC.

Absorption of triglycerides in the absence of lipase

1990 ◽  
Vol 68 (4) ◽  
pp. 519-523 ◽  
Author(s):  
B. P. C. Chow ◽  
E. A. Shaffer ◽  
H. G. Parsons
Keyword(s):  
Molecular Weight ◽  
Pancreatic Lipase ◽  
Medium Chain Triglyceride ◽  
Sprague Dawley ◽  
Medium Chain Triglycerides ◽  
Medium Chain ◽  
Molecular Weights ◽  
Long Chain Triglycerides ◽  
Long Chain ◽  
Long Chain Triglyceride

Medium chain triglycerides are considered to be readily absorbed intact in the absence of pancreatic lipase, unlike long chain triglycerides. Commercial medium chain triglyceride oils comprise various medium chain fatty acids from 6 to 12 carbons in length resulting in triglyceride molecules of different sizes and molecular weights. The effect of molecular weight and hence fatty acid chain length on the efficiency of intact medium chain triglyceride absorption is unknown. Therefore, this study measured, using a single-pass marker perfusion technique, intestinal jejunum absorption of five medium chain and one long chain triglycerides in anesthetized Sprague–Dawley rats. The molecular weights of the five medium chain triglycerides were 470.7, 498.8, 526.8, 554.9, 639.0, and the long chain triglyceride, 885.4. Residual luminal pancreatic lipase was removed prior to lipid perfusion. This study demonstrated that medium chain triglycerides were absorbed in the absence of lipase whereas long chain triglyceride was not. There was no significant variation in the absorption of the five different medium chain triglycerides perfused. The molecular weight of the medium chain triglyceride did not affect its intact absorption by the small intestine.Key words: triglycerides, intestinal absorption, molecular weight, pancreatic lipase, fat.

scholarly journals ACTR-44. FEASIBILITY, PHARMACODYNAMICS, AND BIOLOGIC ACTIVITY OF THE GLIOMA ATKINS-BASED DIET (GLAD) FOR PREVENTING TUMOR RECURRENCE IN GLIOMA PATIENTS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi23-vi23
Author(s):  
Karisa Schreck ◽  
Fang-Chi Hsu ◽  
Adam Berrington ◽  
Bobbie J Henry-Barron ◽  
Lindsay Blair ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Dietary Intervention ◽  
Serum Insulin ◽  
Diet Therapy ◽  
Intermittent Fasting ◽  
Who Grade ◽  
Dietary Compliance ◽  
Cerebral Activity ◽  
Modified Atkins Diet ◽  
Atkins Diet

Abstract INTRODUCTION Exploiting metabolic vulnerabilities via ketosis is a promising approach for gliomas. The modified Atkins diet is a ketogenic diet therapy efficacious in adults with refractory epilepsy. We evaluated the feasibility, pharmacokinetics/pharmacodynamics(PK/PD), and cerebral activity of this dietary intervention intended to induce ketosis. METHODS 25 patients with biopsy-confirmed WHO Grade 2–4 astrocytoma with stable disease after adjuvant chemotherapy were enrolled in an 8-week GLioma Atkins-based Diet (GLAD). GLAD consisted of 2 ‘intermittent fasting’ days(IF; calories < 20% of recommended daily allowance) interleaved between 5 modified-Atkins diet days(MAD; carbohydrates < 20 gm/day) each week. The primary outcome was dietary compliance. Secondary outcomes were PK assessed by urine ketones post-FAST and post-MAD, PD assessed by serum insulin and IGF-1, and cerebral activity measured by MR spectroscopy at baseline and week 8. RESULTS Grade 2(n=2;8%), Grade 3(n=11;44%) and GBMs(n=12;48%) were enrolled. While only 48% of participants satisfied pre-defined compliance criteria, overall compliance with MAD(80%) was higher than IF(72%). Weight loss was observed (-4.8 + 2.2kg,p< 0.0001) consisting primarily of decreased fat mass (-2.5 + 3.1%,p< 0.0001), with increased lean body mass (2.4 + 3.2%,p< 0.0001), stable nutritional status (phase angle, -0.26 + 0.94%,p=0.22), and normalization of BMI. Urine acetoacetate significantly increased with 55% achieving moderate ketosis at week 8 (p=0.0005). Serum insulin and IGF-1 significantly decreased indicating systemic dietary response and were associated with higher ketones post-IF, but not post-MAD. MRS demonstrated cerebral activity with increased ketones in lesional (0.06±0.03- >0.27±0.06i.u,p=0.005) and contralateral brain at week 8 (0.041±0.01- >0.16±0.04i.u.,p=0.004). Higher cerebral acetone correlated with higher urine ketones (r >0.75,p< 0.02) and lower fasting glucose (r >-0.74,p< 0.05). CONCLUSIONS The GLAD diet was challenging to maintain but demonstrated quantifiable biologic effects systemically and intratumorally. MAD was more feasible than IF, but changes in PD markers correlated most strongly with IF. The role of ketogenic diet therapy for preventing glioma growth remains uncertain.

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