Nutricia Specialised Nutrition EXPO
Istanbul 2024
I was honoured to be invited to speak at Nutricia’s Specialized Nutrition Expo for Dietitians, Paediatricians and Neurologists from the Middle East and North Africa regions. We had a two day ketogenic and metabolic satellite symposium focussed on all things keto and metabolic. Some attendees had years of experience with ketogenic diets and others were new to the speciality and ready to learn about all things keto! It was a really wonderful opportunity to share practice and ideas.
Success with ketogenic diet therapy and the need for early use
In my first session, I began with an overview of the evidence supporting the use of ketogenic diet therapy, along with the clinical guidelines that inform our practice as keto teams and dietitians. I primarily focused on drug-resistant epilepsy but also highlighted emerging research areas where the ketogenic diet is being explored as a treatment option, including bipolar disorder, schizophrenia, mental health more broadly, autism, Parkinson’s and Alzheimer’s diseases, brain tumours, and other cancers. The field of ketogenic diet therapy is continually expanding, making it an incredibly exciting and rewarding area for dietitians to work in, with promising prospects for patients with a broader range of conditions in the future.
Clinical guidelines recommend that ketogenic diet therapy is considered when two anti-seizure medications have failed to control seizures (Kossoff et al., 2018). Yet, we still see examples where children have tried many more anti seizure medications before ketogenic diet is considered. So this session was really about encouraging health professionals to consider KD earlier and not to leave it as a ‘last resort’ option.
I shared the results of our CORE-KDT study (Carroll et al., 2024), emphasising the findings from interviewed parents regarding their experiences with epilepsy and the ketogenic diet, the successes they have observed, and the outcomes they value for their children. This provides us with invaluable insight into why the ketogenic diet is such a valued and essential treatment for children with drug-resistant epilepsy.
A mother in the study highlighted the beneficial effects of the ketogenic diet on her son, stating ‘It’s opening the window up to him learning those new skills that he never had a possibility to before’ . Parents described a broad range of seizure and non seizure benefits of the diet.
When asked to prioritise the most important outcomes, parents chose seizure reduction, learning and cognition, anti-seizure medication reduction, quality of life, independence and participation. Parents wanted to see their children able to make decisions and partake in school, family life and activities.
Finally, I presented anonymized case studies to provide the audience with a real-world perspective on the life-changing impact of the ketogenic diet for the families we work with. This also highlighted the rewarding aspect of my role as a dietitian in supporting them on their journey.
There were other very informative talks, including Dr. Yasmin Galal, who shared her experiences from a tertiary care center in Egypt, and Sanaa Elyafee, who discussed the importance of successful dietetic collaboration for the effective initiation of ketogenic diet therapy, reflecting on her experiences from her center in Oman.
Ketogenic diet masterclass
I was tasked by the organising team to lead a ketogenic diet masterclass to help improve dietitians confidence with calculating ketogenic diets for their patients. I love leading workshops, they are an amazing way for us to learn from each other and share practice. You can see the lightbulb moments in action!
My goal was to encourage dietitians to be flexible in their approach when choosing a ketogenic diet and consider all diets not just the classical KD, which is perceived to be the strictest version and arguably the most labour intensive for the dietitian and parents.
Through a range of activities we addressed;
- a typical patient pathway
- factors influencing our choice of KD
- calculation of classical ketogenic diet, modified Atkins diet and a modified ketogenic diet
- using medical formulae in ketogenic diets
- strategies to support improved compliance with ketogenic diets.
We had a great session with lots of discussion and engagement!
Thank you to the Nutricia Middle East and North Africa Regional teams for welcoming us to the beautiful city of Istanbul and supporting the ongoing education and continuing professional development of keto health professionals.
Next week I jump on a flight to Barcelona with my brilliant mentor colleagues; Zoe Simpson, Imogen Clarke and Laura Healy to support Spanish, Middle Eastern, Italian and Polish keto dietitians to enhance their knowledge and understanding of ketogenic diet therapy.
