Dietary therapies COPY Flashcards
How does MCT diet differ from Ketogenic diet? (4)
- Uses MCT oil as a source of medium-chain fatty acids
- More easily absorbed than Long-chain fatty acid (KDT)
- More easily delivered to liver than LCFA
- Thus allows greater consumption of protein and carbohydrates
Calories obtained from Fat in:
- Keto Diet
- MCT Diet
- MAD
- LGIT Diet
- Keto diet: 90%
- MCT diet: 60-70%
- MAD: 60-65% (30% protein)
- LGIT diet 60% (20-30% protein)
Downside of MCT diet
more GI side effects from MCT oil (i.e. diarrhea, vomiting, abdominal pain)
Contraindications for Dietary therapy
- Disorders of fatty acid metabolism
Conditions in which KDT Is Treatment Of Choice
- Glucose transporter deficiency (glucose can’t be transported across BBB)
- Pyruvate dehydrogenaze deficiency (pyruvate cannot be metabolized into acetyl-CoA)
Duration of dietary therapy
- Time to give therapy to see results
- consider discontinuation after___.
- “give it a chance” time: 3 months
- consider discontinuation after 2 years
Short-Term complications of Ketogenic diet (4)
Short term
- vomiting
- dehydration
- hypoglycemia
- acidosis
Recommend surveillance testing for KDT
- how often?
- blood (12)
- Urine (3)
Every 3 months:
Labs
- Fasting lipids
- BMP
- HFP
- Calcium
- magnesium
- phosphorous
- CBC
- Free and total Carnitine
- Zinc
- Selenium
- Vitamin D
-Beta hydroxy butyrate
Urine
- Urinalysis
- Urine calcium
- Creatinine
Add-on testing for longer term Dietary therapies (i.e. > 2 years) or high risk patients
Consider DEXA scan