Q) Besides the multifaceted benefits derived from just reducing one’s weight, are there any other medical conditions that can be treated, at least partially, by changing one’s diet to a ketogenic one.
A) We recently discussed the theoretical benefits that a ketogenic diet (KD) might play in the recovery from a concussion (also known as a traumatic brain injury) as well some of the essential elements of this diet (high fat, low carbohydrates at its essence).
The biochemical basis for its effects on various systems is the ability to enhance what is known as neuronal plasticity which can normalize function within areas of our brain that have been damaged. The case for the use of a KD as a part of concussion therapy looks promising but in truth, this diet may have a role to play in several other diseases as well.
One example for which the evidence supporting its effectiveness is virtually unassailable is in the treatment of pharmaceutical drug resistant epilepsy in children. It was first used as an epileptic treatment in 1921 since it was a way to mimic a fasting state within the body which had already been proven to be effective for seizure suppression.
The KD diet can reduce seizures by as much as 85% in children whose epilepsy has proven particularly difficult for mainstream therapy to control. The reason behind its effectiveness is not clear but there is a growing theory that abnormal metabolism may be the cause of epilepsy and the metabolic changes induced by the KD (as we described in brief last week) may play a normalizing role.
As we have mentioned as well, diets like KD are not without their risks. Impaired heart function can occur as a result of a selenium deficiency for example, so it is important to consult with a dietician who can ensure all nutritional requirements are being met. Perhaps not surprisingly given its noted weight loss benefits, KD is now being investigated for its potential to at least improve or possibly even reverse type 2 diabetes which is the form of diabetes most commonly caused by being overweight and inactive. This makes sense as type 2 diabetes is essentially a state of carbohydrate intolerance so reducing their intake should help reverse the underlying problem.
The research, which is still scant at this point in time, seems to support a role for a KD as it seems to improve glycemic control (i.e. blood sugar levels) and insulin sensitivity often resulting in a reduction in dose or elimination of the need for some diabetic type medications.
Once again, this diet should only be attempted with the support of your health professionals so that your medication regimen can be reduced, if necessary, to prevent hypoglycemic events (these occur when your blood sugars drop too low) which can be life threatening in rare cases.
KD are also being studied for their impact on the treatment of cancer as a whole. While the word cancer describes a disparate group of diseases which differ in many ways from each other, one fact that connects many of them is the fact that cancer cells use glucose as their main source of energy in order to fuel their rapid growth. Hence, in theory at least, consuming a KD should deprive a tumor of its energy supply and slow its progression.
Anecdotal reports have noted a trend toward improved outcomes but unfortunately most of the studies conducted thus far have been of poor design making definitive conclusions impossible to make at this time.
The benefits of KD in epilepsy has also spurred research into whether it might help other neurologic disorders due to its purported neuro-protective effects. Research, once again, is still in its infancy but early results are impressive.
Migraines, which are thought to be caused in part by an energy deficiency disorder, have also been shown to respond favourably to ketone supplements which would be similar to the increase in circulating ketones that a KD diet would produce. Patients with mild to moderate Alzheimer’s have shown Improved cognitive test scores after 3 months of following a KD.
Improved functioning has been seen in Parkinson’s patients and there have been some reports of behavioural improvements in children with autism. There is not enough evidence yet to fully support trying this as an attempt to improve your own battles with disorders of these types but with the plethora of studies being conducted, hopefully soon we should be able to come out with more definitive guidance.
All diets are hard, perhaps particularly so in a pandemic world where many of us seek comfort from our food choices, but a KD type one tends to be less so as its participants are not left starving (recall its not so much calorie reduction as it is getting one’s calories from different sources).
With guidance from your doctor and dietician, it could well be worthwhile to see if it can improve the quality of your life. For more information about this or any other health related questions, contact your pharmacist.