In the past few years, the ketogenic (keto) diet has gained mainstream popularity as a non-pharmacological treatment for many medical conditions. The keto diet was first developed in 1924 by Dr. Russell Wilder at the Mayo Clinic as a treatment for epilepsy but was later abandoned as anticonvulsant medications were developed. Over the years, the keto diet has been shown to help other neurological disorders. Who can benefit from the ketogenic diet?
What Is The Ketogenic Diet
The keto diet is a high-fat, low-carbohydrate diet with the goal of putting your body in a fasting state. In a fasting state, your body gets its energy from fat metabolism instead of carbohydrate or protein metabolism. Glucose levels drop and ketone bodies (acetoacetate and beta-hydroxybutyrate) are produced by the liver. Your brain uses the ketone bodies for energy instead of glucose.
The classic keto diet is composed of a ratio of 4g fat to 1g protein plus carbohydrate. Your meals should consist of 80-90% fat, 8-15% protein and 2-5% carbohydrate to induce the production of ketone bodies.
The classic keto diet may be difficult and unpleasant for people to follow. Three variations of the ketogenic diet allowing for more carbohydrates may be just as helpful for neurological disorders and more palatable. The modified Atkin diet limits carbohydrate to about 10-20g/day for about 1-2g fat to 1g protein plus carbohydrate ratio. The medium-chain triglycerides in coconut and/or palm kernel oils supplements allows for more carbohydrate and protein intake for ketosis. And lastly, the low glycemic index diet focuses on choosing food with low glycemic index to avoid a spike in blood glucose.
Benefits of Ketogenic (Keto) Diet on Neurological Disorders
The keto diet helps treat neurological disorders by modulating neurotransmitter signals as well as having antioxidant and anti-inflammatory benefits. The ketogenic diet has been used as a nonpharmacological treatment or supplemental treatment for many neurological disorders.
- Epilepsy – The keto diet has modest efficacy in the treatment of drug-resistant epilepsy or difficult to control status epilepticus.
- Malignant Gliomas – Case reports and small studies have shown potential benefit of the ketogenic diet in survival without tumor progression. However, larger randomized-control trials with control groups are needed to better assess the efficacy of the ketogenic diet in malignant glioma treatment.
- Alzheimer Disease – High glycemic diets are associated with increased amyloid which is responsible for Alzheimer disease. Low carbohydrate keto diet may improve cognition in mild Alzheimer disease patients.
- Migraine Headache – The keto diet may help reduce migraines by calming the brain hyperexcitability and counteract the inflammatory and oxidative stress during migraine attacks.
What Foods are Keto Friendly
- Meat and poultry
- Fish and seafood
- Eggs
- Cheese and full-fat dairy
- Fruit and berries
- Non-starchy vegetables – brussels sprout, kale, cabbage, avocado, cauliflower
- Nuts and seeds
What Foods to Avoid
- Sugar – candy, cookies, soda
- Grain and grain-products – bread, pasta, tortilla
- Dried fruits – apples, banana, oranges
- Starchy vegetables – corn, potato, yams
- Low-fat dairy products
- Alcohol
Side Effects of the Ketogenic Diet
Initiation and management of the ketogenic diet for epilepsy includes a dietician, neurologist, and pharmacist. The most common reported side effects of the ketogenic diets are weight loss, gastrointestinal symptoms, high lipids and vitamin deficiencies.
Gastrointestinal side effects include diarrhea, constipation, nausea, vomiting and rare pancreatitis. Symptoms may improve as you stay on the diet and your dietician can make adjustments that may help.
Given the potential for weight loss, anorexia is a contraindication for the ketogenic diet. The vitamins found in carbohydrates need to be supplemented especially in postmenopausal women.
Make an appointment with our neurologists to discuss whether you can benefit from the ketogenic diet.