If you think this article is about the "wrong" keto diet, please read this FAQ before posting.
Isn't this the trendy keto diet that's in the news?
No. The typical minimum fat content for most kids on this diet is more than the maximum fat content for adults who are on the very most extreme keto diets for weight loss and other goals. Most adults on a "keto" diet plan for 60% to 80% of calories from fat (and then they cheat). Most kids on this diet get 90% of their calories from fat (80% of their food by weight), and cheating has potentially deadly consequences. The sample menu shown at Ketogenic diet#Classic contains about 150 grams of fat, 25 grams of protein, and 10 grams of carbohydrates (including fiber). The very low-carbohydrate ketogenic diet typically recommends up to 50 grams of total carbohydrates per day, with 50 to 100 grams of protein.
Why doesn't this article talk about weight-loss or bodybuilding diets? Bodybuilders call their diets "ketogenic".
Any diet that metabolizes any fat at all is "ketogenic", because ketones are the natural, unavoidable metabolic byproduct of eating fat. Even everyday, normal diets are "ketogenic" at some level. This article is not about weight loss or body building, which produce higher levels of ketones than typical diets, but far lower levels than this medically supervised treatment for epilepsy. The average diet for epilepsy usually produces 150% of the ketones that even an extreme diet for weight loss or bodybuilding does. If you are interested in those diets, please read Low-carbohydrate diet.
Why doesn't this article talk about Inuit dietary practices? They ate a lot of fat during part of the year.
This article is not about the Inuit diet. This article is only about the medical diet for treating epilepsy. The diet for epilepsy eats far more fat than even the highest estimates for the Inuit diet. The Inuit diet is estimated to have included high levels of fat, amounting to 25% to 35% of the food by weight. A typical diet to treat epilepsy is 80% fat by weight, which is more than double the amount in the Inuit diet.
Lots of diets have been called "ketogenic" since 2015. Why did you pick this name for an epilepsy treatment?
Pick a subject – in this case, an extremely strict dietary treatment for epilepsy.
Look at high-quality reliable sources about your subject to identify possible names for the subject – in this case, "ketogenic diet" is the most widely used name for this treatment for epilepsy, and has been for the last century.
Determine whether the common name used by sources is already used for another article – it wasn't, so we used it. Note that this article was named in 2004, a full decade before the "keto" diet trend started.
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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)[reply]
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°Talk13:10, 2 May 2023 (UTC)[reply]
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)[reply]
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°Talk07:29, 5 May 2023 (UTC)[reply]
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°Talk19:05, 8 May 2023 (UTC)[reply]
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)[reply]
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°Talk22:37, 13 January 2024 (UTC)[reply]
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°Talk08:29, 1 March 2024 (UTC)[reply]
