Keto Edition – Nutrition Research and News

The ketogenic diet and MCT oil for children with autism

Low in carbohydrates, moderate in protein, and high in fat, the ketogenic diet has shown promise in the treatment of ASD. 

In this study, 15 children aged 2 to 17 were prescribed a modified ketogenic diet with supplemental medium-chain triglycerides (MCT) oil for 3 months. 

Individuals with ASA suffer from mitochondrial dysfunction –mitochondria act like the cell’s “engine” and helps produce energy. The scientists wanted to see if adding MCT to the modified ketogenic diet could improve ketone and fatty acid production which would optimize mitochondrial efficiency.

The children’s caregivers received 2 hours of training on the modified ketogenic, gluten free diet and MCT protocol. This diet consisted of: 

  • 20 – 25g of carbohydrates per day
  • Protein, twice the RDA requirements, based on the child’s weight and height
  • Various types of fats including 20% of pure MCT oil or coconut oil

At the end of the study, 50% of the children showed moderate to considerable improvement in ADOS-2 scores for the social affect component. No significant difference was observed in restricted and repetitive behavior scores.

Furthermore, 50% showed improvement on CARS-2 scores in the areas of imitation, body use, and fear or nervousness.

Findings from this study suggest that this modified diet could improve inflammation levels, gut health, and cellular health in ASD patients.

Study Reference: Lee, R. W., Corley, M. J., Pang, A., Arakaki, G., Abbott, L., Nishimoto, M., … & Lum-Jones, A. (2018). A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiology & behavior, 188, 205-211.Physiology & behavior
, 188, 205-211.

GFCF vs. Keto Diet in Autism

In this 6-month study, Egyptian researchers compared the effects of two different dietary interventions versus a normal (control) diet on core symptoms of autism.  

The study population consisted of 45 children – 33 boys and 12 girls – aged between 3 and 8. The children were randomly assigned to three groups:

  •     Group 1: received the modified ketogenic diet (keto)
  •     Group 2: received a gluten-free, casein-free diet (GFCF)
  •     Group 3: the control group, received balanced nutrition

The results were exciting. Both the GFCF and Keto group have significant improvements compared to the control group (that did not do a special diet). There were some differences, but overall the results show that a special diet is very helpful to improving autism symptoms.

Autism severity decreased among children in groups 1 and 2 indicating that the Keto and GFCF diet were effective in improving autism symptoms.

The ketogenic diet yielded better results than the GFCF diet. The ketogenic diet can be a great diet for autism… for the right person. The keto diet can address some underlying mitochondrial issues and neuroinflammation that can be wonderful!! By improving the underlying biochemistry, the symptoms of autism can be significantly reduced (as we saw in the study).

However, 1/3 of the children dropped out of the Keto group. The fact that the keto diet is more restrictive is one of its challenges. No one dropped out of the GFCF group and great benefits were seen by that group too.

This research is further proof that a special diet helps people with autism. 

And it shows: both a GFCF diet and a keto diet were effective. See more on my write up of this paper, here, at my autism nutrition website:

Study reference: El-Rashidy, O., El-Baz, F., El-Gendy, Y., Khalaf, R., Reda, D., & Saad, K. (2017). Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic brain disease, 32(6), 1935-1941.

The ketogenic diet provides adequate nutrition (in Alzheimer’s disease)

Researchers wanted to study whether the ketogenic diet is nutritionally dense and can provide adequate nutrition.  15 older adults with very mild, mild, or moderate Alzheimer’s disease were involved in this study.

The study partners of each participant were counseled by a registered dietitian and participants were instructed to consume a 1:1 ketogenic diet consisting of about 70% fat, 20% protein, and at most 10% of carbohydrates.

The participants’ study partners completed self-reported 3-day food records (i) at baseline, (ii) after one month, and (iii) after two months. To assesses ketosis, evening urinary ketones was monitored daily by participants and serum beta-hydroxybutyrate was measured after a 12-hour fast within 48 hours of each 3-day food record.

Although only 10 of the 15 participants adhered to the diet, results indicated that it is possible to consume a nutrient-dense ketogenic diet with MCT oil and:

  • Plenty of non-starchy vegetables
  • Avocados
  • Nuts and seeds

Study reference: Taylor, M. K., Swerdlow, R. H., Burns, J. M., & Sullivan, D. K. (2019). An Experimental Ketogenic Diet for Alzheimer Disease Was Nutritionally Dense and Rich in Vegetables and Avocado. Current Developments in Nutrition, 3(4), nzz003.

People with type 2 diabetes may reverse or reduce their insulin use with intermittent fasting
Note: this study is on intermittent fasting rather than the ketogenic diet.

In a new study, Suleiman Furmli, MD, and his team reported that, under medical supervision, therapeutic 24-hour fasting regimens can help reverse type 2 diabetes. The fasting interventions could also reduce the use of medications in patients with type 2 diabetes and minimize surgical interventions in this population.

This small study involved 3 male patients aged between 40 and 67. The 3 participants also had high blood pressure and high cholesterol levels in addition to type 2 diabetes and were taking at least 70 units of insulin daily at the beginning of the study. 

Two of the patients fasted three times weekly for 7 months. After the intervention, one patient discontinued insulin and metformin use while the other stopped his fixed-dose insulin mix.

The other patient fasted on alternating days for 11 months and was able to eliminate metformin and pre-mixed insulin.

HbA1c levels improved for all 3 participants who also lost weight and inches off their waists.

Study reference: Furmli, S., Elmasry, R., Ramos, M., & Fung, J. (2018). Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin. Case Reports, 2018, bcr-2017.

3 Responses to Keto Edition – Nutrition Research and News

  1. Natalie Campbell October 1, 2019 at 5:20 pm #

    Dear Julie,
    A contraindication to keto would be acute intermittent porphyria. This is rare, but if you see it once you won’t forget it. Acute attacks involve many symptoms of the body including abdominal pain, many neurologic symptoms, and psychiatric symptoms. Attacks are brought on by many drugs, including barbituates, and a high protein low carbohydrate diet. They can sometimes be rescued with simple carbohydrates.
    Natalie Campbell MS, NTP

  2. Marianne Rothschild MD October 1, 2019 at 5:51 pm #

    I would be interested in knowing if there is any data on the effect of a ketogenic diet on kidney function tests? Would the BUN or Creatinine be higher?

  3. Bonnie Camo MD October 2, 2019 at 3:42 pm #

    The ketogenic diet is likely to work partly because it is likely to contain very little gluten or casein.

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