Nutrition
Volume 22, Issue 1 , Pages 1-8 , January 2006

Breath acetone predicts plasma ketone bodies in children with epilepsy on a ketogenic diet

  • Kathy Musa-Veloso, Ph.D.

      Affiliations

    • Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Sergei S. Likhodii, Ph.D.

      Affiliations

    • Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Exequiel Rarama

      Affiliations

    • Alcohol Countermeasure Systems, Mississauga, Ontario, Canada
    • ,
  • Stephanie Benoit

      Affiliations

    • Department of Neurology, Hôpital Ste-Justine, Montréal, Quebec, Canada
    • ,
  • Yeou-mei Christiana Liu, M.S., R.D., C.H.E.S.

      Affiliations

    • Bloorview MacMillan Children’s Centre, Toronto, Ontario, Canada
    • ,
  • Dominic Chartrand

      Affiliations

    • Department of Neurology, Hôpital Ste-Justine, Montréal, Quebec, Canada
    • ,
  • Rosalind Curtis, M.D. (F.R.C.P.(C))

      Affiliations

    • Bloorview MacMillan Children’s Centre, Toronto, Ontario, Canada
    • ,
  • Lionel Carmant, M.D.

      Affiliations

    • Department of Neurology, Hôpital Ste-Justine, Montréal, Quebec, Canada
    • ,
  • Anne Lortie, M.D.

      Affiliations

    • Department of Neurology, Hôpital Ste-Justine, Montréal, Quebec, Canada
    • ,
  • Felix J.E. Comeau

      Affiliations

    • Alcohol Countermeasure Systems, Mississauga, Ontario, Canada
    • ,
  • Stephen C. Cunnane, Ph.D.

      Affiliations

    • Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationCorresponding author. Tel.: 819-821-1170, ext. 2670; fax: 819-829-7141

Received 18 November 2004 ,Accepted 19 April 2005.

References 

  1. Huttenlocher PR . Ketonemia and seizures (metabolic and anticonvulsant effects of two ketogenic diets in childhood epilepsy) . Pediat Res . 1976;10:536–540
  2. Whedon B , Sirven JI , O’Dwyer J , Sperling MR . Therapeutic serum beta-hydroxybutyrate levels in adult ketogenic diet patients . Epilepsia . 1999;40(suppl 7):221
  3. Gilbert DL , Pyzik PL , Freeman JM . The ketogenic diet (seizure control correlates better with serum β-hydroxybutyrate than with urine ketones) . J Child Neurol . 2000;15:787–790
  4. Dekaban AS . Plasma lipids in epileptic children treated with the high fat diet . Arch Neurol . 1966;15:177–184
  5. Schwartz RM , Boyes S , Aynsley-Green A . Metabolic effects of three ketogenic diets in the treatment of severe epilepsy . Dev Med Child Neurol . 1989;31:152–160
  6. Fraser DD , Whiting S , Andrew RD , Macdonald EA , Musa-Veloso K , Cunnane SC . Elevated polyunsaturated fatty acids in blood serum obtained from children on the ketogenic diet . Neurology . 2003;60:1026–1029
  7. Bridge EM , Iob LV . The mechanism of the ketogenic diet in epilepsy . Johns Hopkins Med J . 1931;48:373–389
  8. Freeman JM , Freeman JB , Kelly MT . The ketogenic diet (a treatment for epilepsy) . 3rd ed. New York: Demos Publications; 2000;
  9. Freund G . The calorie deficiency hypothesis of ketogenesis tested in man . Metabolism . 1965;14:985–990
  10. Livingston S . Dietary management of epilepsy . In:  Thomas CC editors. Comprehensive management of epilepsy in infancy, childhood, and adolescence . IL: Springfield; 1972;p. 378–405
  11. Schwartz RM , Eaton J , Bower BD , Aynsley-Green A . Ketogenic diets in the treatment of epilepsy (short-term clinical effects) . Dev Med Child Neurol . 1989;31:145–151
  12. Laffel L . Ketone bodies (a review of physiology, pathophysiology and application of monitoring to diabetes) . Diabetes Metab Res Rev . 1999;15:412–426
  13. Likhodii SS , Musa K , Cunnane SC . Breath acetone as a measure of systemic ketosis assessed in a rat model of the ketogenic diet . Clin Chem . 2000;48:115–120
  14. Musa-Veloso K , Likhodii SS , Cunnane SC . Breath acetone is a reliable indicator of ketosis in adult volunteers consuming ketogenic meals . Am J Clin Nutr . 2002;76:65–70
  15. Musa-Veloso K , Rarama E , Comeau F , Curtis R , Cunnane SC . Epilepsy and the ketogenic diet (Assessment of ketosis in children using breath acetone) . Pediatr Res . 2002;52:443–448
  16. Harano Y , Ohtsuki M , Ida M . Direct automated assay method for serum or urine levels of ketone bodies . Clin Chim Acta . 1985;151:177–183
  17. Bland JM , Artman DO . Statistical methods for assessing agreement between two methods of clinical measurement . Lancet . 1986;i:307–310
  18. Sulway MJ , Malins JM . Acetone in diabetic ketoacidosis . Lancet . 1970;2:736–740
  19. Owen OE, Trapp VE, Skutches CL, Mozzoli MA, Hoeldtke RD, Boden G, et al. Acetone metabolism during diabetic ketoacidosis . Diabetes . 1982;31:242–248
  20. Levey S , Balchum OJ , Medrano V , Jung R . Studies of metabolic products in expired air (II. Acetone) . J Lab Clin Med . 1964;63:574–584
  21. Brechner VL , Bethune RWM . Determination of acetone concentration in arterial blood by vapor phase chromatography of alveolar gas . Diabetes . 1965;14:663–665
  22. Tassopoulos CN , Barnett D , Fraser TR . Breath acetone and blood sugar measurements in diabetes . Lancet . 1969;i:1282–1286
  23. Owen OE , Caprio S , Reichard GA , Mozzoli MA , Boden G , Owen RS . Ketosis of starvation (a revisit and new perspectives) . Clin Endocrinol Metab . 1983;12:359–379
  24. Reichard GA , Haff AC , Skutches CL , Paul P , Holroyde CP , Owen OE . Plasma acetone metabolism in the fasting human . J Clin Invest . 1979;63:619–626
  25. Likhodii SS , Burnham WM . Ketogenic diet (does acetone stop seizures?) . Med Sci Monit . 2002;8:HY19–HY24
  26. Rho JM , Anderson GD , Donevan SD , White HS . Acetoacetate, acetone, and dibenzylamine (a contaminant in L-(+)-β-hydroxybutyrate) exhibit direct anticonvulsant actions in vivo . Epilepsia . 2002;43:358–361
  27. Argiles JM . Has acetone a role in the conversion of fat to carbohydrate in mammals? . Trends Biochem Sci . 1986;11:61–63
  28. Kalapos MP . Possible physiological roles of acetone metabolism in humans . Med Hypotheses . 1999;53:236–242
  29. Kalapos MP . On the mammalian acetone metabolism (from chemistry to chemical implications) . Biochem Biophys Acta . 2003;1621:122–139
  30. Price TD , Rittenberg D . The metabolism of acetone (I. Gross aspects of catabolism and excretion) . J Biol Chem . 1950;185:449–459
  31. Sakami W , Rudney H . The metabolism of acetone and acetoacetate in the mammalian organism . Brookhaven Symp Biol . 1952;5:176–191
  32. Mourkides GA , Hobbs DC , Koeppe RE . The metabolism of acetone-2-C14 by intact rats . J Biol Chem . 1959;234:27–30
  33. Luick JR , Black AL , Simesen MG , Kametaka M , Kronfeld DS . Acetone metabolism in normal and ketotic cows . J Dairy Sci . 1967;50:544–549
  34. Black AL , Luick JR , Lee SL , Knox K . Glucogenic pathway for acetone metabolism in the lactating cow . Am J Physiol . 1972;222:1575–1580

 The Bloorview MacMillan Children’s Hospital Foundation, Dairy Farmers of Canada, NSERC, Stanley Thomas Johnson Foundation, and the University of Toronto Awards Division are thanked for their financial support.

PII: S0899-9007(05)00226-1

doi: 10.1016/j.nut.2005.04.008

Nutrition
Volume 22, Issue 1 , Pages 1-8 , January 2006

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