Effect of classic ketogenic diet treatment on lipoprotein subfractions in children and adolescents with refractory epilepsy.
Level 4 - case-series / case-control
Prospective single-arm longitudinal study without an untreated control group
PubMed 27712963 · doi:10.1016/j.nut.2016.06.016
What was done
This prospective outpatient study evaluated the effects of a classic ketogenic diet (KD) on lipid profiles and lipoprotein subfractions in children and adolescents with drug-refractory epilepsy. Measurements taken at baseline, 3 months, and 6 months included standard lipid panels (TC, TG, LDL-C, HDL-C), apolipoproteins (apoA-I, apoB), 10 HDL subfractions, 7 LDL subfractions, LDL phenotype, and LDL size using the Lipoprint system.
What was found
Total cholesterol, triglycerides, LDL-C, HDL-C, apoA-I, and apoB increased at 3 months and remained elevated at 6 months. Atherogenic ratios (non-HDL-C, TC/HDL-C, LDL-C/HDL-C, and apoB/apoA-I) also increased significantly. Qualitative changes occurred over time: small LDL subfractions increased, LDL particle size decreased from 27.3 nm to 26.7 nm, and 52.1% of patients displayed a non-A LDL phenotype at 6 months. Small HDL subfractions decreased at 6 months.
Why it matters
Demonstrates that the classic ketogenic diet alters not only traditional lipid concentrations but also lipoprotein particle quality toward a smaller, more atherogenic LDL profile in pediatric patients.
Limits
The total sample size is not stated in the abstract. The study lacked a non-diet control group, and outcomes were restricted to surrogate lipid biomarkers over a 6-month period rather than long-term clinical cardiovascular events.
Cited by
- supports Studies indicate the classical ketogenic diet can elevate LDL and cause high triglyceride levels in children.