Ketogenic diet

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

The ketogenic diet is a high-fat, medium protein, low carbohydrate diet primarily used for children with treatment-resistant epilepsy. It induces ketosis, a metabolic state in which the body derives most of its energy from ketones rather than glucose.

Types of ketogenic diets[edit | edit source]

Evidence for a ketogenic diet[edit | edit source]

General effects[edit | edit source]

In an animal model, a ketogenic diet was shown to increase mitochondrial biogenesis.[1] A similar result was found in a study of fasting mice.[2]

Epilepsy[edit | edit source]

Neurotransmitters regulate nerve impulses is the brain by either inhibiting impulse firing or exciting the neuron to fire. A primary inhibitory neurotransmitters is GABA and a primary excitatory neurotransmitters is glutamate. In patients with epilepsy, if the normal balance of inhibition and excitation is disrupted, a seizure can occur.

It us unknown why ketogenic diets are protective against epilepsy. In animal models, the ketone bodies acetoacetate and acetone have anticonvulsant properities through a novel pathway.[3] Ketone bodies are also a more efficient fuel than glucose.

The Charlie Foundation supports the use of ketogenic diets with children with severe epilepsy.[4]

Neurodegenerative diseases[edit | edit source]

There is evidence from uncontrolled clinical trials and animal models that ketogenic diets may be protective in neurodegenerative disorders including Alzheimer's and Parkinson's.[5]

Mice fed a ketogenic diet had increased activity of dopaminergic neurons.[6] In a rat model of Parkinson's, a ketogenic diet was protective against neurotoxicity by up-regulating glutathione.[7]

A study found dietary ketosis enhanced memory in patients with mild cognitive impairment.[8]

Chronic fatigue syndrome[edit | edit source]

No studies have been done on the effects of ketogenic diets in Chronic fatigue syndrome. Some CFS clinicians recommend ketogenic diets as a management strategy[9][10] citing mitochondrial dysfunction[11], immune dysfunction, and neuroinflammation as pathways through which ketogenic diets could confer some benefit.

Risks & side effects[edit | edit source]

  • The ketogenic diet was found to regulate blood sugar but over the long term cause fat to accumulate in the liver in an animal model of Type II Diabetes.[12]
  • Two children on the diet for refractory epilepsy had selenium deficiency which resulted in sudden cardiac death.[13]
  • Diet Debunked: The Ketogenic Diet YouTube (2017) "The keto diet has a dark side that only few in the community have the courage to confront and it is all based on the scientific literature."

Notable studies[edit | edit source]

Medium chain triglycerides (MCT)[edit | edit source]

Supplementation with medium-chain triglycerides (MCTs) increases blood levels of ketones.[14] They are often used in ketogenic diets to help maintain ketosis at a lower proportion of fat intake. A study showed improved cognition in Alzheimer's disease patients.[15]

Exogenous ketones[edit | edit source]

Ketone salts can be supplemented so that ketone bodies are present in the blood at higher concentrations, indicating ketosis, much more quickly than with a typical ketogenic diet.[16]

Clinical use[edit | edit source]

Doctor Sarah Myhill has a page on her web site describing the ketogenic diet.[17] Doctor Courtney Craig has published a hypothesis on the treatment of mitochondrial failure in ME/CFS using a ketogenic diet, as well as caloric restriction and fasting.[18]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. Rho, Jong M; Rogawski, Michael A (March 2007), "The Ketogenic Diet: Stoking the Powerhouse of the Cell", Epilepsy Currents, 7 (2): 58–60, doi:10.1111/j.1535-7511.2007.00170.x, PMID 17505556
  2. Cerqueira, Fernanda M; Laurindo, Francisco R M; Kowaltowski, Alicia J (March 31, 2011), "Mild Mitochondrial Uncoupling and Calorie Restriction Increase Fasting eNOS, Akt and Mitochondrial Biogenesis", PLOS ONE, 6 (3): –18433, doi:10.1371/journal.pone.0018433
  3. Hartman, Adam L; Gasior, Maciej; Vining, Eileen P G; Rogawski, Michael A (May 2007), "The Neuropharmacology of the Ketogenic Diet", Pediatric neurology, 36 (5): 281–292, doi:10.1016/j.pediatrneurol.2007.02.008, PMID 17509459
  4. | title = The Charlie Foundation for Ketogenic Therapies | url = http://www.charliefoundation.org/
  5. Gasior, Maciej; Rogawski, Michael A; Hartman, Adam L (September 2006), "Neuroprotective and disease-modifying effects of the ketogenic diet", Behavioural Pharmacology, 17 (5–6): 431–439, PMID 16940764
  6. Church, William H; Adams, Ryan E; Wyss, Livia S (June 13, 2014), "Ketogenic diet alters dopaminergic activity in the mouse cortex", Neuroscience Letters, 571: 1–4, doi:10.1016/j.neulet.2014.04.016, PMID 24769322
  7. Cheng, Baohua; Yang, Xinxin; An, Liangxiang; et al. (August 25, 2009), "Ketogenic diet protects dopaminergic neurons against 6-OHDA neurotoxicity via up-regulating glutathione in a rat model of Parkinson's disease", Brain Research, 1286: 25–31, doi:10.1016/j.brainres.2009.06.060
  8. Krikorian, Robert; Shidler, Marcelle D; Dangelo, Krista; Couch, Sarah C; Benoit, Stephen C; Clegg, Deborah J (February 2012), "Dietary ketosis enhances memory in mild cognitive impairment", Neurobiology of Aging, 33 (2): 425–19-27, doi:10.1016/j.neurobiolaging.2010.10.006, PMID 21130529
  9. Segura, Gabriela (August 9, 2013), Ketogenic diet - a connection between mitochondria and diet
  10. Craig, Courtney (March 30, 2015), A Ketogenic Diet for ME/CFS & Fibro
  11. Myhill, S; Booth, NE; McLaren-Howard, J (January 15, 2009), "Chronic fatigue syndrome and mitochondrial dysfunction", Int J Clin Exp Med, 2 (1): 1–16, PMID 19436827
  12. Zhang, Xiaoyu; Qin, Juliang; Zhao, Yihan; Shi, Jueping; Lan, Rong; Gan, Yunqiu; Ren, Hua; Zhu, Bing; Qian, Min; Du, Bing (April 1, 2016), "Long-term ketogenic diet contributes to glycemic control but promotes lipid accumulation and hepatic steatosis in type 2 diabetic mice", Nutrition Research, 36 (4): 349–358, doi:10.1016/j.nutres.2015.12.002
  13. Sudden Cardiac Death in Association With the Ketogenic Diet - Pediatric Neurology - December 2008
  14. Wikipedia - Ketogenic diet, MCT oil
  15. Reger, Mark A; Henderson, Samuel T; Hale, Cathy; et al. (March 2004), "Effects of beta-hydroxybutyrate on cognition in memory-impaired adults", Neurobiology of Aging, 25 (3): 311–314, doi:10.1016/S0197-4580(03)00087-3, PMID 15123336
  16. Keys to Ketosis (January 11, 2016), The Beginner's Guide to Exogenous Ketones
  17. Myhill, Sarah, Ketogenic diet - the practical details
  18. Craig, Courtney (November 2015), "Mitoprotective dietary approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric restriction, fasting, and ketogenic diets", Medical Hypotheses, 85 (5): 690-693, doi:10.1016/j.mehy.2015.08.013, PMID 26315446