This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 | Archive 6 |
I have been very fortunate to obtain an expert review of this article ( at this version) by Eric Kossoff MD from Johns Hopkins Hospital. This pointed out some mostly minor mistakes, suggested some changes and commented on various aspects. The changes I made as a result can be seen here. Dr Kossoff suggested two pieces of additional information but I have been unable to find a published reliable source for them:
Hopefully some future review or publication will contain this information and it can be incorporated.
Dr Kossoff described the article as a "strong work" and that the changes I made "look good". His review has been very helpful and reassuring to me. Any remaining errors are my fault :-).
-- Colin° Talk 21:01, 3 December 2009 (UTC)
The following comments by Fvasconcellos ( talk · contribs) copied from the FAC and numbered:
1. What do you think of the following changes for the "Epilepsy" section?
: Epilepsy is one of the most common neurological disorders after stroke, [1] and affects at least 50 million people worldwide. [2] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory to treatment when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. Some of these may be candidates for epilepsy surgery, [1] and some, for the ketogenic diet.
2. You should also probably link or explain "hypersynchronously". (Does any article even explain hypersynchronous activity?)
3. In "History": Although popular for a while, it was discarded by most academic centres in the 1940s when anticonvulsant drugs became available. Effective anticonvulsant drugs? Bromides and barbs where already around, weren't they?
4. Kudos for not explicitly or unequivocally attributing authorship of On the Sacred Disease and Epidemics to Hippocrates.
5. Any more context on Rollin Woodyatt? Something such as "Chicago physician Rollin Woodyatt..." We really should have an article on him. Could be a challenge, hint hint... Same with Merritt, Putnam and Huttenlocher, but this is a personal preference of mine (providing context for researcher names) and is in no way necessary.
6. In "Discontinuation": ...it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely. Could or should?
7. Anything on the efficacy of LGIT?
8. Maybe you could add something on the availability of the different formulas. Can you get them in the UK, for example? I see Ketonia is from South Korea—is it commercially available elsewhere? Fvasconcellos ( t· c) 21:05, 4 December 2009 (UTC)
Diabetes and insulin.
Colin° Talk 21:18, 6 December 2009 (UTC)
A recent edit added the following text:
{{
cite journal}}
: |access-date=
requires |url=
(
help)CS1 maint: multiple names: authors list (
link) CS1 maint: unflagged free DOI (
link)The first part, concerning obesity, is sourced to Lyle McDonald's self-published book. Wikipedia does not accept self-published sources as adequate to verify our content.
The second part, concerning diabetes, is sourced to a primary research study on 84 patients with obesity and type 2 diabetes mellitus over 24 weeks. Our medical sourcing guidelines strongly discourage using primary research for medical facts or clinical guidance. For example, the above study looked at improvements in "glycemic control, measured by hemoglobin A1c" and was relatively short-term for a proposed long-term lifestyle change. We need an authoritative review and support from professional bodies (such as the ADA) before we can confidently state that the ketogenic diet "treats diabetes".
For these reasons, I've removed the text. I am endeavouring to locate more sources on these topics with a view to a small expansion in this area. However, the main topics for these aspects are the articles low-carbohydrate diet and diabetic diet. Colin° Talk 18:31, 7 December 2009 (UTC)
Research reviews/opinions:
The first of these defines a low-carbohydrate diet as less than 130 g/d or 26% of a nominal 2000 kcal diet (per ADA guidelines) and a very low carbohydrate ketogenic diet (VLCKD) as less than 30 g/d. It states that ketonuria generally occurs below 50 g/d (10% of the above diet). Most popular low-carb diets have an initial (induction) phase that is ketogenic but this is not continued into the maintenance phase. It is not clear whether some of the benefits concern the low-carb aspect or the ketogenic aspect.
Colin° Talk 18:53, 7 December 2009 (UTC)
I'm working on a short paragraph on weight-loss using low-carbohydrate ketogenic diets. Here's first draft. Comments?
Another source, which is more recent but doesn't have different conclusions is:
Colin° Talk 21:21, 7 December 2009 (UTC)
At FAC, Eubulides suggested this source might be useful to expand on the neuroprotective aspects.
{{
cite journal}}
: Unknown parameter |month=
ignored (
help)CS1 maint: multiple names: authors list (
link)Todo... Colin° Talk 12:33, 11 December 2009 (UTC)
I had included the WikiProject Food and drink banner because the article is concerned mainly with food. It was removed with the statement "I don't think so". I readded the Wikiproject because the article is in the project scope. If there is still a disagreement I'd appreciate a discussion instead of quick removal. Thank you. Hekerui ( talk) 17:43, 19 December 2009 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 | Archive 6 |
I have been very fortunate to obtain an expert review of this article ( at this version) by Eric Kossoff MD from Johns Hopkins Hospital. This pointed out some mostly minor mistakes, suggested some changes and commented on various aspects. The changes I made as a result can be seen here. Dr Kossoff suggested two pieces of additional information but I have been unable to find a published reliable source for them:
Hopefully some future review or publication will contain this information and it can be incorporated.
Dr Kossoff described the article as a "strong work" and that the changes I made "look good". His review has been very helpful and reassuring to me. Any remaining errors are my fault :-).
-- Colin° Talk 21:01, 3 December 2009 (UTC)
The following comments by Fvasconcellos ( talk · contribs) copied from the FAC and numbered:
1. What do you think of the following changes for the "Epilepsy" section?
: Epilepsy is one of the most common neurological disorders after stroke, [1] and affects at least 50 million people worldwide. [2] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory to treatment when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. Some of these may be candidates for epilepsy surgery, [1] and some, for the ketogenic diet.
2. You should also probably link or explain "hypersynchronously". (Does any article even explain hypersynchronous activity?)
3. In "History": Although popular for a while, it was discarded by most academic centres in the 1940s when anticonvulsant drugs became available. Effective anticonvulsant drugs? Bromides and barbs where already around, weren't they?
4. Kudos for not explicitly or unequivocally attributing authorship of On the Sacred Disease and Epidemics to Hippocrates.
5. Any more context on Rollin Woodyatt? Something such as "Chicago physician Rollin Woodyatt..." We really should have an article on him. Could be a challenge, hint hint... Same with Merritt, Putnam and Huttenlocher, but this is a personal preference of mine (providing context for researcher names) and is in no way necessary.
6. In "Discontinuation": ...it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely. Could or should?
7. Anything on the efficacy of LGIT?
8. Maybe you could add something on the availability of the different formulas. Can you get them in the UK, for example? I see Ketonia is from South Korea—is it commercially available elsewhere? Fvasconcellos ( t· c) 21:05, 4 December 2009 (UTC)
Diabetes and insulin.
Colin° Talk 21:18, 6 December 2009 (UTC)
A recent edit added the following text:
{{
cite journal}}
: |access-date=
requires |url=
(
help)CS1 maint: multiple names: authors list (
link) CS1 maint: unflagged free DOI (
link)The first part, concerning obesity, is sourced to Lyle McDonald's self-published book. Wikipedia does not accept self-published sources as adequate to verify our content.
The second part, concerning diabetes, is sourced to a primary research study on 84 patients with obesity and type 2 diabetes mellitus over 24 weeks. Our medical sourcing guidelines strongly discourage using primary research for medical facts or clinical guidance. For example, the above study looked at improvements in "glycemic control, measured by hemoglobin A1c" and was relatively short-term for a proposed long-term lifestyle change. We need an authoritative review and support from professional bodies (such as the ADA) before we can confidently state that the ketogenic diet "treats diabetes".
For these reasons, I've removed the text. I am endeavouring to locate more sources on these topics with a view to a small expansion in this area. However, the main topics for these aspects are the articles low-carbohydrate diet and diabetic diet. Colin° Talk 18:31, 7 December 2009 (UTC)
Research reviews/opinions:
The first of these defines a low-carbohydrate diet as less than 130 g/d or 26% of a nominal 2000 kcal diet (per ADA guidelines) and a very low carbohydrate ketogenic diet (VLCKD) as less than 30 g/d. It states that ketonuria generally occurs below 50 g/d (10% of the above diet). Most popular low-carb diets have an initial (induction) phase that is ketogenic but this is not continued into the maintenance phase. It is not clear whether some of the benefits concern the low-carb aspect or the ketogenic aspect.
Colin° Talk 18:53, 7 December 2009 (UTC)
I'm working on a short paragraph on weight-loss using low-carbohydrate ketogenic diets. Here's first draft. Comments?
Another source, which is more recent but doesn't have different conclusions is:
Colin° Talk 21:21, 7 December 2009 (UTC)
At FAC, Eubulides suggested this source might be useful to expand on the neuroprotective aspects.
{{
cite journal}}
: Unknown parameter |month=
ignored (
help)CS1 maint: multiple names: authors list (
link)Todo... Colin° Talk 12:33, 11 December 2009 (UTC)
I had included the WikiProject Food and drink banner because the article is concerned mainly with food. It was removed with the statement "I don't think so". I readded the Wikiproject because the article is in the project scope. If there is still a disagreement I'd appreciate a discussion instead of quick removal. Thank you. Hekerui ( talk) 17:43, 19 December 2009 (UTC)