Pediatric Neurology: Paul R. Carney, MD Zhao Liu, MD, PhD

Edgard Andrade, MD

Pediatric Gastroenterology (GI): Joel Andres, MD

Christopher Jolley, MD

Research Coordinators: Peggy R. Borum, PhD Lauren L. Jones, PhD

Overview of KT Fasting was recognized as a way to control

seizures.

Seizures would return once a normal diet was resumed.

In 1921 KT was born.

Although the therapy helps many children, we do not know how it works.

Ketogenic Therapy (KT)

High fat, low carbohydrate, adequate protein diet

Ketogenic Ratio = Fat : protein + carbohydrate

Forces the body to utilize fat (in the form of ketones) rather than carbohydrates as the main source of energy Ketones are a byproduct of fatty acid metabolism

Ketogenic Therapy (KT)

Neurological treatment not a diet for weight control

Similar to your other therapies for seizures such as antiepileptic drugs (AEDs)

All changes that are made must be cleared by the research team and your clinical providers

For these reasons, we do not call it the Ketogenic Diet

Ketogenic Therapy (KT) KetoBuddy

Support network Improve your child’s care Research the mechanism of KT Weekly contact Data collection Create and make meals Resource to assist you with all your child’s needs

We DO NOT change medications or provide any medical advice.

UF Ketogenic Therapy Research Program KetoBuddy support system More frequent monitoring of your child’s overall health

More labs More measurements Metabolic cart Daily records

Monitor the progress and personalize your child’s therapy

Patient visits are at Shands in the GCRC All research procedures are done free of charge Inpatient visits at the GCRC are free of charge

Qualifications for Ketogenic Therapy Typically (but not exclusively) used for

children If AEDs or other therapies are ineffective or

produce undesirable side effects If a surgical procedure is not an option Intended for patients without fatty acid

oxidation disorders

Before Initiation

Food Preferences Questionnaire

In order to help your child adjust into a state of ketosis easier, the weekend before: Limit simple sugars and starches Drink sugar-free or unsweetened liquids

Night before Initiation: Overnight fast for at least 8 hours Allowed to have water and medications

Initiation

Day 1-2Start on a 1.5:1 ratio of fat : protein + carbohydrateRatio increases by 0.5 every 1-2 meals

Day 3Usually discharge between a 3:1 to 4:1 ratio

What to Bring to Initiation Caregivers Guide

Foods/drink for Initiation that you and your KetoBuddy discussed

Daily home records of seizures

Multistix 10 SG

Food Scale

All medications and supplements in their original bottles

Videos, DVD player and DVDs, favorite toys, coloring books…something to keep your child occupied and feel more at home

What will be provided at Initiation A mini fridge, microwave, and kitchen

supplies One caregiver will be provided with

meals during their GCRC stay Wireless internet access is available if

you wish to bring your laptop

What to expect the first few weeks after Initiation Adjustment period may include

Lethargy Nausea/Vomiting Hunger

Record keeping