Dietary Therapy in Epilepsy

Epilepsy ◽  
2021 ◽  
pp. 239-248
Author(s):  
Katherine C. Nickels ◽  
Elaine C. Wirrell
Keyword(s):  
2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S38-S38
Author(s):  
Chen Sarbagili-Shabat ◽  
Lindsey Albenberg ◽  
Johan Van Limbergen ◽  
Dror Weiner ◽  
Michal Yaakov ◽  
...  

Abstract Background Newer strategies that target the microbiome may offer an alternative therapeutic approach for Ulcerative Colitis (UC). We developed a novel diet that targets changes in the microbiome and barrier function that have been reported in UC. The goal of the current study was to evaluate the efficacy of two sequential induction of remission strategies that target the microbiota: the novel diet termed the ulcerative colitis diet (UCD) and an antibiotics cocktail combination in dietary non responders. Methods This was a prospective, single arm, open label, pilot study in patients aged 8–19, with a pediatric UC activity index (PUCAI) scores >10 and ≤45 on stable maintenance therapy (5ASA or thiopurines). PUCAI score was assessed at week 3 and 6. Patients failing to enter remission or intolerant to dietary therapy could receive an open label 14-day course of Amoxycillin, Metronidazole and Doxycycline (AMD), and had PUCAI scored at day 21. Response was defined a decline in PUCAI ≥ 10 points, remission as PUCAI< 10. The primary endpoint was intention to treat (ITT) remission at week 6 with diet as the sole intervention. Results Twenty-three children mean age of 15.1±2.9 years were enrolled. Two patients (1 responder, 1 remission) withdrew by 3 weeks, four required additional therapy by week 3, all were considered failures by ITT. Mean PUCAI decreased at week 3 and 6 from 34.5±9.8 to 21.7±14.9 and 17.6±17.2 respectively (P=0.005, P=0.001) at ITT analysis including all patients. Sixteen out of twenty-three patients (69.6%) responded by week 6. Ten of twenty-three (43.5%) achieved remission by week 6, and nine (39.1%) had clinical remission at week 6. The median fecal calprotectin (FC) level decreased in patients (n=5) who achieved remission from 630 (IQR, 332–1586) μg/g at week 0 to 230 (75–1298) μg/g at week 6. Eight patients received treatment with antibiotics after failing diet, 4/8 (50.0%) subsequently entered remission. Conclusion A dietary intervention called the UC Diet appears to be effective for induction of remission in children with mild to moderate UC. Sequential use of diet, followed by antibiotic therapy in dietary non responders, needs further evaluation as a microbiome directed steroid sparing therapy in patient’s refractory to 5ASA and thiopurines.


1993 ◽  
Vol 328 (17) ◽  
pp. 1213-1219 ◽  
Author(s):  
Donald B. Hunninghake ◽  
Evan A. Stein ◽  
Carlos A. Dujovne ◽  
William S. Harris ◽  
Elaine B. Feldman ◽  
...  
Keyword(s):  

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1917
Author(s):  
Roswitha Siener

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.


2021 ◽  
pp. 8-14
Author(s):  
Светлана Тарасовна Быкова ◽  
Тамара Григорьевна Калинина ◽  
Ирина Макаровна Московская

Полноценное, сбалансированное питание - основной фактор в формировании здоровья детей, когда в организме наиболее интенсивно протекают процессы роста и развития, формируются и созревают многие органы и системы, совершенствуются их функции. В статье приведены основные направления исследований зарубежных и отечественных ученых по лечению генетических заболеваний, таких как фенилкетонурия. Одним из приоритетных направлений в области здорового питания населения России в соответствии со Стратегией научно-технологического развития РФ до 2030 г. является развитие производства пищевых продуктов, обогащенных незаменимыми ингредиентами, специализированных продуктов детского питания, продуктов функционального назначения, диетических пищевых продуктов и биологически активных добавок. По данным ВОЗ от структуры питания на 70 % зависят здоровье и физическое развитие детей и подростков. Фенилкетонурия (ФКУ) - наследственное заболевание, вызывающее нарушение метаболизма аминокислоты фенилаланина у ребенка, одно из первых, рекомендованных ВОЗ для ранней диагностики у новорожденных. Отсутствие лечения вызывают серьезное поражение центральной нервной системы, отставание в умственном и физическом развитии. Особенностью современного этапа развития диетотерапии для детей, страдающих различными заболеваниями, в том числе наследственными, является разработка качественных функциональных продуктов питания, способствующих сохранению и улучшению здоровья ребенка за счет регулирующего и нормализующего воздействия на организм с учетом его физиологического состояния и возраста. Данные продукты можно широко использовать в практике лечебного питания не только в составе гипофенилаланиновой диеты, но и при любых заболеваниях, требующих ее соблюдения. В настоящее время единственным методом лечения ФКУ является диетотерапия, организованная с первых дней жизни с использованием специализированных смесей без фенилаланина. Из питания исключаются высокобелковые продукты растительного и животного происхождения. Целью лечебного воздействия диеты на ребенка является поддержка концентрации фенилаланина (ФА) в крови в пределах 2-12 мг на 100 мл в зависимости от возраста ребенка. Full-fledged balanced nutrition is the main factor in the formation of children's health, when the processes of growth and development are most intense in the body, many organs and systems are formed and mature, and their functions are improved. The article presents the main research areas of foreign and domestic scientists on the treatment of genetic diseases, such as phenylketonuria. One of the priority areas in the field of healthy nutrition of the Russian population in accordance with the Strategy for Scientific and Technological Development of the Russian Federation until 2030 is the development of the production of food products enriched with essential ingredients, specialized children's food products, functional products, dietary food products and biologically active additives. According to WHO, the health and physical development of children and adolescents depends on the nutritional structure by 70%. Phenylketonuria (PKN) - an inherited disease that causes impaired metabolism of the amino acid phenylalanine in a child - is one of the first recommended by WHO for early diagnosis in newborns. Lack of treatment causes serious damage to the central nervous system, a lag in mental and physical development. A feature of the modern stage of development of dietary therapy for children suffering from various diseases, including hereditary ones, is the development of quality functional food products that contribute to the preservation and improvement of the health of the child, due to the regulatory and normalizing effect on the body, taking into account its physiological state and age. These products can be widely used in the practice of therapeutic nutrition not only in the sastava of the hypophenylalanine diet, but also for any diseases requiring its observance. Currently, the only method of treating PKN is diet therapy, organized from the first days of life using specialized mixtures without phenylalanine. High-protein products of vegetable and animal origin are excluded from nutrition. The goal of the therapeutic effect of the diet on the child is to maintain the concentration of phenylalanine (FA) in the blood in the range of 2-12 mg per 100 ml, depending on the age of the child.


PEDIATRICS ◽  
1973 ◽  
Vol 51 (3) ◽  
pp. 539-548
Author(s):  
William L. Nyhan ◽  
Nancy Fawcett ◽  
Toshiyuki Ando ◽  
Owen M. Rennert ◽  
Richard L. Julius

A 14-month-old girl with a virtual arrest in development at a 3-month stage was found to have methylmalonic acidemia. She was unresponsive to large doses of B12 or of dimethylbenzimadazole cobamide. Dietary therapy was devised to restrict protein containing isoleucine, threonine, valine, and methionine to the amounts required for growth. She had a dramatic response both clinically and chemically. Catch-up somatic growth was matched by growth in head size and intellectual development. These observations indicate that marked improvement in brain function may occur during the treatment of metabolic disease, even well after a year of age.


PEDIATRICS ◽  
1967 ◽  
Vol 40 (2) ◽  
pp. 289-304
Author(s):  
CHARLES U. LOWE ◽  
DAVID BAIRD COURSIN ◽  
FELIX P. HEALD ◽  
MALCOLM A. HOLLIDAY ◽  
DONOUGH O'BRIEN ◽  
...  

THIRTEEN YEARS AGO a dietary approach to the therapy of phenylketonuria was proposed, and data on the usefulness as well as the very real limitations of this program have accumulated in the intervening years. At the present time studies on the application of special diets for use in this disease, as well as for many other hereditary metabolic diseases, are in progress. As wider use is made of procedures for detection of hereditary metabolic disease in the newborn, an increasingly larger number of patients who may benefit from appropriate nutritional therapy will be identified very early in life. For example, calculations based on the current birth rate and apparent incidence of phenylketonuria indicate that as many as 4,000 infants with this disorder in the United States alone could require dietary therapy in the next decade. There is, therefore, a need to evaluate the principles governing nutritional management of hereditary metabolic disease in order to develop optimal treatment facilities for use in conjunction with new detection methods. It seems anomalous that comparatively little has been done either to establish good treatment practices in hereditary metabolic disease or to mobilize scientific resources to ensure an optimistic out-come for therapeutic endeavors, while so much emphasis has been placed on detection. Dietary treatment of hereditary metabolic disease is simple in theory; however, practical application may be unexpectedly difficult, or even hazardous, if not carefully supervised. It should be determined whether: (1) the untreated disease is in fact harmful, (2) the treatment is useful in preventing or reversing the unfavorable progression of the disease, (3) the therapy may be harmful by interfering with growth or development, and (4) the program may be harmful to others to whom it is inadvertently or inappropriately given.


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