History of the ketogenic diet

Abstract

SUMMARYFasting and other dietary regimens have been used to treat epilepsy since at least 500 BC. To mimic the metabolism of fasting, the ketogenic diet (KD) was introduced by modern physicians as a treatment for epilepsy in the 1920s. For two decades this therapy was widely used, but with the modern era of antiepileptic drug treatment its use declined dramatically. By the end of the twentieth century this therapy was available in only a small number of children's hospitals. Over the past 15 years, there has been an explosion in the use, and scientific interest in the KD. This review traces the history of one of the most effective treatments for childhood epilepsy.

1. Cortical functional correlates of responsiveness to short-lasting preventive intervention with ketogenic diet in migraine: A multimodal evoked potentials study

“…Reduced potentiation/hyperresponsivity mechanisms in ketogenic diet-fed rats [11,25] is consistent with a general modulation of cortical excitability. This was confirmed by the observation that KD is a useful tool in controlling childhood seizures [27,28]. In hippocampal in vitro seizures models, KD feeding limited epileptic activity in several portions of the hippocampus by promoting ATP-sensitive K+ channel activity that is implicated in plasma membrane excitability and in regulation of aerobic metabolism [29][30][31].…”

Metabolic Changes in Epileptic Patients Experiencing Seizure During Fasting in the Ramadan

“…[16] Today, even though the exact mechanism of effect is not known, ketogenic diets are still used in children with refractory epilepsy. [17] …”

Recomendaciones para el manejo clínico pediátrico de la dieta cetogénica en el tratamiento de la epilepsia refractaria

“…4 El ayuno como método para alcanzar el control de las convulsiones fue descrito hace alrededor de 90 años. 5 Luego, con el advenimiento de múltiples fármacos, la dieta cayó en desuso y, recientemente, en la década de 1990, resurgió junto con la estimulación vagal y la cirugía de la epilepsia para intentar dar respuesta a los casos en los que la terapéutica farmacológica aislada resultaba ineficaz. Como resultado, la dieta cetogénica en sus distintas modalidades (clásica, con triglicéridos de cadena media, Atkins modificada y de bajo índice glucémico) ocupa hoy un nuevo rol de relevancia en el tratamiento de estos pacientes y se utiliza en aproximadamente 200 centros en todo el mundo, con eficacia comprobada.…”