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.
- 1 Types of ketogenic diets
- 2 Evidence for a ketogenic diet
- 3 Risks & side effects
- 4 Notable studies
- 5 Medium chain triglycerides (MCT)
- 6 Exogenous ketones
- 7 Clinical use
- 8 Learn more
- 9 See also
- 10 References
Types of ketogenic diets
Evidence for a ketogenic diet
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. Ketone bodies are also a more efficient fuel than glucose.
The Charlie Foundation supports the use of ketogenic diets with children with severe epilepsy.
A study found dietary ketosis enhanced memory in patients with mild cognitive impairment.
Chronic fatigue syndrome
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 citing mitochondrial dysfunction, immune dysfunction, and neuroinflammation as pathways through which ketogenic diets could confer some benefit.
Risks & side effects
- 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.
- Two children on the diet for refractory epilepsy had selenium deficiency which resulted in sudden cardiac death.
- 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."
- Efficacy and Safety of Ketogenic Diet as Adjunctive Treatment in Adults With Refractory Epilepsy (KD) (This study is ongoing, but not recruiting participants.)
Medium chain triglycerides (MCT)
Supplementation with medium-chain triglycerides (MCTs) increases blood levels of ketones. 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.
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.
Doctor Sarah Myhill has a page on her web site describing the ketogenic diet. 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.
- Rho, Jong M; Rogawski, Michael A (Mar 2007), "The Ketogenic Diet: Stoking the Powerhouse of the Cell", Epilepsy Currents, 7 (2): 58–60, PMID 17505556, doi:10.1111/j.1535-7511.2007.00170.x
- Cerqueira, Fernanda M; Laurindo, Francisco R M; Kowaltowski, Alicia J (31 Mar 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
- 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, PMID 17509459, doi:10.1016/j.pediatrneurol.2007.02.008
- | title = The Charlie Foundation for Ketogenic Therapies | url = http://www.charliefoundation.org/
- Gasior, Maciej; Rogawski, Michael A; Hartman, Adam L (Sep 2006), "Neuroprotective and disease-modifying effects of the ketogenic diet", Behavioural Pharmacology, 17 (5-6): 431–439, PMID 16940764
- Church, William H; Adams, Ryan E; Wyss, Livia S (2014-06-13), "Ketogenic diet alters dopaminergic activity in the mouse cortex", Neuroscience Letters, 571: 1–4, PMID 24769322, doi:10.1016/j.neulet.2014.04.016
- Cheng, Baohua; Yang, Xinxin; An, Liangxiang; et al. (2009-08-25), "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
- Krikorian, Robert; Shidler, Marcelle D; Dangelo, Krista; Couch, Sarah C; Benoit, Stephen C; Clegg, Deborah J (Feb 2012), "Dietary ketosis enhances memory in mild cognitive impairment", Neurobiology of Aging, 33 (2): 425–19–27, PMID 21130529, doi:10.1016/j.neurobiolaging.2010.10.006
- Segura, Gabriela (9 Aug 2013), Ketogenic diet - a connection between mitochondria and diet
- Craig, Courtney (30 Mar 2015), A Ketogenic Diet for ME/CFS & Fibro
- Myhill, S; Booth, NE; McLaren-Howard, J (15 Jan 2009), "Chronic fatigue syndrome and mitochondrial dysfunction", Int J Clin Exp Med, 2 (1): 1–16, PMID 19436827
- Zhang, Xiaoyu; Qin, Juliang; Zhao, Yihan; Shi, Jueping; Lan, Rong; Gan, Yunqiu; Ren, Hua; Zhu, Bing; Qian, Min; Du, Bing (1 Apr 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
- Sudden Cardiac Death in Association With the Ketogenic Diet - Pediatric Neurology - December 2008
- Wikipedia - Ketogenic diet, MCT oil
- Reger, Mark A; Henderson, Samuel T; Hale, Cathy; et al. (Mar 2004), "Effects of beta-hydroxybutyrate on cognition in memory-impaired adults", Neurobiology of Aging, 25 (3): 311–314, PMID 15123336, doi:10.1016/S0197-4580(03)00087-3
- Keys to Ketosis (11 Jan 2016), The Beginner's Guide to Exogenous Ketones
- Myhill, Sarah, Ketogenic diet - the practical details
- 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, PMID 26315446, doi:10.1016/j.mehy.2015.08.013