State of the ketogenic diet(s) in epilepsy

Abstract

Fasting has been recognized as a treatment for seizures since ancient times. The ketogenic diet is a low-carbohydrate, adequate-protein, high-fat diet that biochemically mimics the fasting state and has been used to successfully treat seizures for 85 years. The diet has enjoyed a resurgence in popularity over the past decade and is gaining acceptance and use worldwide. Many studies over the past several years have explored possible mechanisms of action for the ketogenic diet. This review addresses these studies, as well as recent research regarding possible indications for the diet, variations in its initiation, side effect profiles, and the recent use of modified formulations to improve tolerability.

The Ketogenic Diet for Medically and Surgically Refractory Status Epilepticus in the Neurocritical Care Unit

“…Dietary therapies have been described in the treatment of epilepsy since 1921 [4]. These include high fat, low carbohydrate diets such as the traditional ketogenic diet [5][6][7], the modified Atkins diet [1,[8][9][10][11][12][13][14], as well as the low-glycemic index treatment [15], and all three have been used primarily in the treatment of children. However, even as long ago as 1930, these treatments have been recognized as beneficial for adults [16].…”

The influence of the ketogenic diet on the elemental and biochemical compositions of the hippocampal formation

“…Fats are the predominant caloric source of the ketogenic diet, while carbohydrate and protein intake is restricted. Catabolism of fats results in the production of ketone bodies, and they become an alternative substrate to glucose for energy utilization [3,4].…”

Ketogenic diets in patients with inherited metabolic disorders

“…This results in Ba myriad of metabolic changes^ (Huffman and Kossoff 2006) with ketosis (β-hydroxybutyrate, acetoacetate, acetone), but usually without catabolism.…”