HNU Nutrition in Metabolic Disease

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					  HNU 461: Nutrition in
   Metabolic Disease
Clinical and Alternative Care for Pregnant
           Women with Epilepsy

                        Presented By: Angela Ward
Introduction &
          Antiepileptic Drugs
   Epilepsy is the most common chronic neurological
    condition found in pregnancy.
   Effects of epilepsy and antiepileptic drugs on the
    pregnancy outcome.
   Opportunity to look at nutrition intervention to
    control epilepsy and decrease risk of birth defects.
    Antiepileptic Drugs (AED’s)
   AED’s are associated with having a high risk for
    birth defects in infants of epileptic mothers.
   The use of antiepileptic drugs has the tendency to
    decrease serum folate levels in the maternal blood.
   Lowest dose, mono-therapy or completely stop
    medication to protect the fetus.
Nutrition Intervention
 Low Glycemic Index Diet
 Ketogenic Diet
 Folic acid supplementation
 Vitamin K supplementation
   Low Glycemic Index              ◦ Ketogenic Diet
     60g of carbohydrate a      90% of calories come
      day and 60% of calories     from fat.
      coming from fat.           Inappropriate and
     50 or lower on the          dangerous for pregnant
      glycemic index.             epileptics.
     Counteracts seizure        Increased demand for
      effects by decreasing       glucose availability.
      blood glucose levels.      Prolonging restriction
     50% research                of carbohydrates
      participants,               increases the fetus’
      experienced a 90%           dependence on ketones.
      reduction in seizure
    Folic Acid Supplementation
 antiepileptic drugs decrease folate
 Increase pre-conceptual use of
  multivitamins with folic acid, while also
  continuing throughout pregnancy.
 0.4-4mg dose of folic acid per day.
 No conclusive results of acting as a pro-
  convulsant towards seizure frequency.
Vitamin K Supplementation
 Antiepileptic drug exposure increases the
  risk of a hemorrhagic disease called
  neonatal coagulopathy.
 10-20mg of vitamin K daily.
   Choulika, S., Grabowski, E., & Holmes, L. (2004). Is antenatal vitamin k
    prophlaxis needed for
         pregnant women taking anticonvulsants? American Journal of
    Obstetrics and Gynecology.
         190(4), 882-883.
   Lee, S., & Chung, S. (2010). A review of the effects of vitamins and other
    dietary supplements
         on seizure activity. Epilepsy and Behaviour. 18(3), 139-150.
   Phiefer, H., & Thiele, E. (2005). Low-glycemic-index treatment: a
    liberalized ketogenic diet for
         treatment of intractable epilepsy. Neurology. 65(11), 1810-1812.

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