Epileptic Diet Raises 'Bad' Cholesterol in Kids

But close monitoring can prevent problems, a study says.

By Randy Dotinga, HealthDay Reporter, 8/19/2003

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TUESDAY, Aug 19 (HealthDayNews) -- Back in Biblical times, people suffering from seizures felt better after heading out to the desert to fast. Nowadays, doctors put some epileptic children on a high-fat, low-carb diet that mimics some of the effects of temporary starvation.

But new research suggests that the special diet could spell trouble without proper monitoring.

Children who were on the so-called ketogenic diet for six months developed high levels of "bad" cholesterol, according to a new study. While the diet shouldn't be dumped, doctors must keep an eye on the children's cholesterol levels, said study co-author Dr. Peter Kwiterovich, director of the Division of Lipid Research and Atherosclerosis at the Johns Hopkins Children's Center.

"The point of our paper is not to say you shouldn't use the ketogenic diet in kids," he said.

According to Kwiterovich, doctors have put epileptic kids on the high-fat, low-carb diet -- similar to the popular Atkins diet for adults -- for about 75 years.

Epileptic seizures diminish when the body begins to use up its stores of fat, as happens during fasting and when someone is on a low-carb diet, he said. In some cases, epileptic seizures disappear entirely after a child is on the ketogenic diet for two years.

Scientists don't fully understand why the diet works so well, Kwiterovich said. But its success appears to have something to do with "ketogenic bodies" that are produced when the body breaks down fat cells. Those bodies travel to the brain and seem to have a positive effect on neurons, he said.

In the new study, Kwiterovich and colleagues examined cholesterol levels in 141 epileptic children who were on the ketogenic diet for six months. They report their findings in the Aug. 20 issue of the Journal of the American Medical Association.

About 83 percent of the children developed abnormally high levels of "bad" cholesterol. In some cases, the levels rose from about 110 to 160. Only 5 percent of normal children have levels above 130, Kwiterovich said.

Meanwhile, the levels of "good" cholesterol dipped in the children.

Even so, the kids don't appear to be at risk of coronary disease. So long as they don't stay on the diet for more than a year or two, the high cholesterol levels shouldn't come back to haunt them later in life either, he said. "It probably wouldn't increase their risk for heart disease when they're 40 or 50 or 60."

The study findings point to the importance of measuring the levels of cholesterol and lipids -- fats in the blood -- before putting a child on the ketogenic diet, Kwiterovich said. And then, he said, doctors should keep an eye on the levels as the kids remain on the diet.

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Oy! Doesn't anybody read their own profession's medical literature? The standard lab number for LDL is not a genuine measurement, but a calculation (look up the terms "LDL" and "Friedwald equation" together in a web search engine). Moreover, the calculation tells you *nothing* about the composition of the LDL. On a ketogenic diet, it's not unusual to see a rise in the level of the "Type A" particles -- large and fluffy, which some studies indicate have a protective effect on the CV system. The "Type B" particles, small and dense, are the one implicated in CV disease, and their levels almost always go down on a ketogenic diet.

Acohn,
Could it be Type A=LDL and Type B= VLDL.
I read somewhere that VLDL is very bad and inversely proportional to
HDL.
TG/HDL is a better indicator of CV health...
neeam.

I think what escapes the author is how debilitating these epileptic seizures are, and the toll they take on children's development. Kids with sever epilepsy could be brain damaged for life or die without the ketogenic diet. The diet is prescribed for 2-5 years and in most cases the child can stop the diet after that time, and be free of seizures..
So what if their cholesterol is high for a few years? They are alive and well, and they have many years to correct that.

It is like saying that chemotherapy is like poisoning the body and it is bad for you. Of course it is bad but what are the alternatives?

And while I am on the soap box: The claims that Atkins like diets are bad for you are probably also correct, but what you rather have, a person that eats a "balanced" diet who weighs 400lb with diabetes, of a person who eats an "unbalanced" diet for a while, but is dropping weight and is healthier.. Critics of lo-carb diets scream bloody hell if someone wants to go on 2-3 weeks induction, but will not bat an eye if someone chooses to do a gastric bypass surgery... Go figure.

Ok ok, I am getting off...

You can easily be on Atkins diet eating all the allowed tasty foods while keeping your daily cholesterol intake under 350 mg.

Neeam wrote


Possibly, but I don't think so. All cholesterol leaves the liver packaged as VLDL - Very-Low Density Lipoprotein. This package is large, relative to LDL. As the VLDL package makes its rounds through the bloodstream, it gets smaller (LDL) and smaller (HDL). So when researches say that small, dense LDL particles are harmful, the nomenclature would seem to indicate that these particles are distinct from VLDL.

Arie,
way to go.. you look to be in mid 30..yeah you can
go back in time..thanks for sharing..

neeam