Ketogenic diet

The ketogenic diet is a high-fat, medium protein, low carbohydrate diet primarily used for children with treatment-resistent 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
Medium-chain triglycerides (MCTs) produce more ketone bodies than normal dietary fats and so are often used in ketogenic diets to help maintain ketosis at a lower proportion of fat intake.

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

Epilepsy
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.

Neurodegenerative diseases
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

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

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.

Exogenous ketones
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.

Clinical Use
Dr Sarah Myhill has a page on her web site describing the ketogenic diet.