Ketogenic diet: A nutritional remedy for some metabolic disorders
KeywordsKetogenic diet, nutritional remedy, diseases, metabolic disorders
Background: Ketogenic diets (KD) consist of high fat, moderate protein and low carbohydrates.
Aim: This review explores the effect of ketogenic diet and its mechanism of actions in disease management.
Methods: Recent information on ketogenic diets and disease management were retrieved from academic journals using scientific search engines and popular library databases such as PubMed, Scopus, Web of Science, JSTOR amongst others.
Commentary: Ketogenic diet means a high fat, low-carbohydrate diet, with enough protein content, which makes the body utilize fat, rather than carbohydrate, as a preferred energy source. There are four different types of ketogenic diet, the traditional classic ketogenic diet, medium chain triglyceride (MCT) ketogenic diet, the modified Atkins diet (MAD), and the low glycemic index treatment (LGIT). The classic ketogenic diet, also known as long-chain fats consist of 16-20 carbon atoms. Its peculiarity is the low carbohydrate content, which could be difficult to maintain. The MCT was developed as an alternative to classic ketogenic diet. It has a fat composition of 60% octanoic acid (eight-carbon fatty acid) and 40% decanoic acid (10-carbon fatty acid). The MCT provides about 45% of energy when compared with the classic ketogenic diet. The MAD though strongly encourages the intake of high fat, it allows for 10-20 g of carbohydrate per day. The LGIT permits only low glycemic index foods. Ketogenic diets have been a therapeutic strategy for several diseases such as obesity, dyslipidemia, cancer and a broad range of neurological disorders.
Conclusion: The ketogenic diet, an effective and age-long treatment for epilepsy in children, is gradually gaining acceptance as a therapeutic modality for many other diseases.
Vidalia S, Aminzadeha S, Lambert B, Rutherford T, Sperl W, Kofler B, Feichtingera R. Mitochondria: The ketogenic diet-A metabolism-based therapy. Int. J. Biochem. Cell Biol 2015;63, 55–59.
Kulaka, D. & Polotsky, A. (2013). Should the ketogenic diet be considered for enhancing fertility? Maturitas, 74 :10– 13.
Branco AF, Ferreira A, Simoes R, Novais S, Zehowski C, Cope E, Silva A, Pereira D, Vilma S, Oliveira T. Ketogenic diets: from cancer to mitochondrial diseases and beyond. Eur J Clin Invest 2016;46 (3): 285–298.
Wilder R. The effects of ketonemia on the course of epilepsy. Mayo Clin Proc 1921; 2:307–8.
Ferreira L, Lisenko K, Barros B, Zangeronimo M, Pereira L, Sousa R. Influence of medium-chain triglycerides on consumption and weight gain in rats: a systematic review. J Anim Physiol Anim Nutr (Berl) 2014;98:1–8.
Giordano C, Marchio M, Timofeeva E, Biagini G. Neuroactive peptides as putative mediators of antiepileptic ketogenic diets. Front Neurol 2014; 63.
Wibisono C, Rowe N, Beavis E, Kepreotes H, Mackie F, Lawson J et al. Ten-year single-center experience of the ketogenic diet: factors influencing efficacy, tolerability, and compliance. J Pediatr 2015;166:1030 e1–1030 e6.
Auvin S. Should we routinely use modified Atkins diet instead of regular ketogenic diet to treat children with epilepsy? Seizure 2012;21:237–40.
Radhika D., Susan E, Elaine W. Ketogenic Diet. Can J Neurol Sci. 2013; 40: 158-167
Paoli A, Bianco A, Grimaldi K, Lodi A, Bosco G. Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol. Nutrients 2013;5, 5205–5217.
Alwahab A, Pantalone KM, Burguera B. A Ketogenic Diet May Restore Fertility In Women with Polycystic Ovary Syndrome: A Case Series. AACE Clinical Case Reports 2018;4; e427.
Kosinski C, Jornayvaz J. Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients 2017;9, 517; doi:10.3390/nu9050517.
Murata Y, Nishio K, Mochiyama T, Konishi M, Shimada M, Ohta H, Itoh N. Fgf21 Impairs Adipocyte Insulin Sensitivity in Mice Fed a Low-Carbohydrate, High-Fat Ketogenic Diet. PLoS ONE 2013;8, e69330.
Bielohuby M, Sisley S, Sandoval D, Herbach N, Zengin A, Fischereder M, Menhofer D, Stoehr B, Stemmer K., Wanke R, et al. Impaired glucose tolerance in rats fed low-carbohydrate, high-fat diets. Am. J. Physiol. Endocrinol. Metab 2013;305, E1059–E1070.
Lima PA, de Brito Sampaio LP, Damasceno N. Ketogenic diet in epileptic children: Impact on lipoproteins and oxidative stress. Nutr. Neurosci 2015;18, 337–344.
Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein SA. Randomized Trial of a Low-Carbohydrate Diet for Obesity. N. Engl. J. Med 2003;348, 2082–2090.
Garbow JR, Doherty JM, Schugar RC, Travers S, Weber ML, Wentz AE, Ezenwajiaku N, Cotter DG, Brunt EM, Crawford PA. Hepatic steatosis, inflammation, and ER stress in mice maintained long term on a very low-carbohydrate ketogenic diet. Am. J. Physiol. Gastrointest. Liver Physiol 2011;300, G956–G967.
Jornayvaz FR, Jurczak MJ. Lee HY, Birkenfeld AL, Frederick DW, Zhang D, Zhang XM, Samuel VT, Shulman GI. A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain. Am. J. Physiol. Endocrinol. Metab 2010;299, E808–E815.
Douris N, Melman T, Pecherer J, Pissios P, Flier J, Cantley L, Locasale J, Maratos-Flier E. Adaptive changes in amino acid metabolism permit normal longevity in mice consuming a low-carbohydrate ketogenic diet. Biochim. Biophys. Acta 2015;1852, 2056–2065.
Saisho Y, Butler A, Manesso E, Elashoff D, Rizza R, Butler P.. Cell mass and turnover in humans. Effects of obesity and aging. Diabetes Care 2013;36, 111–117.
Neal EG, Cross JH. Efficacy of dietary treatments for epilepsy. J Hum Nutr Diet 2010;23:113–9.
Neal, E. Dietary treatment of epilepsy: practical implementation of ketogenic therapy.1st ed. Oxford, UK: Wiley-Blackwell 2012.
Bough KJ, Rho JM. Anticonvulsant mechanisms of the ketogenic diet. Epilepsia 2007;48: 43–58.
Włodarek D. Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer’s Disease and Parkinson’s Disease). Nutrients 2019, 11, 169; doi:10.3390/nu11010169
Warburg O. On the origin of cancer cells. Science 1956;123:309–14.
Chen Z, Lu W, Garcia-Prieto C, Huang P. The Warburg effect and its cancer therapeutic implications. J Bioenerg Biomembr 2007;39:267–74.
Feichtinger RG, Zimmermann F, Mayr JA, Neureiter D, Hauser-Kronberger C, Schilling FH, et al. Low aerobic mitochondrial energy metabolism in poorly — or undifferentiated neuroblastoma. BMC Cancer 2010;10:149.
Scheck AC, Abdelwahab MG, Fenton KE, Stafford P. The ketogenic diet for the treat-ment of glioma: insights from genetic profiling. Epilepsy Res 2012;100:327–37.
Lv M, Zhu X, Wang H, Wang F, Guan W. Roles of caloric restriction, ketogenic diet and intermittent fasting during initiation, progression and metastasis of cancer in animal models: a systematic review and meta-analysis. PLoS ONE 2014;9:e115147.
Zhou W, Mukherjee P, Kiebish M, Markis W, Mantis J, Seyfried T. The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutr Metab (Lond) 2007; 4:5.
Abdelwahab MG, Fenton KE, Preul MC, Rho JM, Lynch A, Stafford P., et al. The keto-genic diet is an effective adjuvant to radiation therapy for the treatment of malignant glioma. PLoS ONE 2012;7:e36197.
Sanjay K, Rajiv S, Rahul R, Munish D, Deepak K, Bharti K. The Ketogenic Diet. US Endocrinology. 2018;14(2):62–4.
Wajeed M, Kalyan RU. Ketogenic Diet. NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK499830.
Chorągiewicz T, Ziarnowska I, Gasior M, Ziarnowski T. Anticonvulsant and neuroprotective effects of the ketogenic diet. Przegląd Lekarski 2010, 67, 205–212. (In Polish).
Wheless JW. The Ketogenic Diet: An Effective Medical Therapy With Side Effects. Journal of Child Neurology, 2001, 16:9.
Kayode OT, Rotimi DE, Olaolu TD, Adeyemi OS. Ketogenic diet improves and restores redox status and biochemical indices in monosodium glutamate-induced rat testicular toxicity. Biomedicine & Pharmacotherapy, 2020 127 110227.
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