Ketogenic Diet in the 1990s

Use of the ketogenic diet decreased greatly until it received national media attention in October 1994, when NBC-TV's Dateline aired a program on the treatment (7,8,42,63-66). This television program was based on the true story of Charlie, a 2-yr-old with intractable myoclonic, generalized tonic, and tonic-clonic seizures (Fig. 4). A videotape presentation made later summarizes Charlie's condition in 1994 Thousands Fig. 4. Charlie Abrahams, age 4, with his parents Jim and Nancy, as they...

Perspectives On The Antiepileptic Mechanism Of Caloric Restriction

We propose that CR inhibits seizure susceptibility by shifting brain energy metabolism from glucose to ketone bodies. A CR-induced reduction in glucose utilization and increase in ketone utilization will, on the one hand, reduce the glycolytic energy reserves related to seizure activity and, simultaneously, decrease neuronal excitability through ketone metabolism. This involves multiple metabolic changes that would ultimately shift the neural environment from excitation to inhibition. An...

Inborn Errors of Metabolism in Which the KD Is Contraindicated

There are definitive contraindications to the use of the KD. These include defects in fat metabolism and disorders that require high carbohydrate contents. Failure to diagnose these disorders before starting the KD could result in significant morbidity and may be fatal. These contraindications should therefore be considered in every child before the KD treatment is started. P-Oxidation defects were first described in 1973, and since then at least 22 additional inborn errors of metabolism have...

Pre Ketogenic Diet Session

The rigors of ketogenic diet management should be discussed during the pre-keto-genic diet session. The process of food preparation and food weighing should be explained. The caregiver should be provided with the information for purchasing a scale that weighs in tenths of a gram (0.1 g). A description of the typical meals and beverages, and the requirement for the omission of carbohydrate-rich foods, should be clearly communicated. The caregiver should be informed about the appropriate foods...

Inborn Errors of Metabolism

The major use of the KD is as a treatment for intractable epilepsy. In a few inborn errors of metabolism, however, the metabolic defects in carbohydrate metabolism are bypassed by using ketone bodies as the primary energy source. We discuss these disorders because the KD, with the steady production of ketone bodies, is the treatment of choice, and early diagnosis and treatment may prolong life and reduce morbidity in these patients. 1.7.1. Facilitated Glucose Transporter Protein Deficiency...

References

In Engel JJ, Pedley TA (eds.). Epilepsy A Comprehensive Textbook, Vol. 1. Lippincott-Raven, New York, 1997, pp. 47-57. 2. Engel JJ, Pedley TA. Introduction what is epilepsy In Engel JJ, Pedley TA (eds.). Epilepsy A Comprehensive Textbook, Vol. 1. Lipponcott-Raven, New York, 1997, pp. 1-10. 3. Baumann RJ. Classification and population studies of epilepsy. In Anderson VE, Hauser WA, Penry JK, Sing CF (eds.). Genetic Basis of the Epilepsies. Raven, New York,...

Control Of Npy And Galanin Expression By Nutritional Status

The circulating hormones leptin and insulin have inhibitory effects on the expression of orexigenic neuropeptides. Leptin is a satiety hormone that is secreted by fat cells and serves as a signal of energy stores. When energy stores are abundant, leptin levels are high. Leptin decreases food intake via two mechanisms. Leptin activates preprome-lanocortin (POMC) neurons in the ARC, which release a-melanocyte-stimulating hormone (a-MSH). a-MSH stimulates cells expressing melanocortin-4 receptors,...

The Ketogenic Diet

At about the same time as the study of Cobb and Lennox, in 1921, a review article about diet adjustments and diabetes by Woodyatt stated acetone, acetic acid, and beta-hydroxybutyric acid appear in a normal subject by starvation, or a diet containing too low a proportion of carbohydrate and too high a proportion of fat. It ketoacidosis appears to be the immediate result of the oxidation of certain fatty acids in the absence of a sufficient proportion of 'oxidizing' glucose (32). Concurrently,...

Choline Enriched Diets

Choline is an amine that has been of interest for many years because of its critical role in brain development and response to injury. Choline is an essential nutrient for all mammals, and an adequate supply is particularly important during fetal development, when the organism grows rapidly (3). Pregnancy and lactation are the periods of highest dietary demands for choline, when large amounts of this compound are transferred from the mother to the offspring via placenta and milk. Choline serves...

Dietary Longchain Polyunsaturated Fatty Acids In A Ketogenic Diet Clinical Challenges

The data outlined thus far regarding LC-PUFAs can be summarized as follows 1. Supplementation exposure to LC-PUFAs may reduce seizure susceptibility. 2. Increased serum levels of LC-PUFAs have been observed in subjects consuming a KD. Although incorporating LC-PUFAs into a KD may enhance the diet's efficacy, there are several clinical challenges that must first be addressed. The optimal dosage and composition of the LC-PUFA supplement must be determined. Preliminary evidence suggests that only...

Conclusion

We suggest that CR may underlie the anticonvulsant mechanism of the KD and that CR alone may be an effective antiepileptic diet therapy. Moreover, the anticonvulsant action of CR may operate through the combined effects of reducing blood glucose and elevating blood ketones, thereby modulating cerebral energy metabolism. Our preclinical findings in EL mice suggest that CR may be an effective dietary therapy for some human epilepsies because CR is easy to administer and is devoid of the adverse...

Regulation by Absolute Changes in Protein HMGCS2 Concentration

At the genetic level HMGCS2 gene expression is upregulated by glucocorticoids, fatty acids, and cyclic adenosine monophosphate (cAMP) and downregulated by insulin Fig. 3. The HMGCS2 gene promoter. The promoter region is depicted by an open box for the DNA sequence upstream of the transcription start site tss and a solid box for the transcribed region downstream of the transcription start site. Abbreviations for DNA sequence elements and receptors GRE, glucocorticoid response element CRE, cAMP...

Putative Effect Of The Kd On Npy And Galanin Systems

Taken together, these data indicate that starvation conditions induce the expression of galanin and NPY. It stands to reason that these peptides would also be induced by the KD. A combination of the starvation-like phenotype, i.e., ketosis, and low glucose intake elicited by the KD would lead to decreased leptin and insulin. Low leptin and insulin levels would stimulate the activity of NPY-ergic neurons and increase NPY and galanin expression. Furthermore, because fat ingestion may enhance...

Freeman Ketogenic Diet

The Ketogenic Diet A Treatment for Epilepsy, 3rd ed. Demos, New York, 2000. 2. Musa-Veloso K, Likhodii SS, Cunnane SC. Breath acetone is a reliable indicator of ketosis in adult volunteers consuming ketogenic meals. Am J Clin Nutr 2002 76 65-70. 3. Freund G. The calorie deficiency hypothesis of ketogenesis tested in man. Metabolism 1965 14 985-990. 4. Livingston S. Dietary treatment of epilepsy. In Comprehensive Management of Epilepsy in Infancy, Childhood and...

References Of Kodama S On Ketogenic Diet At 2012

Prasad AN, Stafstrom CE, Holmes GL. Alternative epilepsy strategies the ketogenic diet, immunoglobulins, and steroids. Epilepsia 1996 37 Suppl 1 S81-S95. 2. Merritt HH, Putnam TJ. Sodium diphenylhydantoinate in the treatment of convulsive disorders. J Am Med Assoc 1938 111 1068-1073. 3. Richards RK, Everett GM. Analgesic and anticonvulsive properties of 3,5,5-trimethyloxazoliidine-2,4-dione Tridione . Fed Proc 1944 3 39. 4. Krall RL, Penry JK, White BG, Kupferberg HJ, Swinyard EA....