Ketogenic dietary therapy for epilepsy and other disorders: current perspectives

Abstract

The ketogenic diet (KD) is a high-fat, restricted-carbohydrate regime, originally designed to mimic metabolic responses to fasting and has been used since the 1920s as a treatment for epilepsy. Modified variants of the KD include the addition of medium-chain triglyceride and less-restrictive modified Atkins and low glycemic index protocols. Scientifically proven as treatment for intractable seizures in children, these ketone-generating diets are increasingly also being used in adults. They are the treatment of choice in glucose transporter type 1 deficiency syndrome and pyruvate dehydrogenase deficiency. Evidence for the potential of KD therapy to be included within the treatment options for cancer and neurodegenerative disorders is more limited, albeit an exciting area of research with future clinical potential. This review discusses the key aspects of KD therapy, including the efficacy of treatments and clinical implementation. The importance of appropriate initiation, adequate clinical supervision, regular monitoring, and assessment of nutritional needs is highlighted.

Food and Food Products on the Italian Market for Ketogenic Dietary Treatment of Neurological Diseases

“…For example, if CKD with a KR 3:1 fails to reach therapeutic ketonemia, one valuation can be made of the possibility of replacing a part of the daily lipids with MCTs from vegetable oils, before moving to a more restrictive KD. Indeed, in clinical practice many dietitians adopt a more flexible, patient-tailored approach to KD, combining elements from one or more variants of KD, rather than sticking to a rigid dietary protocol [77].…”