The ketogenic diet: beyond epilepsy

The ketogenic diet was developed in the 1920′ as a treatment for intractable epilepsy. In more than 20% of individuals, the diet offers complete remission from seizures, and it decreases by 75% the frequency of attacks in more than half of the patients (see my previous post on the use of the ketogenic diet for epilepsy).

English: PET scan of a human brain with Alzhei...

English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)

However, in spite of these impressive results, the mechanisms of the ketogenic diet remained obscure until recent scientific studies shed some light on possible modes of action (see my previous post on that topic). An increased in ketones and the general reduction in available glucose are discussed as primary agents in the effects of the ketogenic diet. Among proposed mechanisms, a neuroprotective effect of the diet was proposed as well as a global normalization of aberrant energy metabolism.  These characteristics suggest that the diet would be beneficial in neurological disorders and other disorders linked to an abnormal energy regulation, or lipid dysregulation.

Ketogenic diet for neurogenerative diseases

Alzheimer’s disease

Alzheimer’s disease is a degenerative disorder characterized by cognitive impairment, affecting memory and behavior. A study using an experimental drug producing a ketogenic effect demonstrated cognitive improvement in Alzheimer’s patients not genetically predisposed to the disease (patients with the APOe4 allele did not show improvement).

Parkinson disease

Parkinson disease results in motor and cognitive impairment related to degenerating dopaminergic neurons in the basal ganglia. A small study on 7 subjects showed improvement on symptoms in the 5 subjects who were able to follow the diet. Placebo effect however, could not be ruled out.

Amyotrophic lateral sclerosis (ALS) is characterized by loss of voluntary motor function due to the degeneration of motor neurons in the brain and the spinal cord. A study on transgenic mice showed that animals fed a ketogenic diet retained more motor neurons and more motor perfomance that control mice.

Multiple Sclerosis

Multiple Sclerosis or MS is an autoimmune disorder linked to due to heightened neuro-inflammation, and resulting in learning and memory as well as in motor impairment. A study conducted on a mouse model of MS showed that the ketogenic diet helped reduce neuro-inflammation and increased performance of memory-based tasks.

Ketogenic diet for other neurological and psychiatric disorders

Autism

Autistic behavior is characterized by impaired social interaction and verbal and non-verbal communication, and by restricted, repetitive or stereotyped behavior. One study run on children with autistic behavior showed that the use of a modified ketogenic diet (including Medium Chain Triglycerides as the main source of fat) resulted in a decrease in behavioral markers of the disease.

Migraine

Migraines are debilitating throbbing headaches often localized on one side of the head, and accompanied by various symptoms such as nausea and phtophobia (extreme sensitivity to light). Evidence in support of the efficacy of the ketogenic diet is scarce but promising. One case report explains the complete cessation of migraine headaches in one individual, who was able to resume a normal diet after 7 months without recurring headaches.

My personal experience, as a high frequency migraine sufferer, is that after following a modified ketogenic diet for about 2 weeks, I have been able to reduce than stop my daily migraine medication (topamax, an anti-seizure medicine), after 7 years of use (with a break during my pregnancy). I still need to wait and see how the frequency of my migraines will be affected in the long-term, but it is already an amazing personal result.

Narcolepsy

Narcolepsy is characterized by excessive daytime sleepiness and uncontrollable sleep attacks. A small study of 9 patients reports that the use of a modified ketogenic diet (the Atkins diet) resulted in modest improvement of daytime sleepiness.

Depression

A study looking at the effect of the ketogenic diet on an animal model for depression reported beneficial effects of the diet on rats.

Ketogenic diet for weight loss and type 2 diabetes

Weight loss

A review of studies investigating changes in diet for weight loss reports that individuals following a very low-carbohydrate ketogenic diet achieved a greater weight loss than individuals following a low fat diet.

Type-2 Diabetes

Although the ketogenic diet might be dangerous for type-1 diabetic people (insulino-dependent diabetes) because of the risks of ketoacidosis (not to be confused with dietary ketosis), some studies suggest that the use of low-carbohydrate ketogenic diet might be beneficial to obese individuals with type-2 diabetes to a larger extent than low-calorie diets.

Ketogenic diet for cancer

Studies run on mice showed that Ketogenic diets result in reduced tumor growth in the case of several types of cancer, such as gliomas (brain cancer), prostate cancer, and gastric cancer.

If you have insight or experience with the use of the ketogenic diet or other low-carbohydrate diets for any of these conditions, I would love to hear about it!

References used  in this article

Barañano, K.W., Hartman, A.L., The ketogenic diet: Uses in epilepsy and other neurologic illnesses. Current Treatment Options in Neurology, 2008 (Nov), 10, 6, 410-419

Stafstrom CE, Rho JM., The ketogenic diet as a treatment paradigm for diverse neurological disorders. Front Pharmacol. 2012;3:59. 

Henderson ST, Vogel JL, Barr LJ, Garvin F, Jones JJ, Costantini LC. Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer’s disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Metab (Lond). 2009 Aug 10;6:31. doi: 10.1186/1743-7075-6-31.

Vanitallie TB, Nonas C, Di Rocco A, Boyar K, Hyams K, Heymsfield SB., Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study. Neurology. 2005 Feb 22;64(4):728-30.

Zhao Z, Lange DJ, Voustianiouk A, MacGrogan D, Ho L, Suh J, Humala N, Thiyagarajan M, Wang J, Pasinetti GM., A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC Neurosci. 2006 Apr 3;7:29.

Kim do Y, Hao J, Liu R, Turner G, Shi FD, Rho JM., Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis. PLoS One. 2012;7(5):e35476. doi: 10.1371/journal.pone.0035476. Epub 2012 May 2.

Evangeliou A, Vlachonikolis I, Mihailidou H, Spilioti M, Skarpalezou A, Makaronas N, Prokopiou A, Christodoulou P, Liapi-Adamidou G, Helidonis E, Sbyrakis S,Smeitink J, Application of a ketogenic diet in children with autistic behavior: pilot study. J Child Neurol. 2003 Feb;18(2):113-8.

Strahlman RS., Can ketosis help migraine sufferers? A case report. Headache. 2006 Jan;46(1):182.

Husain AM, Yancy WS Jr, Carwile ST, Miller PP, Westman EC. Diet therapy for narcolepsy. Neurology. 2004 Jun 22;62(12):2300-2.

Murphy P, Likhodii S, Nylen K, Burnham WM., The antidepressant properties of the ketogenic diet. Biol Psychiatry. 2004 Dec 15;56(12):981-3.

Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T., Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 May 7:1-10.

Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM.Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012 Oct;28(10):1016-21. 

Otto C, Kaemmerer U, Illert B, Muehling B, Pfetzer N, Wittig R, Voelker HU, Thiede A, Coy JF., Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides. BMC Cancer. 2008 Apr 30;8:122. 

Freedland SJ, Mavropoulos J, Wang A, Darshan M, Demark-Wahnefried W, Aronson WJ, Cohen P, Hwang D, Peterson B, Fields T, Pizzo SV, Isaacs WB., Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008 Jan 1;68(1):11-9.

Zhou W, Mukherjee P, Kiebish MA, Markis WT, Mantis JG, Seyfried TN., The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutr Metab (Lond). 2007 Feb 21;4:5.

 

Copyright (see copyright page): © “Food, Science and Health” (FoodScienceHealth.com) by Barbara Cerf-Allen, 2013 All Rights Reserved

Disclaimer: I am not advocating any of the above mentioned diets, nor am I making any claim about their usefulness for your specific condition. I am not a medical doctor and I am not giving medical advice. This blog is about sharing scientific information and my personal anecdotal experience,

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