The right bioindividual nutrition plan for your client can bring about profound improvement and benefit.
In this article, I want to focus on some diets that have received a lot of attention in the news and nutrition community: the ketogenic diet and intermittent fasting.
But are they right for your client or patient and how do you know?
This is something that I cover extensively in the BioIndividual Nutrition Training program. I teach practitioners in my professional program to consider symptoms, diet history, conditions, lab results, genetics, microbiome, and more.
Today I want to present 5 studies that are using these diets for three important neurological and metabolic conditions: autism, Alzheimer’s, and diabetes.
The ketogenic or “keto” diet has been long-studied in regards to the benefit for individuals with intractable seizures and other neurological conditions. You may also have heard a friend or relative talking about the weight loss effects from a ketogenic diet. It can be very helpful for those looking to switch from carb burning to fat burning. The ketogenic diet can also improve blood sugar regulation in type 2 diabetes.
Intermittent fasting, while not a ketogenic diet, does encourage lower carbohydrate consumption, and has also been shown to improve blood sugar control and risk markers of disease. Additionally, while different dietary approaches, intermittent fasting and the ketogenic diet are sometimes combined based on metabolic need.
The basic premise of intermittent fasting is that the individual will have cycles between periods of fasting and eating. So this “diet” doesn’t necessarily dictate what to eat but rather when to eat. And there are different variations of this depending on the effects your client or patient may be seeking. For example:
- The 16/8 method: this restricts daily eating period to 8 hours, such as 1–9 p.m. Then fasting for 16 hours in between.
- Eat-Stop-Eat: This involves fasting once or twice a week for a full 24 hours.
- The 5:2 diet: This method involves consuming only 500–600 calories on two nonconsecutive days of the week, then your clients would eat normally the other 5 days.
Some changes that occur from fasting:
- Increase in Human Growth Hormone (HGH)
- Improvement in Insulin
- Cellular repair
- Gene expression specifically related to longevity and protection against disease
But, are these safe for your clients?
The science says… they can be.
And I’ll share a research study showing the ketogenic diet can provide adequate nutrition (in a study on older adults with Alzheimer’s).
While more frequently used with adults, there are times where these dietary approaches may be used for children under professional guidance.
Just like any other diet out there, there are pros and cons and a specific profile of people who may find the greatest benefit. And getting support from a qualified nutrition practitioner and health care provider are important, especially for diets that restrict macronutrients as these do.
And similarly, there are ways to do a healthy ketogenic diet and intermittent fasting as well, as ways that are less than healthy in my opinion. All fats are not created equal so slathering on cheese or loading up on poor quality, high fat meats is technically keto (as long as protein is not too high) but not very healthy by my standards. Whereas a diet high in fats like avocado, nuts, seeds, coconut oil/MCT (depending on individual allergies/intolerances) can provide those nutrients in a healthy way.
So what does the research say? Below, I break down 5 different research studies looking at the ketogenic diet (and intermittent fasting) and how they may benefit your clients and patients.
The Ketogenic Diet and MCT Oil for Children with Autism
GFCF vs. Keto Diet in Autism
The Ketogenic Diet Provides Adequate Nutrition (in Alzheimer’s Disease)
A Ketogenic Diet Improved Blood Sugar Regulation in Type 2 Diabetes
People with Type 2 Diabetes May Reverse or Reduce Their Insulin Use with Intermittent Fasting
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: NourishingHope.com.
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.
A Ketogenic Diet Improved Blood Sugar Regulation in Type 2 Diabetes
This study looked at 28 overweight participants with type 2 diabetes for a 16-week diet trial. It is interesting that the research team noted that prior to the use of exogenous insulin for the treatment of diabetes in the 1920’s, the traditional therapy was dietary modification. Diet recommendations during that time were very different than the current recommendations of a low-fat, high-carbohydrate diet and consisted of “meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea.”
This study focuses on a keto diet’s effects on blood sugar and diabetes medication use in patients who prepared (or bought) their own high fat, low carb meals.
The majority of the participants were males and the mean age was 56. The study provided Low Carb Ketogenic Diet (LCKD) counseling, with an initial goal of consuming less than 20 g carbohydrate/day, and diabetes medication dosages were reduced at the start of the diet. Measurements, counseling, and medication were adjusted as needed every other week. Food records were completed and evaluated several times throughout the study.
The results were impressive!
Results included a 6.6% decrease in body weight, 42% decrease in triglycerides, 16% reduction in hemoglobin A1c, 17% decrease in mean fasting glucose, and 10% in reduction in uric acid levels. “The LCKD improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most [17 out of the 21] participants.”
Yancy WS, Foy M, Chalecki AM, Vernon MC, Westman EC. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutrition & metabolism. 2005 Dec;2(1):1-7.
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.
“On eating days, patients are encouraged to eat a diet low in sugar and refined carbohydrates, which decreases blood glucose and insulin secretion.”
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.
As you can see there is science to validate the ketogenic diet and intermittent fasting for some individuals. I will say that I personally see more value in intermittent fasting (for health reasons and compliance) in my adult client population. Those working with children may find a ketogenic diet more appropriate and actionable than intermittent fasting.
What is clear through these studies is how impactful the right diet can be for improvement in health and wellness and even reduction in symptoms and improvement in metabolic markers. A healthy ketogenic diet, when guided by an experienced and knowledgeable practitioner for the right individual can make the world of difference to individuals seeking relief from neurological issues, obesity, diabetes, and increased metabolic health. The ketogenic diet is one of over a dozen diets we study at the BioIndividual Nutrition Institute. If you are a practitioner seeking advanced level training on specialized diets like the ketogenic diet, I encourage you to explore my BioIndividual Nutrition Training.
