Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study

El-Rashidy, Omnia Fathy; El-Baz, Farida; Gendy, Yasmin Gamal El; Khalaf, Randa I.; Reda, D. J.; Saad, Khaled

doi:10.1007/s11011-017-0088-z

Cited by 109 publications

(115 citation statements)

References 22 publications

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“…In the present study, we obtained data from 10 participants that maintained the diet past the 3-month time point and found the improvements in social behavior are maintained. Moreover, our findings of significant improvement in CARS-2 scores after 3 months on our modified KD are in agreement with a recent case control study in 45 children that found significant improvement in CARS scores after 6 months on the modified Atkins diet [15]. Taking into account this case control study and our study, both studies suggest that a specific component of a KD may mediate the beneficial effects for ASD behavior.…”

Section: Discussionsupporting

confidence: 92%

“…After 3 months on the modified KD/GF/MCT, approximately 50% showed moderate to substantial improvement in ADOS-2 scores. In agreement with previous studies, we did not observe significant relationships between BHB levels and the degree of improvement in ASD symptoms [14,15]. The degree of improvement (20%) represented moderate changes in ADOS-2 scores.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings of ASD related improvements from the KD support prior animal and human studies investigating the relationship between ketogenic therapies and autism [11,12,14,15,17–19]. In the present study, we obtained data from 10 participants that maintained the diet past the 3-month time point and found the improvements in social behavior are maintained.…”

Section: Discussionsupporting

confidence: 85%

“…Initial case reports and a prospective pilot study of 30 individuals with autistic behavior suggests the KD may be effective as a treatment strategy for ASD [11–13]. Follow up clinical studies of 187 Greek and 45 Egyptian children have provided additional support that the KD may safely improve symptoms of certain individuals with ASD [14,15]. In addition, research using animal mouse models of ASD have demonstrated improvements in behavior on the KD [16–19].…”

Section: Introductionmentioning

confidence: 99%

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A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder

Lee

Corley

Pang

et al. 2018

Physiology & Behavior

117

111

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Purpose The ketogenic diet is a low-carbohydrate, moderate protein, high-fat diet that has emerged as a potential treatment for autism spectrum disorder. Autism spectrum disorder is a neurodevelopmental disorder of social communication, and restricted, repetitive behaviors and interests in need of novel therapies. An open-label clinical trial was done in Honolulu, Hawaii to test a modified ketogenic diet for improvement of core clinical impairments in children with ASD. Intervention A modified ketogenic gluten-free diet regimen with supplemental MCT was completed in 15 children ages 2 to 17 years for 3 months. Clinical (ADOS-2, CARS-2) and biochemical measures were performed at baseline and 3-months on the ketogenic diet. Main outcome Children administered a modified ketogenic gluten-free diet with supplemental MCT significantly improved core autism features assessed from the ADOS-2 after 3 months on diet (P = 0.006). No significant difference was observed in restricted and repetitive behavior score (P = 0.125) after 3 months on the diet protocol. Substantial improvement (> 30% decrease ADOS-2 total score) was observed in six participants, moderate improvement (> 3 units) in two participants, and minor/no improvement in seven participants. Ten participants assessed at a six-month time point sustained improvement in total ADOS-2 and social affect subdomain scores comparing baseline and 6 months (P = 0.019; P = 0.023), but no significant improvement in restricted and repetitive behavior scores were noted (P = 0.197). Significant improvements in CARS-2 items after 3 months of the modified ketogenic protocol were observed in imitation, body use, and fear or nervousness (P = 0.031, P = 0.008, P = 0.039). The percent change on ADOS-2 score from baseline to 3 months was associated with baseline high-density lipoprotein levels (ρ = −0.67, P = 0.007) and albumin levels (ρ = −0.60, P = 0.019). Moreover, the percent change from baseline to 3 months in ADOS-2 scores was significantly associated with percent change in high-density lipoprotein levels (ρ = 0.54, P = 0.049) and albumin levels (ρ = 0.67, P = 0.010). Conclusions A modified gluten-free ketogenic diet with supplemental MCT is a potentially beneficial treatment option to improve the core features of autism spectrum disorder and warrants further investigation. Trial registration Trial Registry: Clinicaltrials.gov Registration Number: NCT02477904URL: https://www.clinicaltrials.gov/ct2/show/NCT02477904?term=ketogenic+diet&cond=Autism&rank=1

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder

Lee

Corley

Pang

et al. 2018

Physiology & Behavior

117

111

View full text Add to dashboard Cite

show abstract

“…In the BTBR mouse model of ASD, a ketogenic diet improved symptoms by increasing sociability and decreasing self-directed repetitive behaviour 174 . It was recently reported that a ketogenic diet also improves symptoms in children with ASD 175 . As yet, trials of IF in ASD have not been performed.…”

Section: Ims and Neurological Disordersmentioning

confidence: 97%

Intermittent metabolic switching, neuroplasticity and brain health

et al. 2018

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During evolution, individuals whose brains and bodies functioned well in a fasted state were successful in acquiring food, enabling their survival and reproduction. With fasting and extended exercise, liver glycogen stores are depleted and ketones are produced from adipose-cell-derived fatty acids. This metabolic switch in cellular fuel source is accompanied by cellular and molecular adaptations of neural networks in the brain that enhance their functionality and bolster their resistance to stress, injury and disease. Here, we consider how intermittent metabolic switching, repeating cycles of a metabolic challenge that induces ketosis (fasting and/or exercise) followed by a recovery period (eating, resting and sleeping), may optimize brain function and resilience throughout the lifespan, with a focus on the neuronal circuits involved in cognition and mood. Such metabolic switching impacts multiple signalling pathways that promote neuroplasticity and resistance of the brain to injury and disease.

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Dendritic Cells and Their Expression of Costimulatory Molecules in Children with Autism Spectrum Disorders

Saad¹,

Alblihed²,

Al-Atram³

et al. 2019

Encyclopedia of Autism Spectrum Disorders

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Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study

Abstract: UMIN-CTR Study Design: trial Number UMIN000021433.

Cited by 109 publications

References 22 publications

A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder

A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder

Intermittent metabolic switching, neuroplasticity and brain health

Dendritic Cells and Their Expression of Costimulatory Molecules in Children with Autism Spectrum Disorders

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