I am really grateful to Reto for bringing attention to the ketogenic diet. Ketones and the ketogenic diet is something I suspect we will be hearing more about in years to come. The diet has proved spectacularly successful as a treatment for children with otherwise hard-to-control epilepsy and as Reto points out, researchers are now exploring whether there is potential for a ketogenic diet (KD) to play a role in treating other neurological conditions, including Alzheimer's, Parkinsons and MS (1). What appears particularly exciting is that doctors have observed children remaining seizure-free during two years on the diet, and continuing to be free of seizures even after the diet and anti-consvulsant medicine was discontinued. So maybe KD has the ability to 're-boot' the brain?
The website http://www.ketogenic-diet-resource.com
(created by a dietician with a Master's degree in Applied Clinical Nutrition) explains that:
"the restriction of carbohydrate is key to the KD diet. When carbohydrate foods (sugar and starch) are digested, they are broken down into blood sugar (glucose) in the body. The more carbs we eat, the more glucose is created. If we reduce carb intake and instead eat more fat and proteins, it causes our internal metabolic pathways to switch from burning sugar to burning fat. This switch produces ketone bodies while at the same time reducing blood sugar and insulin levels."
The heart, muscle and brain come to rely on fats to fuel themselves (humans developed the ability to burn ketones as fuel as an adaptation for periods when other food was unavailable) and the body enters a state of nutritional ketosis. As the article by Stafstrom & Rho (1) outlines, there is growing research evidence that this state of nutritional ketosis has the capacity to protect neurological pathways and even reverse neurogeneration (damaged myelin in the case of MS).
The 2015 article in 'Multiple Sclerosis International' (2) to which Reto provided a link reviews the research evidence for a ketogenic diet being effective for treating progressive MS. The authors also question the long held assumption that inflammation comes first and leads to the neurological damage, instead putting forward the idea that it is the neurological damage that leads to the inflammation. Their rationale for this is that there is increasing observation of neurological degeneration even when there is no inflammation.
Reading this, I was struck by the recollection of a post I read on on this forum just a few weeks ago: the writer had been for an interval scan and was told there was no evidence of inflammation. Why then, she had asked, was her walking continuing to deteriorate? The medical practitioner had given what sounded like rather a vague reply along the lines of 'there must be some inflammation somewhere'.
The thought that the neurological damage is continuing to take place even though the inflammation is being controlled (by keeping saturated fats to the minimum possible, as per the OMS guidelines) makes me, at any rate, keen to explore whether it would be possible to combine any of the (neuroprotective) KD components with OMS..
ZoÃ« provides a brilliant summary and critique of the CharitÃ© pilot study and I can only agree with her conclusion that it would not be possible to combine OMS with the KD diet followed in the CharitÃ© study. Given the many thousands of people who have derived huge benefits from following the OMS guidelines it is not at all tempting to abandon OMS for the unknown territory of KD, either. As Reto says, it would be ideal to come up with superdiet that combined the two! The Charlie Foundation (http://www.charliefoundation.org
), who treat children with epilepsy, do distinguish different levels of KD, with the classic ketonic diet having a 4:1 or 3:1 ratio of fat to non-fat (protein and carbohydrate) and a modified ketogenic diet having a fat to non-fat ratios of 2:1 and 1:1.
It might be interesting to explore whether any of these modified KD ratios would a) be likely to have any therapeutic effect and b) be compatible with OMS? There are already many forum contributors who choose to avoid or minimise sugar, and I - for one - could doubtless do to watch my carbohydrate intake (it is very easy to reach for the cereal, bread or pasta, especially when the energy levels are low . . .).
For anyone wishing to explore KD in more detail, http://www.ketogenic-diet-resource.com
has a wealth of information to offer and http://ketodietapp.com/Blog/page/Start-Here
has comprehensive lists of KD foods, a food pyramid, meal plans (including ones for vegans), recipes etc.
All this worrying about food almost makes one want to fast. Which actually, is another way of achieving ketosis . . .
Bon appetit to one and all!
1) Carl E. Stafstrom and Jong M. Rho, 'The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders', Frontiers in Pharmacolgy, April 2012 - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321471/
(2) Mithu Storoni and Gordon T. Plant, 'Review Article: The Therapeutic Potential of the Ketogenic Diet in Treating Multiple Sclerosis', "Multiple Sclerosis International", Vol. 15 - http://dx.doi.org/10.1155/2015/681289