Ketogenic diet

high-fat dietary therapy for epilepsy

A ketogenic diet is a diet in which most of the calories come from fat (70-75%). A moderate amount of calories come from protein (20-25%). Only a small number of the calories come from carbohydrates (5%).

The diet forces the body to burn fats rather than carbohydrates for energy. Normally, the carbohydrates you eat are turned into glucose in the body, which is used for energy around the body and in the brain. But, if you don't eat enough carbohydrates, your body has a back-up system of burning fat instead. The liver can use stored fat and the fat you eat for energy. Stored fat is broken into two parts, fatty acids, and ketone bodies. Ketone bodies power the brain instead of glucose. This state of having a lot of ketone bodies in your blood is called "Ketosis." The liver can also make or release its own glucose through two processes(gluconeogenesis and glycogenolosis) as glucose is still needed for normal body function.[1]

When you eat fewer carbs, your body starts using fat for fuel. This can cause your body to enter a metabolic state known as ketosis. Your liver converts fat into little energy molecules known as ketones, which your brain and other organs can utilize for energy.

Overview

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The keto diet is any diet that elicits ketosis. To achieve ketosis Keto Archived 2021-12-21 at the Wayback Machine we need to limit carbohydrates and use fat for fuel, to produce ketones. The regular ketogenic diet has two to four times more fat by weight than protein, and very little carbohydrates every day. This means not eating foods that are made from starch or sugar. High-carbohydrate foods are foods like fruits, bread, pasta, grains, cookies, and ice cream. Also, you have to increase your intake of fatty foods, like oils(usually from olives, avocados, or coconuts), butter, and fatty meats. It's also important to not eat too much protein. You should only eat just enough protein so you don't lose muscles. Too much protein reduces the ketone bodies in your blood and blocks fat burning.

History

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The ketogenic diet was originally created to treat people with epilepsy. Until other medicines became available, this was a good option for managing the condition.[2]

Now, due to the other treatments available, and how restrictive the diet is, the ketogenic diet is usually prescribed when other options do not work for the patient.

Treatment in Epilepsy

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The ketogenic diet can lower the number of seizures.[3] Most children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[4] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[5] Adolescents and adults may also benefit from the diet, though this diet is hard to follow.[6] Questions still remain on why this diet works.[7]

The ketogenic diet can also have some side effects, especially if not done properly, such as gastrointestinal problems.[8]

References

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  1. Noguchi, Rei; Kubota, Hiroyuki; Yugi, Katsuyuki; Toyoshima, Yu; Komori, Yasunori; Soga, Tomoyoshi; Kuroda, Shinya (2013-05-14). "The selective control of glycolysis, gluconeogenesis and glycogenesis by temporal insulin patterns". Molecular Systems Biology. 9: 664. doi:10.1038/msb.2013.19. ISSN 1744-4292. PMC 4039368. PMID 23670537.
  2. "Ketogenic Diet". Epilepsy Foundation. Retrieved 2021-05-18.
  3. Kossoff, Eric H.; Zupec-Kania, Beth A.; Rho, Jong M. (2009-08-01). "Ketogenic Diets: An Update for Child Neurologists". Journal of Child Neurology. 24 (8): 979–988. doi:10.1177/0883073809337162. ISSN 0883-0738. PMID 19535814. S2CID 11618891.
  4. Kossoff, Eric H.; Zupec-Kania, Beth A.; Auvin, Stéphane; Ballaban-Gil, Karen R.; Bergqvist, A. G. Christina; Blackford, Robyn; Buchhalter, Jeffrey R.; Caraballo, Roberto H.; Cross, J. Helen (2018). "Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group". Epilepsia Open. 3 (2): 175–192. doi:10.1002/epi4.12225. ISSN 2470-9239. PMC 5983110. PMID 29881797.
  5. Freeman, John M.; Kossoff, Eric H.; Hartman, Adam L. (2007-03-01). "The Ketogenic Diet: One Decade Later". Pediatrics. 119 (3): 535–543. doi:10.1542/peds.2006-2447. ISSN 0031-4005. PMID 17332207. S2CID 26629499.
  6. Husari, Khalil S.; Cervenka, Mackenzie C. (2020-05-01). "The ketogenic diet all grown up—Ketogenic diet therapies for adults". Epilepsy Research. 162: 106319. doi:10.1016/j.eplepsyres.2020.106319. ISSN 0920-1211. PMID 32199222. S2CID 212644194.
  7. Maria, Bernard L. (2009). Current Management in Child Neurology. PMPH-USA. ISBN 978-1-60795-000-4.
  8. D’Andrea Meira, Isabella; Romão, Tayla Taynan; Pires do Prado, Henrique Jannuzzelli; Krüger, Lia Theophilo; Pires, Maria Elisa Paiva; da Conceição, Priscila Oliveira (2019-01-29). "Ketogenic Diet and Epilepsy: What We Know So Far". Frontiers in Neuroscience. 13: 5. doi:10.3389/fnins.2019.00005. ISSN 1662-4548. PMC 6361831. PMID 30760973.