Exploring the Rise of the Ketogenic Diet for Epilepsy in Latin America: A Systematic Review and Meta-Analysis
Rodrigo Shibaki1, Mateus Della Nina Serra de Oliveira Franco1, Juan Silva Locks Camargo1, Giulia Mulero Citro1, Enrique Monllor Ramos2, Maria Bruzzone3
1Faculdade de Medicina de São José do Rio Preto, FAMERP, 2Neurology Institute of 'Hospital de Clinicas, Facultad de Medicina, UDELAR', 3Deparment of Neurology, University of Florida
Objective:
The Ketogenic Diet (KD) is a treatment option for refractory epilepsy in both pediatric and adult patients. Despite its historical use, there are limited studies examining the current use and efficacy of the KD for treating refractory epilepsy in Latin America. This systematic review and meta-analysis aim to evaluate the effectiveness of the KD in Latin American populations.
Background:
The KD, characterized by high fat and low carbohydrate intake, has gained attention for its potential to reduce seizures in individuals with epilepsy who do not respond to conventional treatments. However, its application in Latin American populations remains underexplored.
Design/Methods:
A literature search was conducted in PubMed, Embase, and LILACS databases for studies published until September 2, 2024. Inclusion criteria: i. South American studies ii. Language: English, spanish, portuguese iii. Intervention: KD, Modified Atkins Diet, Medium Chain Triglycerides Diet, Low Glicemic Index Diet iv. Reported seizure reduction outcomes. Exclusion criteria: i. Animal studies ii. No time to establish intervention efficacy.
Results:
A total of 345 articles were initially identified, of which 13 studies met the inclusion criteria for this review. The meta-analysis results indicate that, for seizure reduction of any degree at 6 months of treatment, the pooled effect size was 1.86 (95% CI: 1.48 to 2.23), indicating a substantial reduction in seizure frequency compared to baseline. Additionally, in terms of seizure freedom, the pooled effect size was 0.67 (95% CI: 0.41 to 0.93), suggesting a moderate improvement in the like hood of achieving complete seizure freedom 6 months after starting the diet.
Conclusions:
The findings from this meta-analysis demonstrate that the use of KD in Latin America is an effective treatment for refractory epilepsy, significantly reducing seizure frequency and increasing the likelihood of seizure freedom. However, further studies are necessary to explore the long-term effects and challenges of the KD programs in Latin America.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.