Talk:Ketogenic diet

Infobox

Ketogenic diet
Testing for ketone bodies in urine
Pronunciation	/ˌkiːtəʊˈd͡ʒɛnɪk/
Specialty	Neurology, endocrinology
Uses	Refractory paediatric epilepsy
Complications	Stunted growth, bone fractures, kidney stones, constipation, dyslipidemia, dysmenorrhea, low-grade acidosis
Approach	Dietary intervention
Outcomes	Seizure reduction

I haven't found any previous discussions about adding an infobox in the archives. This is the only FA-class disease or therapy article connected to WikiProject Medicine that doesn't have an infobox, which makes it a bit unusual. On the other hand, there's no rule requiring one. Do we want an infobox at the top of this article? It could look something like this. WhatamIdoing (talk) 17:42, 30 April 2023 (UTC)

I think when the article was developed, many medical infoboxes looked like the one at Hepatorenal syndrome: a list of codes only a medical professional would care about (on a project no medical professional should trust to get codes from) and all external links. I'm not sure what the above example is offering the general reader. It is such a primary region of the article, I'm loathe to distract the reader with stuff that isn't jump-out-at-you vital and easy to describe. Our lead sentence is more lay-friendly than "Refractory paediatric epilepsy" and if you know what epilepsy is, then the outcome should be obvious. We know it is a dietary intervention from the article title and lead sentence already. The "complications" are listed in a take-it-or-leave-it form, rather than explaining their frequency or degree of seriousness. One might imagine stunted-growth could be dwarfism but is more subtle than that (and may resolve when the child comes off the diet). Btw, Water fluoridation doesn't have one either, though whether that is a medical therapy is up for debate. -- Colin°^Talk 13:10, 2 May 2023 (UTC)

You are correct about the history of the infobox. I don't feel strongly either way myself. It's normal for disease articles to have an infobox, but it's not required.

I don't think that infoboxes need to contain solely vital information. The contents I've mocked up here are just an example. A lot of them have little more than the specialty identified. I think, for this article, that the "Uses" line might help reinforce the not-about-the-fad-diet theme (as could the "Complications" list). WhatamIdoing (talk) 14:55, 4 May 2023 (UTC)

Yes, I thought the same about the "Uses". Graham Beards (talk) 17:22, 4 May 2023 (UTC)

The "not-about-the-fad-diet" is only really a problem with editors. Readers already get a hat note and the lead sentence is pretty clear what the topic is. And we have a FAQ for the editors, should any of them care to read it. I'm not keen to have either medical jargon (uses) or a frightening list of complications just to scare off the health fad folk and say "this is a serious medical intervention for a serious medical condition".

I think that we have done everything we can to highlight to readers and editors what the scope is, without distracting readers who want to learn about this medical intervention. What we know is that editors who want this article to be about the fad diet, don't and won't care what the article says or what we write in a faq, because they either don't read it or think it is wrong. -- Colin°^Talk 07:29, 5 May 2023 (UTC)

Do you think that infoboxes are distracting? WhatamIdoing (talk) 00:19, 6 May 2023 (UTC)

You didn't ask me, but, yes. SandyGeorgia (Talk) 00:33, 6 May 2023 (UTC)

Yes but distraction isn't always bad, if the content is worth grabbing someone's attention for. Magazines frequently publish pictures and captions to grab a reader's attention and draw them to consider reading the body text. I can't think of any other publication aimed at general readers that would squander the real-estate at the top of the article to include a list of jargon terms and medical codes. -- Colin°^Talk 19:05, 8 May 2023 (UTC)

First umbrella review published

The first umbrella review of 68 randomized clinical trials on the effects of the ketogenic diet has been published. The results of high-quality evidence were a reduction in seizure frequency, triglycerides and a significant increase in low-density lipoprotein cholesterol. Moderate-quality evidence included a decrease in weight and an increase in total cholesterol. If the review is to be cited it would be worth citing the high-quality results. There is no long-term clinical data because the trials were between 8weeks and 9 months. But these findings suggest that the ketogenic diet is not heart healthy long-term, as they raise LDL-c and total cholesterol which will increase the risk of cardiovascular disease and events. Here is a link to the paper [1], in full [2]. High-quality evidence supports a reduction in seizure frequency but this is already stated on the article. If anyone wants to add this umbrella review to the article please add it. I wouldn't say there is anything new here that we did not know already but this is the biggest review to date that has looked at 68 trials. Psychologist Guy (talk) 11:05, 22 June 2023 (UTC)

It looks like the research included is mostly about adults, and mostly not about epilepsy. WhatamIdoing (talk) 01:01, 2 March 2024 (UTC)

Not fad diet

Ketogenic diet is not a fad diet. So the link to Fad diet in the "See also" section should be removed. CometVolcano (talk) 07:20, 13 January 2024 (UTC)

It is outside of epilepsy treatment. See also sections are for tangential topics, they are not categorizations. Bon courage (talk) 07:38, 13 January 2024 (UTC)

I've removed it. While diets that are (somewhat) ketogenic can be fad diets, those are covered in other articles, not this one. It is rather odd for someone to get to the bottom of a medical therapy article and be given a link to "fad diet" as though that was relevant to this topic. -- Colin°^Talk 22:37, 13 January 2024 (UTC)

harms or dietary intolerance in young children

This edit by User:FULBERT added the text "while harms or dietary intolerance in young children were rarely reported in the literature." The relevant text I can find in the source (Pharmacologic and Dietary Treatments for Epilepsies in Children Aged 1–36 Months) is "Dietary harms were not well-reported." There is a section in the source called "Harms of Dietary Treatments" It discusses four trials that report various harms along with their other findings. It isn't clear what led them to conclude "Harms of diets were rarely reported, so we drew no conclusions about harms or dietary intolerance." Possibly the wide range of occurrence reported, type of side-effect or lack of specifics of side effects mean they were unable to draw conclusions. But I think the text added to our article suggests harm or intolerance is rarely reported because it rarely occurs, rather than that details of harm or intolerance are rarely adequately collected during studies. Often there is just a non-specific rate of drop-out without going into details of why. The review is critical of current studies in this population group ("the lack of reporting on treatment outcomes beyond seizure frequency"). I would be surprised if the infant population was significantly better at tolerating this diet compared to slightly older children.

My conclusion is this is a review critical of the lack of knowledge in this field (epilepsy treatment of very young children) and a comment that they so lack information in one aspect (harm caused by diet) they can't draw any conclusions is probably not encyclopaedically relevant to this article. We certainly shouldn't give the impression that side-effects or harm is rare in infants, because it doesn't say that. If you agree, I'll remove the sentence. Perhaps there is something else we can draw from this source? -- Colin°^Talk 08:29, 1 March 2024 (UTC)

I am finding that sentence confusing, and now that I've read your comment, I'm even more confused about what was meant. WhatamIdoing (talk) 01:01, 2 March 2024 (UTC)

Revert of addition of immunomodulatory effect

bon courage reverted my addition of what I thought was a pretty interesting finding, published by folks from the NIAID. He said in his revert the edit needed a Med RS. -:) Oh well , I am not sure what more of a medical resource it would need, if he had cared to look it up ( or my credentials -:). It is a medical resource. This entire page doesnt have anything about immune modulation (yet) and this new finding is cutting edge, might explain why ketogenic diet works in epilepsy. I will restor emy edit as I think this was a frivolous revert of a well sourced good faith edit. Wuerzele (talk) 21:26, 11 April 2024 (UTC)

You added this paper [3], a 2-week primary study. It doesn't pass WP:MEDRS. No dispute that you added this in good faith but this is not well sourced content. It doesn't belong on Wikipedia. Psychologist Guy (talk) 21:41, 11 April 2024 (UTC)

... if he had cared to look it up ( or my credentials -:). It is a medical resource ... I think this was a frivolous revert ← this combination of cluelessness about the basics of our medical sourcing guidelines, assumption of bad faith, and "don't you know who I am!?" argumentation is pretty alarming in an editor with a non-trivial contribution history. Bon courage (talk) 03:44, 12 April 2024 (UTC)