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Ketogenic diet and other dietary treatments for epilepsy

Overview of attention for article published in Cochrane database of systematic reviews, February 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

2 news outlets
2 blogs
34 tweeters
7 Facebook pages
2 Wikipedia pages
1 video uploader

Readers on

151 Mendeley
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Ketogenic diet and other dietary treatments for epilepsy
Published in
Cochrane database of systematic reviews, February 2016
DOI 10.1002/14651858.cd001903.pub3
Pubmed ID

Martin, Kirsty, Jackson, Cerian F, Levy, Robert G, Cooper, Paul N


The ketogenic diet (KD), being high in fat and low in carbohydrates, has been suggested to reduce seizure frequency. It is currently used mainly for children who continue to have seizures despite treatment with antiepileptic drugs. Recently, there has been interest in less restrictive KDs including the modified Atkins diet (MAD) and the use of these diets has extended into adult practice. To review the evidence for efficacy and tolerability from randomised controlled trials regarding the effects of KD and similar diets. We searched the Cochrane Epilepsy Group's Specialized Register (30 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 30 March 2015), MEDLINE (Ovid, 30 March 2015), ClinicalTrials.gov (30 March 2015) and the WHO International Clinical Trials Registry Platform (ICTRP, 30 March 2015). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies. Studies of KDs and similar diets for people with epilepsy. Two review authors independently applied pre-defined criteria to extract data and assessed study quality. We identified seven randomised controlled trials that generated eight publications.All trials applied an intention-to-treat analysis with varied randomisation methods. The seven studies recruited 427 children and adolescents and no adults. We could not conduct a meta-analysis due to the heterogeneity of the studies.Reported rates of seizure freedom reached as high as 55% in a 4 : 1 KD group after three months and reported rates of seizure reduction reached as high as 85% in a 4 : 1 KD group after three months.One trial found no significant difference between the fasting-onset and gradual-onset KD for rates of seizure freedom and reported a greater rate of seizure reduction in the gradual-onset KD group.Studies assessing the efficacy of the MAD reported seizure freedom rates of up to 10% and seizure reduction rates of up to 60%. One study compared the MAD to a 4 : 1 KD, but did not report rates of seizure freedom or seizure reduction.Adverse effects were fairly consistent across different dietary interventions. The most commonly reported adverse effects were gastrointestinal syndromes. It was common that adverse effects were the reason for participants dropping out of trials. Other reasons for drop-out included lack of efficacy and non-acceptance of the diet.Although there was some evidence for greater antiepileptic efficacy for a 4 : 1 KD over lower ratios, the 4 : 1 KD was consistently associated with more adverse effects.No studies assessed the effect of dietary interventions on quality of life, or cognitive or behavioural functioning. The randomised controlled trials discussed in this review show promising results for the use of KDs in epilepsy. However, the limited number of studies, small sample sizes and a sole paediatric population resulted in a poor overall quality of evidence.There were adverse effects within all of the studies and for all KD variations, such as short-term gastrointestinal-related disturbances, to longer-term cardiovascular complications. Attrition rates remained a problem with all KDs and across all studies, reasons for this being lack of observed efficacy and dietary tolerance.There was a lack of evidence to support the clinical use of KD in adults with epilepsy, therefore, further research would be of benefit.Other more palatable but related diets, such as the MAD ketogenic diet, may have a similar effect on seizure control as classical KD but this assumption requires more investigation. For people who have medically intractable epilepsy or people who are not suitable for surgical intervention, a KD remains a valid option; however, further research is required.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 151 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 2 1%
United States 2 1%
Spain 1 <1%
France 1 <1%
South Africa 1 <1%
Brazil 1 <1%
Ireland 1 <1%
Unknown 142 94%

Demographic breakdown

Readers by professional status Count As %
Student > Master 32 21%
Student > Bachelor 27 18%
Student > Ph. D. Student 21 14%
Other 19 13%
Researcher 17 11%
Other 35 23%
Readers by discipline Count As %
Medicine and Dentistry 78 52%
Agricultural and Biological Sciences 34 23%
Nursing and Health Professions 6 4%
Psychology 6 4%
Neuroscience 5 3%
Other 22 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 53. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 February 2017.
All research outputs
of 7,667,486 outputs
Outputs from Cochrane database of systematic reviews
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Outputs of similar age
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Outputs of similar age from Cochrane database of systematic reviews
of 185 outputs
Altmetric has tracked 7,667,486 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,634 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.7. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,284 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 185 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.