Nutrition365 – Ketogenic diet & epilepsy

Since the 1920s, the ketogenic diet has been recognized as an effective non-pharmacological and non-invasive therapy in the treatment of drug-resistant epilepsy. It is characterized by a high fat content and a low carbohydrate intake, leading to the production of ketone bodies. The classic ketogenic diet generally uses a ratio of 4 units of fat to 1 unit of carbohydrates + protein. Less restrictive variations have been developed, such as the modified Atkins diet or the medium-chain triglyceride (MCT) diet, to account for factors such as compliance, palatability, and individual needs.

Ketogenic diet: what are the beneficial effects?

The clinical effectiveness of the ketogenic diet in reducing the frequency of attacks is now increasingly recognized. However, the mechanisms underlying this action are still the subject of intense research. The mechanism of action is in fact complex and multimodal (Reduction of neuronal excitability, Production of inhibitory neurotransmitters such as agmatine, etc.). The ketogenic diet, however, has the potential to improve mitochondrial function by increasing metabolic efficiency and reducing free radical production, thereby protecting the brain against oxidative stress that damages mitochondria and contributes to epileptic seizures. Recent research has also established a link between the beneficial effects of the ketogenic diet in the treatment of drug-resistant epilepsy and the changes induced in the intestinal microbiota by modulating the gut-brain axis. While awaiting further advances, a better understanding of the underlying mechanisms of the ketogenic diet would help optimize its effectiveness, use and applicability.