Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example

Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example

The Keto diet, also known as the ketogenic diet, is a popular diet regime that aims to help people live healthy lives. The ketogenic diet (KD) is a diet with low fat, protein, and carbohydrates used as an alternative treatment therapy for epileptic conditions that are difficult to control (Kossoff et al., 2018; Williams & Cervenka, 2017). Ketogenic dietary therapies (KDTs) are well-researched, non-pharmacological interventions for children and adults with epileptic conditions that do not respond to medication. With the popularity of Keto, it is imperative to examine evidence on the relevance and efficacy of KDT as an alternative treatment for epileptic adults.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

Article 1: Green, S. F., Nguyen, P., Kaalund-Hansen, K., Rajakulendran, S., & Murphy, E. (2020). Effectiveness, retention, and safety of modified ketogenic diet in adults with epilepsy at a tertiary-care center in the UK. Journal of Neurology, 267(4), 1171-1178. https://doi.org/10.1007%2Fs00415-019-09658-6

Green et al. (2020) aimed to determine ketogenic diet therapy’s efficacy, retention rate, and safety among epileptic adults. Of the forty-one participants recruited for the study, eleven were males, and 31 were females, all with a mean age of 36.8, and all had a history of antiepileptic drugs (AEDs). The independent variable was a modified ketogenic diet (MKD). Individual MKD was calculated using estimated energy and macronutrient requirements and a min of 80% of total fat calories and 10-25g of carbohydrates per day. The independent variables included seizure frequency and freedom. Self-reported side effects were also recorded.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

            Green et al. (2020) adopted a prospective cohort methodology with 100 participants referred for an adult ketogenic diet. The patient commenced a modified ketogenic diet in January 2016 and continued until January 2018. There was a 12-month follow-up period. Data were collected at baseline, twice every week, or once every two weeks through telephone and during consequent appointments quarterly with the clinician. Results revealed 60% retention rates at three months, which reduced to 43% after six months, and further reductions to 29% after 12 months. Results also revealed an improvement in seizure frequency, with 38% of the participants reporting more than 50% reduction and 13% reporting seizure freedom. Lastly, 30% of the participants reported worsened seizure frequency throughout the ketogenic therapy.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

The reason given for the high retention rates were the diet restrictiveness and side effects, including weight loss, low mood, and gastrointestinal symptoms. However, the likeliness of MKD discontinuation decreased with decreased seizure frequency. Therefore, the study demonstrated that a Ketogenic diet with regular dietetic support could be an effective alternative intervention for adults with epilepsy, mainly by reducing seizure frequency.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

Article 2: Martin-McGill, K. J., Jenkinson, M. D., Smith, C. T., & Marson, A. G. (2017). The modified ketogenic diet for adults with refractory epilepsy: an evaluation of a setup service. Seizure, 52, 1-6. https://doi.org/10.1016/j.seizure.2017.08.013

Martin-McGill et al. (2017) carried out a randomized control trial to determine the cost-effectiveness and clinical significance of the ketogenic diet among adults not recommended for the intervention. The authors assessed the feasibility of MKD among adults with refractory epilepsy and the potential participants to participate in a consequent randomized controlled trial. Out of the 102 patients, 51 agreed to try the ketogenic diet therapy for three months to determine its impact on the frequency of seizures. Further, 41 patients agreed to be part of the clinical trial to examine the ketogenic diet’s efficacy, tolerability, and deliverability. Additionally, 37 were ailing to participate in a randomized controlled trial. Only 17 patients tried the MKD therapy.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

The independent variable in the trial was MKD, and the independent variables included the feasibility of MKD in adult patients diagnosed with refractory epilepsy and the inclination to participate in a randomized controlled trial. A multidisciplinary team who also conducted diet evaluation admitted questionnaires. Nine participants completed the three months of MKD, with seven patients staying on a diet for the long term.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

The results confirm the previous reports that adults have a response to a Ketogenic diet. Besides, the KD is well-tolerated and cost-effective for adults diagnosed with epilepsy. MKD is equally feasible for hospitalized epileptic patients, with most patients demonstrating the willingness to participate in a randomized controlled trial in the UK. Six patients reported constipation, and three others reported loose stools as the only adverse effects of MKD therapy.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

The authors did not observe changes in cholesterol profiles, which contradicts previous studies and argues that weight loss could have influenced the cholesterol profiles. However, the study demonstrates the Ketogenic diet’s potential as an intervention for refractory epilepsy in adults considering the financial feasibility and viability as evidenced in the UK setting. Equally, the side effects are limited, and populace interest is high. Therefore, there is a need for further large-scale studies to assess the efficacy of the KD as an alternative treatment for epileptic adults.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

Article 3: Roehl, K., Falco-Walter, J., Ouyang, B., & Balabanov, A. (2019). Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life. Epilepsy & Behavior, 93, 113-118. https://doi.org/10.1016/j.yebeh.2018.12.010

Roehl et al. (2019) assessed the efficacy of an MKD therapy on the participants’ quality of life, the frequency of seizures, and their severity. Moreover, the authors evaluated the potential adverse effects of MKD among adult patients with refractory epilepsy, also known as drug-resistant epilepsy (DRE). Baseline data were collected from 74 participants, out of which 55 met the inclusion criteria, i.e., drug-resistant epilepsy, age above 17 years, and other reasons. The participants’ mean age was 38. Forty-nine of the participants had focal epilepsy. Thirty-nine patients followed the MKD-15 therapy, while 16 participants followed MKD-50 therapy.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

The independent variable was the modified ketogenic diet, while the dependent variables included seizure severity, frequency, and quality of life. The methodology involved obtaining data at baseline and during 3-months follow-up visits. The data obtained included demographic characteristics, carnitine levels, anthropometrics, vagus nerve stimulator history and changes during the therapy, the type of seizure, antiepileptic drugs, and dosage and seizure frequency. Moreover, the authors recorded the side effects and determined the compliance rate using multiple-pass twenty-four-hour diet recalls.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

Thirty-three of the participants reported more than 50% improvement in seizure frequency. Forty-two participants reported positive responses on seizure severity, and 48 participants had improved quality of life. Patients on MKD-15 therapy reported improved quality of life compared to MKD-50 therapy. The authors observed a decline in weight for all participants while the low-density lipoprotein (LDL) and total cholesterol increased. These findings indicate that MKD effectively reduces the severity of an individual’s seizures and the frequency and improves the quality of life among adults diagnosed with drug-resistant epilepsy. Weight loss was the only recorded side effect indicating the tolerability of MKD, which is also desirable for this population. Therefore, the findings support the Keto diet as an alternative treatment for epileptic adults.(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)

References

Green, S. F., Nguyen, P., Kaalund-Hansen, K., Rajakulendran, S., & Murphy, E. (2020). Effectiveness, retention, and safety of modified ketogenic diet in adults with epilepsy at a tertiary-care center in the UK. Journal of Neurology, 267(4), 1171-1178. (Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)https://doi.org/10.1007%2Fs00415-019-09658-6

Kossoff, E. H., Zupec‐Kania, B. A., Auvin, S., Ballaban‐Gil, K. R., Christina Bergqvist, A. G., Blackford, R., … & Practice Committee of the Child Neurology Society. (2018). Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open, 3(2), 175-192. (Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)https://dx.doi.org/10.1002%2Fepi4.12225

Martin-McGill, K. J., Jenkinson, M. D., Smith, C. T., & Marson, A. G. (2017). The modified ketogenic diet for adults with refractory epilepsy: an evaluation of a setup service. Seizure, 52, 1-6(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example). https://doi.org/10.1016/j.seizure.2017.08.013

Roehl, K., Falco-Walter, J., Ouyang, B., & Balabanov, A. (2019). Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life. Epilepsy & Behavior, 93, 113-118. (Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example)https://doi.org/10.1016/j.yebeh.2018.12.010

Williams, T. J., & Cervenka, M. C. (2017). The role of ketogenic diets in epilepsy and status epilepticus in adults. Clinical Neurophysiology Practice, 2, 154-160(Finding Evidence on the Relevance of Ketogenic Diet Comprehensive Nursing Essay Example). https://doi.org/10.1016/j.cnp.2017.06.001