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Ketogenic Diet Therapy for Epilepsy and Other Neurologic and
Metabolic Based Conditions

Beth Zupec-Kania, RDN, CD
Edited by Wolf J. Rinke, PhD, RDN, CSP

C316
6 CPEUs
HARD COPY

$59.95

C316E
6 CPEUs
ELECTRONIC
$54.95

Manual with 1 reporting form, 48 pgs.
An evidence-based CPE program that will enable you to apply ketogenic diet therapies (KDTs) for patients with medication-resistant epilepsy and other neurologic and metabolic based conditions. More specifically you will discover how to:

  • Formulate a KDT plan including initiation, monitoring, and follow-up care.
  • Assess conditions for which KDTs are contraindicated.
  • Implement the ratio system of the classic ketogenic diet to determine its macronutrient composition.
  • Determine appropriate vitamin and mineral supplementation for KDTs.
  • Explain potential adverse effects of KDTs and how to prevent them.
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To order an ADDITIONAL Reporting Form click below:

C316F
6 CPEUs
REPORTING FORM
$40.00

Ketogenic Diet Therapy for Epilepsy and Other Neurologic and
Metabolic Based Conditions

Beth Zupec-Kania, RDN, CD
Edited by Wolf J. Rinke, PhD, RDN, CSP

© 2018 Wolf Rinke Associates, Inc. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, without the prior written permission of the Publisher.

OVERVIEW AND INSTRUCTIONS

The notion of a dietary treatment for epilepsy is rooted in the writing of Hippocrates who described a man whose seizures were cured by fasting. The classic Ketogenic Diet (KD) was initially designed in 1921 at the Mayo Clinic. Although effective at controlling seizures, its restrictive nature limited widespread use. The discovery of several anti-seizure medications over many decades resulted in near extinction of the diet until 1994 when the parents of Charlie Abrahams started a foundation to advocate for the KD that completely arrested his seizures. In the 25 years since the formation of The Charlie Foundation, KDs for epilepsy have experienced a surge in use and research. Multiple randomized controlled trials and prospective studies have confirmed the response rate of approximately 50% in children and adults with medication-resistant epilepsy. Those who maintain KDs for two to three years may receive long-lasting benefits beyond their tenure on the diet. Charlie Abrahams who maintained the diet for five years has been off the diet and seizure-free for the past 23 years.
Variations of the classic KD have been designed in recent years to make the diet simpler to manage and more tolerable. All variations of KDs are referred to as “ketogenic diet therapies” (KDTs) and are high in fat, moderate in protein, and restricted in carbohydrate. (The abbreviation KDT is used throughout this program and is interchangeable with KD.) In the absence of significant carbohydrate intake, mitochondrial beta-oxygenation of fat in the liver generates large quantities of ketone bodies (specifically acetoacetate and beta-hydroxybutyrate), which can be readily used as an energy source, unlike fatty acids. Through a series of complex mechanisms, the diet has been found to have an anti-inflammatory effect on the brain. Though not completely understood, research has confirmed in animals that mitochondrial, neuronal, and mammalian target of rapamycin (mTOR) pathways are positively affected, which may account for the anti-epileptic effect and improvement in brain function experienced in epileptic patients.
New applications of KDTs for metabolic, mitochondrial, and neurologic disorders have emerged in recent years. Use of KDTs for glioblastoma brain cancer has shown benefit in inhibiting cancer growth and improving tumor response to traditional cancer therapies. As science continues to emerge for epilepsy and other applications, clinical and research opportunities for dietetic practitioners will also grow. A 2016 Cochrane Report has validated the use of KDTs in medication-resistant epilepsy based on numerous published studies. The American Academy of Nutrition and Dietetics published a practice paper in 2017 describing the role of the registered dietetic practitioner in KDTs for individuals with epilepsy.
This CPE program is a level 2 Continuing Professional Education (CPE) program approved for six (6) continuing professional education units (CPEUs). That means that the reader has general knowledge of literature and professional practice in the area covered. The focus of the program is to enhance knowledge and application.
To get the most benefit from this program, we suggest you adhere to the following four steps:
Step 1: Review the objectives for the CPE program.
Step 2: Study each chapter. As you read, think of patients from your own practice who fit the situation described.
Step 3: Assess what you have learned by completing the self-assessment instrument at the end of this CPE program.
Step 4: Compare your answers to the answer key that has been provided. If you score at least 80% (16 questions) correct, you are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less than 80% correct, re-read the appropriate sections of the CPE program and re-test yourself until you score at least 80% (16 questions) correct.
After you have successfully completed the program, complete the CPE REPORTING FORM and:
Submit online at www.easyCPEcredits.com,
Or fax to (410) 531-9282,
Or mail to Wolf Rinke Associates, Inc., 13621 Gilbride Lane, Clarksville, MD 21029.

Upon receipt of your CPE Reporting Form, we will email you a Certificate of Completion within 3-5 business days.

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OBJECTIVES

Upon completion of this CPE program you will be better able to:

  • Apply the 2009 International Ketogenic Diet Study Group criteria to identify appropriate candidates with epilepsy for ketogenic diet therapies.
  • Assess conditions for which KDTs are contraindicated.
  • Apply KDTs for the treatment of epilepsy.
  • Implement the ratio system of the classic ketogenic diet to determine its macronutrient composition.
  • Explain the pathophysiology of ketone metabolism.
  • Evaluate the pre-ketogenic diet baseline laboratory studies recommended for children by the International Ketogenic Diet Study Group.
  • Determine appropriate vitamin and mineral supplementation for KDTs.
  • Recommend types of dietary oil that have a high ketogenic potential.
  • Implement different methods of initiating KDTs.
  • Formulate a KDT plan including initiation, monitoring, and follow-up care.
  • Explain potential adverse effects of KDTs and how to prevent them.

TABLE OF CONTENTS

CHAPTER 1: Indications and Contraindications
EPILEPSY
Infants
Children
Adolescents and adults
INHERITED METABOLIC DISORDERS
BRAIN AND OTHER CANCERS
OTHER INDICATIONS
CONTRAINDICATIONS
Relative contraindications
CHAPTER 2: Metabolism and Diet Variations
KETOGENIC METABOLISM
Energy
Protein
Fat
Carbohydrate
DIET VARIATIONS
Classic Ketogenic Diet Therapy
Medium Chain Triglyceride (MCT) Diet
Low Glycemic Index Treatment (LGIT)
Modified Atkins Diet (MAD)
CHAPTER 3: Screening, Assessment, and Diet Determination
SCREENING
Laboratory Studies
ASSESSMENT
DIET DETERMINATION
CHAPTER 4: Education and Initiation
EDUCATION
INITIATION
Initiating the Classic and MCT KDTs
Initiating the Liberal KDTs
CHAPTER 5: Nutrient Adequacy and Supplementation
ADEQUACY
Vitamins and Minerals
Essential Fatty Acids
Carnitine
Selenium
Pre-and Probiotics
Nonnutritive Sweeteners
MCT Oil Supplements
CHAPTER 6: Therapy Management, Adverse Effects, and Discontinuation
THERAPY MANAGEMENT
Monitoring
ADVERSE EFFECTS
Constipation
Dehydration
Kidney Stones
Cardiovascular Health
Growth in Children
DIET DISCONTINUATION FOR EPILEPSY
DIET DISCONTINUATION FOR OTHER CONDITIONS
REFERENCES
FOR YOUR CONTINUING EDUCATION
LIST OF ABBREVIATIONS
GLOSSARY
RESOURCES
SELF-ASSESSMENT QUESTIONS
EXPLANATIONS TO QUESTIONS
ABOUT THE AUTHOR
ABOUT THE EDITORS

ABOUT THE AUTHOR

Beth A. Zupec-Kania RDN, CD, owner of Ketogenic Therapies, LLC, has specialized in ketogenic therapies since 1991. She began her career as a clinical hospital dietitian and has been a private consultant since 2006.
Beth received her Bachelor of Science degree in Nutritional Sciences at the University of Wisconsin, Madison. She consults internationally for individuals with autism, epilepsy, mitochondrial and metabolic disorders, migraine headaches, rare genetic disorders, various cancers, and Parkinson’s disease. She has authored multiple professional and consumer education guides for KDT and co-organized three global ketogenic symposia, as well as provided diet training to over 250 medical centers worldwide. Ms. Zupec-Kania is a member of the International Ketogenic Diet Study Group, serves as a consultant to The Charlie Foundation for Ketogenic Therapies, and designed a web-based tool to calculate ketogenic diets known as the KetoDietCalculator.

ABOUT THE EDITOR

Wolf J. Rinke, PhD, RDN, CSP is the president and founder of Wolf Rinke Associates, Inc., a company that has provided high-quality CPE programs to dietetic practitioners since 1990.
Dr. Rinke earned a BS at Drexel University, a MS at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Dr. Rinke is a past Adjunct Associate Professor, Graduate School of Management & Technology at the University of Maryland, and a former Adjunct Faculty Member of the School of Continuing Studies at The Johns Hopkins University.
He has served as past president of the District of Columbia (DC) Dietetic Association and has been honored by the Academy of Nutrition and Dietetics with the Award for Excellence in the Practice of Management, the Outstanding Dietitian of the Year Award, and the Outstanding Service Award, in addition to delivering the Lenna Frances Cooper Lecture.
Dr. Rinke has served in numerous leadership roles at the Academy of Nutrition and Dietetics: Chair of the Scholarship Committee for Dietitians in Business and Communications; Chair of the Communication Committee, Honors Committee, and Licensure Panel and Ethical Practices Task Force for the Commission on Dietetic Registration; Chair of the Area Coordinating Committee and Chair for the Code of Ethics; Member of the Resource for Education Programs Committee; Member of the House of Delegates; and Member of the Board of Directors.
Dr. Rinke is the author of more than 500 articles, numerous CPE self-study programs, and several popular books including Make It a Winning Life: Success Strategies for Life, Love and Business; Winning Management: 6 Fail-Safe Strategies for Building High-Performance Organizations; and Don’t Oil the Squeaky Wheel and 19 Other Contrarian Ways to Improve Your Leadership Effectiveness.

ACKNOWLEDGMENTS

Special thanks to the following individuals for their careful review of this CPE program.

Meredith J. Hornbuckle, MS, RDN, CSP, LD
Nutritionist 2, Children’s Healthcare of Atlanta
Atlanta, GA

Denise Potter, RDN, CSP, CDE
Ketogenic Diet Nutrition Consultant
Ann Arbor, MI

Lisa Vanatta, MS, RDN, CSP
Ketogenic Program Coordinator, Barrow Neurological Institute at Phoenix Children’s Hospital
Phoenix, AZ

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