Myoclonic astatic epilepsy and the role of the ketogenic diet.

The ketogenic diet remains one of the most effective treatments for medically refractory childhood epilepsy. In spite of the long history of its use, relatively little is known about the mechanism of action. The diet's efficacy in a wide range of epilepsy syndromes suggests that it may have multiple mechanisms of action, each of which may be more relevant to a specific disease state. Further research is necessary to define the mechanism of action, which may, in turn, lead to easier means to provide the therapeutic benefit.

Sources of folate and serum folate levels in older adults.

This study examined dietary folate intake in 173 older adults. A subsample (n=128) also provided data about folic acid from vitamin/mineral supplements and serum folate. Subjects were community-dwelling men and women 60 years of age and older. Overall, this sample had healthful dietary patterns with adequate dietary folate. Mean dietary intake converted to dietary folate equivalents (DFE) was 464 microg DFE/day. However, 20% (n=36) had inadequate and 2% (n=3) had high dietary DFE (>1,000 microg DFE/day). A subsample (n=128) completed a dietary supplement questionnaire and biochemical assessment of folate. Adding folic acid from vitamin/mineral supplements to dietary folate (total DFE), intake increased to 766 microg DFE/day; 13% (n=16) had inadequate, 75% (n=95) had adequate, and 13% (n=13) had high total DFE. No subject with low total DFE reported supplement use, but 94% (n=39) with high total DFE intake did so. In the subsample, all subjects had acceptable serum folate levels (mean serum folate=28.0+/-13.8 ng/mL [63.5+/-31.3 nmol/L]). In conclusion, vitamin/mineral supplements should be included in nutrition assessment of older adults. Older adults may be at risk for inadequate folate intake if their energy intake is low, they do not take a vitamin/mineral supplement, or are not consuming fortified cereals. However, older adults may be at risk for excess folic acid intake if they consume both a supplement and fortified cereals.