Ketogenic diet

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.

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.

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

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.

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."

Notable studies

 * 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.

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
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.

Learn more

 * 2017, Getting Clear on Ketogenic Diets (for Fibromyalgia and ME/CFS): A Review
 * Wikipedia - Ketogenic diet
 * Ketogenic Diet Resource
 * Wikipedia - Fatty acid metabolism