Ketogenic Enteral Nutrition (KEN)

The Questionnaire

Before putting the tube, patients must fill out a questionnaire that gathers their past history in relation to obesity and in relation to major diseases.

In principle, only 3 categories of patients cannot be subjected to KEN:

a) Patients who cannot take a normal amount of protein. The KEN provides the administration of 60-80 grams of protein a day, when the amount that would normally be assumed corresponds to a gram of protein per kilogram of body weight (that is a much greater quantities). But there are patients with kidney failure that are forced on diets which are low in protein, including low-protein pasta and bread. These patients cannot categorically be included in the treatment with KEN.

b) Patients allergic to milk proteins. The solutions that we commonly use are proteins derived from milk. Those who are allergic to milk proteins and are prone to skin irritation due to dairy intake cannot be possibly subjected to the KEN with the usual protein solutions. They must use alternative types of protein solutions, although these have a higher cost.

c) Patients less than 14 years old. Diets below this age are likely to induce severe alterations that might lead to anorexia. We chose not to treat patients that might run this risk.