Long-Term Effects of a Classic Ketogenic Diet on Ghrelin and Leptin Concentration: A 12-Month Prospective Study in a Cohort of Italian Children and Adults with GLUT1-Deficiency Syndrome and Drug Resistant Epilepsy

Abstract

The classical ketogenic diet (cKD) is an isocaloric, high fat, very low-carbohydrate diet that induces ketosis, strongly influencing leptin and ghrelin regulation. However, not enough is known about the impact of a long-term cKD. This study evaluated the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adults affected by the GLUT1-Deficiency Syndrome or drug resistant epilepsy (DRE). We also investigated the relationship between the nutritional status, body composition and ghrelin and leptin variations. We carried out a longitudinal study on 30 patients: Twenty-five children and adolescents (15 females, 8 ± 4 years), and five adults (two females, 34 ± 16 years). After 12-monoths cKD, there were no significant changes in ghrelin and leptin, or in the nutritional status, body fat, glucose and lipid profiles. However, a slight height z-score reduction (from −0.603 ± 1.178 to −0.953 ± 1.354, p ≤ 0.001) and a drop in fasting insulin occurred. We found no correlations between ghrelin changes and nutritional status and body composition, whereas leptin changes correlated positively with variations in the weight z-score and body fat (ρ = 0.4534, p = 0.0341; ρ = 0.5901, p = 0.0135; respectively). These results suggest that a long-term cKD does not change ghrelin and leptin concentrations independently of age and neurological condition.

Effects of a ketogenic diet in overweight women with polycystic ovary syndrome

“…The duration of KD is still a question: there is no evidence of side effects in the short term, they are considered safe for short cycles. Less information is available on diets in the long term, but the experience gained in the field of epilepsy and GLUT-1 deficiency syndrome [73][74][75][76][77][78][79] supports a possible use also for prolonged periods. It is plausible to hypothesize the setting of protocols to be repeated in cycles over time, interspersed with periods of balanced regime.…”

Nutritional Ketosis as a Potential Treatment for Alcohol Use Disorder

“…Although there is some indication that KD may suppress ghrelin levels (see review by Roekenes and Martins (107)), there are some inconsistencies in the literature (108)(109)(110)(111). Leptin and peptide YY have effects opposite to ghrelin, in that they promote satiety (112,113).…”

A Calorie-Restricted Ketogenic Diet Reduces Cerebral Cortex Vascularization in Prepubertal Rats

“…At present, it is not possible to describe the mechanism by which CRKD causes a reduction of angiogenesis, but it is very likely that the key points can be (1) the limited amount of amino acids supplied, which will obviously limit the growth of any kind of tissue, and (2) the reduced production of insulin due to the low level of blood glucose. In fact, reduced levels of insulin and insulin growth factor 1 (IGF-1) due to CRKD have been confirmed in humans [21,22,23]. Moreover, the involvement of insulin in brain angiogenesis is supported by literature and this mechanism is even supposed to play a role in the pathogenesis of Alzheimer’s disease [24].…”