Optimal clinical management of children receiving the ketogenic diet

Recommendations of the International Ketogenic Diet Study Group

Eric H. Kossoff, Beth A. Zupec-Kania, Per E. Amark, Karen R. Ballaban-Gil, A. G. Christina Bergqvist, Robyn Blackford, Jeffrey R. Buchhalter, Roberto H. Caraballo, J. Helen Cross, Maria G. Dahlin, Elizabeth J. Donner, Joerg Klepper, Rana S. Jehle, HeungDong Kim, Y. M. Christiana Liu, Judy Nation, Douglas R. Nordli, Heidi H. Pfeifer, Jong M. Rho, Carl E. Stafstrom & 27 others Elizabeth A. Thiele, Zahava Turner, Elaine C. Wirrell, James W. Wheless, Pierangelo Veggiotti, Eileen P.G. Vining, Anne Anderson, Bruce Cohen, Mary Currey, Diane Donley, Leon Dure, Bhuwan Garg, Michael Goldstein, Brian Grabert, David Griesemer, Edward Kovnar, Roger Larson, Agustin Legido, Leslie Anne Morrison, Colette Parker, J. Ben Renfroe, Juergen Schreck, Shlomo Shinnar, Russell Snyder, Carmela Tardo, G. Dean Timmons, Gregory Yim

Research output: Contribution to journalReview article

318 Citations (Scopus)

Abstract

The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.

Original languageEnglish
Pages (from-to)304-317
Number of pages14
JournalEpilepsia
Volume50
Issue number2
DOIs
Publication statusPublished - 2009 Feb 1

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Ketogenic Diet
Nutritionists
Manuscripts
Neurology
Patient Selection
Counseling
Consensus
Pediatrics
Therapeutics
Research

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Kossoff, E. H., Zupec-Kania, B. A., Amark, P. E., Ballaban-Gil, K. R., Christina Bergqvist, A. G., Blackford, R., ... Yim, G. (2009). Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group. Epilepsia, 50(2), 304-317. https://doi.org/10.1111/j.1528-1167.2008.01765.x
Kossoff, Eric H. ; Zupec-Kania, Beth A. ; Amark, Per E. ; Ballaban-Gil, Karen R. ; Christina Bergqvist, A. G. ; Blackford, Robyn ; Buchhalter, Jeffrey R. ; Caraballo, Roberto H. ; Helen Cross, J. ; Dahlin, Maria G. ; Donner, Elizabeth J. ; Klepper, Joerg ; Jehle, Rana S. ; Kim, HeungDong ; Christiana Liu, Y. M. ; Nation, Judy ; Nordli, Douglas R. ; Pfeifer, Heidi H. ; Rho, Jong M. ; Stafstrom, Carl E. ; Thiele, Elizabeth A. ; Turner, Zahava ; Wirrell, Elaine C. ; Wheless, James W. ; Veggiotti, Pierangelo ; Vining, Eileen P.G. ; Anderson, Anne ; Cohen, Bruce ; Currey, Mary ; Donley, Diane ; Dure, Leon ; Garg, Bhuwan ; Goldstein, Michael ; Grabert, Brian ; Griesemer, David ; Kovnar, Edward ; Larson, Roger ; Legido, Agustin ; Morrison, Leslie Anne ; Parker, Colette ; Renfroe, J. Ben ; Schreck, Juergen ; Shinnar, Shlomo ; Snyder, Russell ; Tardo, Carmela ; Timmons, G. Dean ; Yim, Gregory. / Optimal clinical management of children receiving the ketogenic diet : Recommendations of the International Ketogenic Diet Study Group. In: Epilepsia. 2009 ; Vol. 50, No. 2. pp. 304-317.
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abstract = "The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.",
author = "Kossoff, {Eric H.} and Zupec-Kania, {Beth A.} and Amark, {Per E.} and Ballaban-Gil, {Karen R.} and {Christina Bergqvist}, {A. G.} and Robyn Blackford and Buchhalter, {Jeffrey R.} and Caraballo, {Roberto H.} and {Helen Cross}, J. and Dahlin, {Maria G.} and Donner, {Elizabeth J.} and Joerg Klepper and Jehle, {Rana S.} and HeungDong Kim and {Christiana Liu}, {Y. M.} and Judy Nation and Nordli, {Douglas R.} and Pfeifer, {Heidi H.} and Rho, {Jong M.} and Stafstrom, {Carl E.} and Thiele, {Elizabeth A.} and Zahava Turner and Wirrell, {Elaine C.} and Wheless, {James W.} and Pierangelo Veggiotti and Vining, {Eileen P.G.} and Anne Anderson and Bruce Cohen and Mary Currey and Diane Donley and Leon Dure and Bhuwan Garg and Michael Goldstein and Brian Grabert and David Griesemer and Edward Kovnar and Roger Larson and Agustin Legido and Morrison, {Leslie Anne} and Colette Parker and Renfroe, {J. Ben} and Juergen Schreck and Shlomo Shinnar and Russell Snyder and Carmela Tardo and Timmons, {G. Dean} and Gregory Yim",
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Kossoff, EH, Zupec-Kania, BA, Amark, PE, Ballaban-Gil, KR, Christina Bergqvist, AG, Blackford, R, Buchhalter, JR, Caraballo, RH, Helen Cross, J, Dahlin, MG, Donner, EJ, Klepper, J, Jehle, RS, Kim, H, Christiana Liu, YM, Nation, J, Nordli, DR, Pfeifer, HH, Rho, JM, Stafstrom, CE, Thiele, EA, Turner, Z, Wirrell, EC, Wheless, JW, Veggiotti, P, Vining, EPG, Anderson, A, Cohen, B, Currey, M, Donley, D, Dure, L, Garg, B, Goldstein, M, Grabert, B, Griesemer, D, Kovnar, E, Larson, R, Legido, A, Morrison, LA, Parker, C, Renfroe, JB, Schreck, J, Shinnar, S, Snyder, R, Tardo, C, Timmons, GD & Yim, G 2009, 'Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group', Epilepsia, vol. 50, no. 2, pp. 304-317. https://doi.org/10.1111/j.1528-1167.2008.01765.x

Optimal clinical management of children receiving the ketogenic diet : Recommendations of the International Ketogenic Diet Study Group. / Kossoff, Eric H.; Zupec-Kania, Beth A.; Amark, Per E.; Ballaban-Gil, Karen R.; Christina Bergqvist, A. G.; Blackford, Robyn; Buchhalter, Jeffrey R.; Caraballo, Roberto H.; Helen Cross, J.; Dahlin, Maria G.; Donner, Elizabeth J.; Klepper, Joerg; Jehle, Rana S.; Kim, HeungDong; Christiana Liu, Y. M.; Nation, Judy; Nordli, Douglas R.; Pfeifer, Heidi H.; Rho, Jong M.; Stafstrom, Carl E.; Thiele, Elizabeth A.; Turner, Zahava; Wirrell, Elaine C.; Wheless, James W.; Veggiotti, Pierangelo; Vining, Eileen P.G.; Anderson, Anne; Cohen, Bruce; Currey, Mary; Donley, Diane; Dure, Leon; Garg, Bhuwan; Goldstein, Michael; Grabert, Brian; Griesemer, David; Kovnar, Edward; Larson, Roger; Legido, Agustin; Morrison, Leslie Anne; Parker, Colette; Renfroe, J. Ben; Schreck, Juergen; Shinnar, Shlomo; Snyder, Russell; Tardo, Carmela; Timmons, G. Dean; Yim, Gregory.

In: Epilepsia, Vol. 50, No. 2, 01.02.2009, p. 304-317.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Optimal clinical management of children receiving the ketogenic diet

T2 - Recommendations of the International Ketogenic Diet Study Group

AU - Kossoff, Eric H.

AU - Zupec-Kania, Beth A.

AU - Amark, Per E.

AU - Ballaban-Gil, Karen R.

AU - Christina Bergqvist, A. G.

AU - Blackford, Robyn

AU - Buchhalter, Jeffrey R.

AU - Caraballo, Roberto H.

AU - Helen Cross, J.

AU - Dahlin, Maria G.

AU - Donner, Elizabeth J.

AU - Klepper, Joerg

AU - Jehle, Rana S.

AU - Kim, HeungDong

AU - Christiana Liu, Y. M.

AU - Nation, Judy

AU - Nordli, Douglas R.

AU - Pfeifer, Heidi H.

AU - Rho, Jong M.

AU - Stafstrom, Carl E.

AU - Thiele, Elizabeth A.

AU - Turner, Zahava

AU - Wirrell, Elaine C.

AU - Wheless, James W.

AU - Veggiotti, Pierangelo

AU - Vining, Eileen P.G.

AU - Anderson, Anne

AU - Cohen, Bruce

AU - Currey, Mary

AU - Donley, Diane

AU - Dure, Leon

AU - Garg, Bhuwan

AU - Goldstein, Michael

AU - Grabert, Brian

AU - Griesemer, David

AU - Kovnar, Edward

AU - Larson, Roger

AU - Legido, Agustin

AU - Morrison, Leslie Anne

AU - Parker, Colette

AU - Renfroe, J. Ben

AU - Schreck, Juergen

AU - Shinnar, Shlomo

AU - Snyder, Russell

AU - Tardo, Carmela

AU - Timmons, G. Dean

AU - Yim, Gregory

PY - 2009/2/1

Y1 - 2009/2/1

N2 - The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.

AB - The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.

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U2 - 10.1111/j.1528-1167.2008.01765.x

DO - 10.1111/j.1528-1167.2008.01765.x

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JO - Epilepsia

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Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Christina Bergqvist AG, Blackford R et al. Optimal clinical management of children receiving the ketogenic diet: Recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb 1;50(2):304-317. https://doi.org/10.1111/j.1528-1167.2008.01765.x