As the ketogenic diet approaches 100 years of continuous use, we reflect on its successes and consider new avenues of research for the next century. One controversial question is regarding whether ketogenic dietary therapies could be successful first-line treatments for epilepsy. Second, is it possible to mimic the mechanisms of action of ketogenic dietary therapy with a drug (eg, a tablet formulation)? A third controversy worthy of future study involves its expanded usage in adults with refractory epilepsy and its role in treating women of childbearing age. Finally, as flexible, alternative diets have recently become widely available, is it feasible and safe to have families and patients start ketogenic dietary therapy successfully on their own with limited medical supervision?

中文翻译：

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第二世纪的生酮饮食疗法争议。

随着生酮饮食接近连续使用100年，我们反思其成功之处，并考虑下一个世纪的研究新途径。一个有争议的问题是生酮饮食疗法是否可以成功地治疗癫痫的一线治疗。其次，是否有可能模仿药物（例如片剂）的生酮饮食疗法的作用机制？值得进一步研究的第三项争议涉及其在成年人难治性癫痫中的广泛使用及其在治疗育龄妇女中的作用。最后，随着近来灵活，替代饮食的广泛使用，让家人和患者在有限的医疗监督下成功地自行开始生酮饮食治疗是否可行且安全？