Ketogenic Diet as a Treatment
The Ketogenic Diet may have benefits for a number of medical conditions, many of them serious or life threatening. The research for the use of the Ketogenic Diet in epilepsy is well established, but for other illnesses it is still emerging. However, the Ketogenic Diet is believed to have a number of benefits, especially in cancer and neurological diseases like Alzheimer's and Parkinson's.
Main article: Ketogenic Diets for Epilepsy
The use of the Ketogenic Diets for Epilepsy is well established. Generally, around of 50% of patients have a 50% reduction in seizures, 25% have 90% reduction in seizures, and around 10% become seizure free.
Main article: Ketogenic Diets for Cancer
The Ketogenic Diet may help with the treatment of cancer, including brain tumors. Currently most of the available research is based on animal studies, with just a few human case studies. However, the research to date looks promising.
3 Hypoxia, including Stroke
There are a number of medical conditions that reduce the supply of oxygen (hypoxia), and the Ketogenic Diet may reduce the damage that occurs as a result.
- Head trauma. Head trauma often results in a rapid increase in cerebral glucose metabolism, followed but a prolonged decrease. Administering glucose to patients tends to result in hyperglycemia (high blood sugar) that worsens the outcome. In animal studies, fasting or a ketogenic diet improves tissue preservation, but further research is needed.
- Stroke. Because a stroke involves the reduction of blood flow to areas of the brain, the Ketogenic diet may help reduce the resulting damage. (http://www.ncbi.nlm.nih.gov/pubmed/23050642)
- Altitude Sickness. It is possible that the ketogenic diet may help with altitude sickness (Acute Mountain Sickness), but more research is needed. (Personally, I've found I can tolerate lower oxygen levels during Altitude Training while on the ketogenic diet.)
4 Heart disease
The effect of the ketogenic diet on heart disease risk is unclear. There are some concerns that the ketogenic diet raises blood lipids, and this in turn may increase the risk for heart disease. However, some studies have shown that the ketogenic diet improves markers associated with the risk of heart disease (http://jn.nutrition.org/content/132/7/1879.short).
5 Alzheimer's disease (AD)
AD is a degenerative neurological condition characterized by memory loss and there is currently no treatment. Models of Alzheimer's disease (and Parkinson's) suggest that 4 mmol/L of BOHB can protect neurons and may play a therapeutic role.There is some evidence that a ketogenic diet may not only improve the symptoms of AD, but may also modify the disease activity itself. These benefits may also apply to other neurological conditions involving neuron death. There is evidence that raising Ketone levels through MCT supplementation without carbohydrate restriction may also improve memory function in AD sufferers. In a study of 152 subjects with mild to moderate AD, half were given an MCT based treatment over a period of 90 days and had significantly improved cognitive scores compared with the placebo control group. A drug called Axona was introduced in 2009 as an FDA approved "medical food" and it consists of an MCT oil (caprylic acid). There is also some evidence that a higher carbohydrate intake is associated with poorer memory, and increased aberrant motor behavior in subjects with probable AD.
6 Parkinson's disease
Parkinson's disease appears to generally result from an acquired defect in the mitochondria rather than genetic causes. Animal studies and anecdotal reports suggest that the ketogenic diet may reverse the symptoms of Parkinson's disease, but there are no published human studies. It is possible to treat Parkinson's disease for a time with dopamine , but free radical damage lessens the effectiveness of this therapy over time. Models of Parkinson's disease (and Alzheimer's) suggest that 4 mmol/L of BOHB can protect neurons and may play a therapeutic role. A 28 day study of five Parkinson's patients on the Ketogenic Diet with blood BOHB levels averaging 6.6 mmol/L (range 4.8 to 8.9) had an average decrease in Unified Parkinson's Disease Rating Scale (UPDRS) scores of 43.4% (range 21% to 81%), but the study had too few subjects and no controls, so conclusions could be drawn about effectiveness.
7 Amyotropic Lateral Sclerosis (ALS)
Like Parkinson's disease, there is currently only animal and anecdotal reports of success, but human studies are under way.
8 Type 1 diabetes
At one time, type 1 diabetes (previously called childhood diabetes) was expected to be fatal within a year. The first approach was a starvation diet of 450 calories per day, which lead Fredrick M Allen to use a 70% fat, 8% carbohydrate diet that was the standard treatment before the discovery of insulin.
There are early reports from a Greek study in Crete indicating that the ketogenic diet may produce some improvement in some children. There are also anecdotal reports of epileptic children treated with the ketogenic diet also having improvements in their autism.
While a 1930's textbook talks of the possibility of the ketogenic diet helping with migraines, a study of 8 teenagers with severe migraines at John Hopkins showed the ketogenic diet was ineffective.
11 Severe hyperactivity
There are initial reports that the ketogenic diet improves hyperactivity in animal reports, and some anecdotal reports of the benefit in humans. As with Autism, there are also reports of epileptic children treated with the ketogenic diet also having improvements in their hyperactivity.
There is a case report of a radical improvement in schizophrenia with the ketogenic diet. However, this may be due to a removal of the gluten from the diet rather than the overall dietary changes.
13 Depression and bipolar disorder
There are a number of cases that have been reported where the ketogenic diet helps normalize the Mood State of those with bipolar disorder. One report indicated that over 2-3 years the mood stabilization exceeded that achieved with medication.
14 See Also
- The classifications and types of Low Carbohydrate Diet.
- An introduction to the Ketogenic Diet.
- My experiences with ultrarunning on the Ketogenic Diet
- How the Ketogenic Diet can be used for the treatment and management of disease.
- Health Risks of the Ketogenic Diet
- The time frame and changes that occur with Ketoadaptation
- What are Ketones
- The pros and cons of the Ketogenic Diet for athletes
- The Types of Ketogenic Diet
- My Ketogenic Recipes
- Non-Ketogenic Low Carbohydrate Diets
- TN. Seyfried, MA. Kiebish, J. Marsh, LM. Shelton, LC. Huysentruyt, P. Mukherjee, Metabolic management of brain cancer., Biochim Biophys Acta, volume 1807, issue 6, pages 577-94, Jun 2011, doi 10.1016/j.bbabio.2010.08.009, PMID 20804725
- M. Gasior, MA. Rogawski, AL. Hartman, Neuroprotective and disease-modifying effects of the ketogenic diet., Behav Pharmacol, volume 17, issue 5-6, pages 431-9, Sep 2006, PMID 16940764
- Y. Kashiwaya, T. Takeshima, N. Mori, K. Nakashima, K. Clarke, RL. Veech, D-beta-hydroxybutyrate protects neurons in models of Alzheimer's and Parkinson's disease., Proc Natl Acad Sci U S A, volume 97, issue 10, pages 5440-4, May 2000, PMID 10805800
- Robert Krikorian, Marcelle D. Shidler, Krista Dangelo, Sarah C. Couch, Stephen C. Benoit, Deborah J. Clegg, Dietary ketosis enhances memory in mild cognitive impairment, Neurobiology of Aging, volume 33, issue 2, 2012, pages 425.e19–425.e27, ISSN 01974580, doi 10.1016/j.neurobiolaging.2010.10.006
- Mark A. Reger, Samuel T. Henderson, Cathy Hale, Brenna Cholerton, Laura D. Baker, G.S. Watson, Karen Hyde, Darla Chapman, Suzanne Craft, Effects of β-hydroxybutyrate on cognition in memory-impaired adults, Neurobiology of Aging, volume 25, issue 3, 2004, pages 311–314, ISSN 01974580, doi 10.1016/S0197-4580(03)00087-3
- Samuel T Henderson, Janet L Vogel, Linda J Barr, Fiona Garvin, Julie J Jones, Lauren C Costantini, Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial, Nutrition & Metabolism, volume 6, issue 1, 2009, pages 31, ISSN 1743-7075, doi 10.1186/1743-7075-6-31
- KW. Young, CE. Greenwood, R. van Reekum, MA. Binns, A randomized, crossover trial of high-carbohydrate foods in nursing home residents with Alzheimer's disease: associations among intervention response, body mass index, and behavioral and cognitive function., J Gerontol A Biol Sci Med Sci, volume 60, issue 8, pages 1039-45, Aug 2005, PMID 16127110
- GA. Veech, J. Dennis, PM. Keeney, CP. Fall, RH. Swerdlow, WD. Parker, JP. Bennett, Disrupted mitochondrial electron transport function increases expression of anti-apoptotic bcl-2 and bcl-X(L) proteins in SH-SY5Y neuroblastoma and in Parkinson disease cybrid cells through oxidative stress., J Neurosci Res, volume 61, issue 6, pages 693-700, Sep 2000, PMID 10972966
- TB. Vanitallie, C. Nonas, A. Di Rocco, K. Boyar, K. Hyams, SB. Heymsfield, Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study., Neurology, volume 64, issue 4, pages 728-30, Feb 2005, doi 10.1212/01.WNL.0000152046.11390.45, PMID 15728303
- R.S. El-Mallakh, M.E. Paskitti, The ketogenic diet may have mood-stabilizing properties, Medical Hypotheses, volume 57, issue 6, 2001, pages 724–726, ISSN 03069877, doi 10.1054/mehy.2001.1446
- JR. Phelps, SV. Siemers, RS. El-Mallakh, The ketogenic diet for type II bipolar disorder., Neurocase, volume 19, issue 5, pages 423-6, 2013, doi 10.1080/13554794.2012.690421, PMID 23030231