Evidence map›Paper›PMID 41077678›Full record

SynthesisJournal of human nutrition and dietetics : the official journal of the British Dietetic Association2025

Classical and Modified Ketogenic Diets for Children and Young People With Drug-Resistant Epilepsy: A Reflection of International Dietetic Practice and Best Practice Recommendations for Dietitians.

Natasha E Schoeler, Victoria J Whiteley, Monica Guglielmetti, Lenycia de Cassya Lopes Neri, Robyn Blackford, Charlene Tan-Smith, Nicole Aylward, Katie Barwick, Maria Eugenia Caballero, Sylwia Gudej-Rosa and 10 more

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Natasha E SchoelerUCL Great Ormond Street Institute of Child Health, London, UK.ORCID 0000-0001-6202-1497
Victoria J WhiteleyRoyal Manchester Children's Hospital, Manchester, UK.
Monica GuglielmettiUniversity of Pavia, Pavia, Italy.
Lenycia de Cassya Lopes NeriUniversity of Pavia, Pavia, Italy.
Robyn BlackfordLurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Charlene Tan-SmithChristchurch Hospital, Christchurch, New Zealand.
Nicole AylwardHSC Winnipeg Shared Health, Winnipeg, Manitoba, Canada.
Katie BarwickChildren's Health Queensland, Queensland, Australia.
Maria Eugenia CaballeroHospital de Pediatria J P Garrahan, Buenos Aires, Argentina.
Sylwia Gudej-RosaInstitute of Mother and Child, Warsaw, Poland.
Wan-Ling HuangLinkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Meredith JohnsonChildren's Healthcare of Atlanta, Atlanta, Georgia, USA.
Christine Ong Bee KeowKK Women's & Children's Hospital, Singapore City, Singapore.
Sarianne MadsenUCSF Benioff Children's Hospital, San Francisco, California, USA.
Kath MegawKath Megaw & Associates, Cape Town, South Africa.
Theresa Nyembezi NjobvuUniversity Teaching Hospitals, Lusaka, Zambia.
Heidi PfeiferBoston Children's Hospital, Boston, Massachusetts, USA.
Sian PhillipsSouthampton Children's Hospital, Southampton, UK.
Elles van der LouwErasmus University Medical Center, Rotterdam, The Netherlands.
Best Practice Recommendations Advisory Group, on behalf of the Ketogenic Dietitians Research Network

Funding

This study was funded by Nutricia Advanced Medical Nutrition. The APC was funded by UCL and Nutricia Advanced Medical Nutrition.
6 · The paper itself

Abstract

introductionA global need was identified for a practical, comprehensive tool to guide dietitians internationally working in ketogenic diet therapy (KDT), detailing all aspects of dietetic management. The aim of this project was to develop best practice recommendations for the dietetic management of classical and modified ketogenic diets in the management of epilepsy and neurometabolic conditions.

methodsExpert ketogenic dietitians from six continents were invited to participate as members of either a core working group or advisory group. A systematic literature review was conducted, covering all aspects of dietetic management, from patient selection to diet discontinuation. To complement this, an international survey was distributed to ketogenic dietitians currently delivering classical and modified ketogenic diets, structured around the same key themes.

resultsA total of 111 dietitians responded to the survey, representing six continents. For each theme, findings from the literature were presented alongside survey responses. Recommendations were generated where ≥ 75% consensus was achieved. In areas where this threshold was not met, the most commonly reported practices were presented, acknowledging the variety of international approaches.

conclusionThese are the first international best practice recommendations specifically for ketogenic dietitians and nutrition healthcare professionals supporting children following medically advised classical and modified ketogenic diets. The recommendations are informed by both published evidence and prevailing international dietetic practice, whilst recognizing the variety in clinical delivery.

Indexed as

DieteticsDiet, KetogenicDrug Resistant EpilepsyNutritionistsPractice Guidelines as TopicAdolescentChildHumansSurveys and Questionnairesclassical ketogenic dietclinicaldieteticepilepsyguidelinesmodified ketogenic diet

Identifiers

PMID41077678
PMCPMC12516026

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.