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Chen Y, Yang K, Xu M, Zhang Y, Weng X, Luo J, Li Y, Mao YH. Dietary Patterns, Gut Microbiota and Sports Performance in Athletes: A Narrative Review. Nutrients 2024; 16:1634. [PMID: 38892567 PMCID: PMC11175060 DOI: 10.3390/nu16111634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
The intestinal tract of humans harbors a dynamic and complex bacterial community known as the gut microbiota, which plays a crucial role in regulating functions such as metabolism and immunity in the human body. Numerous studies conducted in recent decades have also highlighted the significant potential of the gut microbiota in promoting human health. It is widely recognized that training and nutrition strategies are pivotal factors that allow athletes to achieve optimal performance. Consequently, there has been an increasing focus on whether training and dietary patterns influence sports performance through their impact on the gut microbiota. In this review, we aim to present the concept and primary functions of the gut microbiota, explore the relationship between exercise and the gut microbiota, and specifically examine the popular dietary patterns associated with athletes' sports performance while considering their interaction with the gut microbiota. Finally, we discuss the potential mechanisms by which dietary patterns affect sports performance from a nutritional perspective, aiming to elucidate the intricate interplay among dietary patterns, the gut microbiota, and sports performance. We have found that the precise application of specific dietary patterns (ketogenic diet, plant-based diet, high-protein diet, Mediterranean diet, and high intake of carbohydrate) can improve vascular function and reduce the risk of illness in health promotion, etc., as well as promoting recovery and controlling weight with regard to improving sports performance, etc. In conclusion, although it can be inferred that certain aspects of an athlete's ability may benefit from specific dietary patterns mediated by the gut microbiota to some extent, further high-quality clinical studies are warranted to substantiate these claims and elucidate the underlying mechanisms.
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Affiliation(s)
- Yonglin Chen
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Keer Yang
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Mingxin Xu
- The Fifth College of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510500, China;
| | - Yishuo Zhang
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Xiquan Weng
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Jiaji Luo
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Yanshuo Li
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
| | - Yu-Heng Mao
- School of Exercise and Health, Guangzhou Sport University, Guangzhou 510500, China; (Y.C.); (K.Y.); (Y.Z.); (X.W.); (J.L.); (Y.L.)
- Guangdong Key Laboratory of Human Sports Performance Science, Guangzhou 510500, China
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2
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Smolensky IV, Zajac-Bakri K, Gass P, Inta D. Ketogenic diet for mood disorders from animal models to clinical application. J Neural Transm (Vienna) 2023; 130:1195-1205. [PMID: 36943505 PMCID: PMC10460725 DOI: 10.1007/s00702-023-02620-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
Mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD) are often resistant to current pharmacological treatment. Therefore, various alternative therapeutic approaches including diets are, therefore, under investigation. Ketogenic diet (KD) is effective for treatment-resistant epilepsy and metabolic diseases, however, only a few clinical studies suggest its beneficial effect also for mental disorders. Animal models are a useful tool to uncover the underlying mechanisms of therapeutic effects. Women have a twice-higher prevalence of mood disorders but very little is known about sex differences in nutritional psychiatry. In this review, we aim to summarize current knowledge of the sex-specific effects of KD in mood disorders. Ketone bodies improve mitochondrial functions and suppress oxidative stress, inducing neuroprotective and anti-inflammatory effects which are both beneficial for mental health. Limited data also suggest KD-induced improvement of monoaminergic circuits and hypothalamus-pituitary-adrenal axis-the key pathophysiological pathways of mood disorders. Gut microbiome is an important mediator of the beneficial and detrimental effects of diet on brain functioning and mental health. Gut microbiota composition is affected in mood disorders but its role in the therapeutic effects of different diets, including KD, remains poorly understood. Still little is known about sex differences in the effects of KD on mental health as well as on metabolism and body weight. Some animal studies used both sexes but did not find differences in behavior, body weight loss or gut microbiota composition. More studies, both on a preclinical and clinical level, are needed to better understand sex-specific effects of KD on mental health.
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Affiliation(s)
- Ilya V Smolensky
- Department for Community Health, University of Fribourg, Fribourg, Switzerland.
- Department of Biomedicine, University of Basel, Basel, Switzerland.
| | - Kilian Zajac-Bakri
- Department for Community Health, University of Fribourg, Fribourg, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Peter Gass
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Dragos Inta
- Department for Community Health, University of Fribourg, Fribourg, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
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3
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Gureev AP, Silachev DN, Sadovnikova IS, Krutskikh EP, Chernyshova EV, Volodina DE, Samoylova NA, Potanina DV, Burakova IY, Smirnova YD, Popov VN, Plotnikov EY. The Ketogenic Diet but not Hydroxycitric Acid Keeps Brain Mitochondria Quality Control and mtDNA Integrity Under Focal Stroke. Mol Neurobiol 2023:10.1007/s12035-023-03325-8. [PMID: 37074549 DOI: 10.1007/s12035-023-03325-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/20/2023] [Indexed: 04/20/2023]
Abstract
Mitochondrial dysfunction in the ischemic brain is one of the hallmarks of stroke. Dietary interventions such as the ketogenic diet and hydroxycitric acid supplementation (a caloric restriction mimetic) may potentially protect neurons from mitochondrial damage induced by focal stroke in mice. We showed that in control mice, the ketogenic diet and the hydroxycitric acid did not impact significantly on the mtDNA integrity and expression of genes involved in the maintenance of mitochondrial quality control in the brain, liver, and kidney. The ketogenic diet changed the bacterial composition of the gut microbiome, which via the gut-brain axis may affect the increase in anxiety behavior and reduce mice mobility. The hydroxycitric acid causes mortality and suppresses mitochondrial biogenesis in the liver. Focal stroke modelling caused a significant decrease in the mtDNA copy number in both ipsilateral and contralateral brain cortex and increased the levels of mtDNA damage in the ipsilateral hemisphere. These alterations were accompanied by a decrease in the expression of some of the genes involved in maintaining mitochondrial quality control. The ketogenic diet consumption before stroke protects mtDNA in the ipsilateral cortex, probably via activation of the Nrf2 signaling. The hydroxycitric acid, on the contrary, increased stroke-induced injury. Thus, the ketogenic diet is the most preferred variant of dietetic intervention for stroke protection compared with the hydroxycitric acid supplementation. Our data confirm some reports about hydroxycitric acid toxicity, not only for the liver but also for the brain under stroke condition.
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Affiliation(s)
- Artem P Gureev
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
- Laboratory of Metagenomics and Food Biotechnology, Voronezh State University of Engineering Technology, 394036, Voronezh, Russia
| | - Denis N Silachev
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119234, Moscow, Russia
| | - Irina S Sadovnikova
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
| | - Ekaterina P Krutskikh
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
| | - Ekaterina V Chernyshova
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
| | - Daria E Volodina
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
| | - Natalia A Samoylova
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
| | - Daria V Potanina
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
- Laboratory of Metagenomics and Food Biotechnology, Voronezh State University of Engineering Technology, 394036, Voronezh, Russia
| | - Inna Yu Burakova
- Laboratory of Metagenomics and Food Biotechnology, Voronezh State University of Engineering Technology, 394036, Voronezh, Russia
| | - Yuliya D Smirnova
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
- Laboratory of Metagenomics and Food Biotechnology, Voronezh State University of Engineering Technology, 394036, Voronezh, Russia
| | - Vasily N Popov
- Department of Genetics, Cytology and Bioengineering, Voronezh State University, 394018, Voronezh, Russia
- Laboratory of Metagenomics and Food Biotechnology, Voronezh State University of Engineering Technology, 394036, Voronezh, Russia
| | - Egor Y Plotnikov
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119234, Moscow, Russia.
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4
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Hobbs NJ, Ferkin MH. Effect of diet quality on food consumption and body mass in Microtus pennsylvanicus. J ETHOL 2022. [DOI: 10.1007/s10164-022-00750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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5
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A ketogenic diet affects brain volume and metabolome in juvenile mice. Neuroimage 2021; 244:118542. [PMID: 34530134 DOI: 10.1016/j.neuroimage.2021.118542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/10/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
Ketogenic diet (KD) is a high-fat and low-carbohydrate therapy for medically intractable epilepsy, and its applications in other neurological conditions, including those occurring in children, have been increasingly tested. However, how KD affects childhood neurodevelopment, a highly sensitive and plastic process, is not clear. In this study, we explored structural, metabolic, and functional consequences of a brief treatment of a strict KD (weight ratio of fat to carbohydrate plus protein is approximately 6.3:1) in naive juvenile mice of different inbred strains, using a multidisciplinary approach. Systemic measurements using magnetic resonance imaging revealed that unexpectedly, the volumes of most brain structures in KD-fed mice were about 90% of those in mice of the same strain but fed a standard diet. The reductions in volumes were nonselective, including different regions throughout the brain, the ventricles, and the white matter. The relative volumes of different brain structures were unaltered. Additionally, as KD is a metabolism-based treatment, we performed untargeted metabolomic profiling to explore potential means by which KD affected brain growth and to identify metabolic changes in the brain. We found that brain metabolomic profile was significantly impacted by KD, through both distinct and common pathways in different mouse strains. To explore whether the volumetric and metabolic changes induced by this KD treatment were associated with functional consequences, we recorded spontaneous EEG to measure brain network activity. Results demonstrated limited alterations in EEG patterns in KD-fed animals. In addition, we observed that cortical levels of brain-derived neurotrophic factor (BDNF), a critical molecule in neurodevelopment, did not change in KD-fed animals. Together, these findings indicate that a strict KD could affect volumetric development and metabolic profile of the brain in inbred juvenile mice, while global network activities and BDNF signaling in the brain were mostly preserved. Whether the volumetric and metabolic changes are related to any core functional consequences during neurodevelopment and whether they are also observed in humans need to be further investigated. In addition, our results indicate that certain outcomes of KD are specific to the individual mouse strains tested, suggesting that the physiological profiles of individuals may need to be examined to maximize the clinical benefit of KD.
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6
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Kapoor D, Garg D, Sharma S. Emerging Role of the Ketogenic Dietary Therapies beyond Epilepsy in Child Neurology. Ann Indian Acad Neurol 2021; 24:470-480. [PMID: 34728937 PMCID: PMC8513984 DOI: 10.4103/aian.aian_20_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 01/18/2023] Open
Abstract
Ketogenic dietary therapies (KDTs) have been in use for refractory paediatric epilepsy for a century now. Over time, KDTs themselves have undergone various modifications to improve tolerability and clinical feasibility, including the Modified Atkins diet (MAD), medium chain triglyceride (MCT) diet and the low glycaemic index treatment (LGIT). Animal and observational studies indicate numerous benefits of KDTs in paediatric neurological conditions apart from their evident benefits in childhood intractable epilepsy, including neurodevelopmental disorders such as autism spectrum disorder, rarer neurogenetic conditions such as Rett syndrome, Fragile X syndrome and Kabuki syndrome, neurodegenerative conditions such as Pelizaeus-Merzbacher disease, and other conditions such as stroke and migraine. A large proportion of the evidence is derived from individual case reports, case series and some small clinical trials, emphasising the vast scope for research in this avenue. The term 'neuroketotherapeutics' has been coined recently to encompass the rapid strides in this field. In the 100th year of its use for paediatric epilepsy, this review covers the role of the KDTs in non-epilepsy neurological conditions among children.
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Affiliation(s)
- Dipti Kapoor
- Department of Pediatrics (Neurology Division), Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Divyani Garg
- Department of Neurology, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatrics (Neurology Division), Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
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Olson CA, Iñiguez AJ, Yang GE, Fang P, Pronovost GN, Jameson KG, Rendon TK, Paramo J, Barlow JT, Ismagilov RF, Hsiao EY. Alterations in the gut microbiota contribute to cognitive impairment induced by the ketogenic diet and hypoxia. Cell Host Microbe 2021; 29:1378-1392.e6. [PMID: 34358434 PMCID: PMC8429275 DOI: 10.1016/j.chom.2021.07.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/17/2021] [Accepted: 07/12/2021] [Indexed: 01/16/2023]
Abstract
Many genetic and environmental factors increase susceptibility to cognitive impairment (CI), and the gut microbiome is increasingly implicated. However, the identity of gut microbes associated with CI risk, their effects on CI, and their mechanisms remain unclear. Here, we show that a carbohydrate-restricted (ketogenic) diet potentiates CI induced by intermittent hypoxia in mice and alters the gut microbiota. Depleting the microbiome reduces CI, whereas transplantation of the risk-associated microbiome or monocolonization with Bilophila wadsworthia confers CI in mice fed a standard diet. B. wadsworthia and the risk-associated microbiome disrupt hippocampal synaptic plasticity, neurogenesis, and gene expression. The CI is associated with microbiome-dependent increases in intestinal interferon-gamma (IFNg)-producing Th1 cells. Inhibiting Th1 cell development abrogates the adverse effects of both B. wadsworthia and environmental risk factors on CI. Together, these findings identify select gut bacteria that contribute to environmental risk for CI in mice by promoting inflammation and hippocampal dysfunction.
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Affiliation(s)
- Christine A. Olson
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA,Correspondence to: ,
| | - Alonso J. Iñiguez
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Grace E. Yang
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Ping Fang
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Geoffrey N. Pronovost
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Kelly G. Jameson
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Tomiko K. Rendon
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jorge Paramo
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jacob T. Barlow
- Division of Chemistry & Chemical Engineering, California Institute of Technology, Pasadena, CA 91108, USA
| | - Rustem F. Ismagilov
- Division of Chemistry & Chemical Engineering, California Institute of Technology, Pasadena, CA 91108, USA
| | - Elaine Y. Hsiao
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA,Correspondence to: ,
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8
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Sahagun E, Bachman BB, Kinzig KP. Sex-specific effects of ketogenic diet after pre-exposure to a high-fat, high-sugar diet in rats. Nutr Metab Cardiovasc Dis 2021; 31:961-971. [PMID: 33546948 DOI: 10.1016/j.numecd.2020.09.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS The objectives were to evaluate the relationship between ketogenic diets, the ketone body beta-hydroxybutyrate (BHB), parameters known to increase risk for cardiovascular and metabolic diseases in both sexes, using a pre-clinical model of obesity. METHODS AND RESULTS Rats had access to a diet high in fat and sugar (HFS) for 12 weeks. After HFS, they switched to chow (HFS-CH) or ketogenic diet (HFS-KD) for 3 weeks to model a dietary intervention. Body weight, adiposity, and food intake were measured. Glucose tolerance and corticosterone response to stress were measured after HFS, then again after the intervention. Both sexes increased body weight, food intake, and adiposity compared to control (CTL) while on HFS. HFS females showed impaired glucose tolerance. HFS males developed a dampened corticosterone to stress, whereas HFS females developed an exacerbated response. The effects of HFS on adiposity and corticosterone were reversed in HFS-CH males. These same improvements were observed in HFS-CH females, although they still had impaired glucose tolerance. HFS-KD males showed some improvements, however, they still had higher body weight and adiposity than CTL. The same pattern was observed in females. These beneficial effects of KD correlated with plasma BHB levels in females but not in males. CONCLUSIONS These data model effects reported in clinical literature and serve as a valuable translational tool to further test causal mechanisms that lead to desirable outcomes of KD. These sex-specific relationships are important, as KD could potentially affect endocrine mechanisms differently in males and females.
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Affiliation(s)
- Elizabeth Sahagun
- Purdue University, Department of Psychological Sciences, 703 3rd Street, West Lafayette, IN, 47907, USA.
| | - Brent B Bachman
- Purdue University, Department of Psychological Sciences, 703 3rd Street, West Lafayette, IN, 47907, USA
| | - Kimberly P Kinzig
- Purdue University, Department of Psychological Sciences, 703 3rd Street, West Lafayette, IN, 47907, USA
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9
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Stefan M, Sharp M, Gheith R, Lowery R, Wilson J. The Effect of Exogenous Beta-Hydroxybutyrate Salt Supplementation on Metrics of Safety and Health in Adolescents. Nutrients 2021; 13:854. [PMID: 33807731 PMCID: PMC8000900 DOI: 10.3390/nu13030854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/23/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022] Open
Abstract
The ketogenic diet is a high-fat, very low-carbohydrate, moderate-protein diet that will induce a state of ketosis, but because of its restrictive nature, it may be difficult to adhere to, especially in adolescents. Supplementing with exogenous beta-hydroxybutyrate salts may induce a state of temporary ketosis without any undesirable side effects, thereby promoting the benefits of ketosis and minimizing adherence requirements to a ketogenic diet. To date, beta-hydroxybutyrate supplementation in healthy adolescents has not been explored. Therefore, the purpose of this study was to examine the safety of exogenous beta-hydroxybutyrate salt supplementation in a healthy adolescent population. In the present study, 22 healthy male and female adolescents consumed 3.75 g of beta-hydroxybutyrate salts or maltodextrin placebo twice daily for 90 days. Comprehensive blood safety analysis, bone densitometry, happiness and emotional intelligence surveys, and blood pressure were assessed at Pre, Day 45, and Day 90. There were no significant differences detected in subjects supplementing with beta-hydroxybutyrate salts, indicating that exogenous beta-hydroxybutyrate salts had no detrimental impact on fasting blood safety metrics, bone density, happiness, emotional intelligence, or blood pressure. We conclude that supplementing with exogenous beta-hydroxybutyrate salts is safe and well-tolerated by healthy adolescents.
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Affiliation(s)
- Matthew Stefan
- The Applied Science and Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (J.W.)
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10
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Dashti HM, Mathew TC, Al-Zaid NS. Efficacy of Low-Carbohydrate Ketogenic Diet in the Treatment of Type 2 Diabetes. Med Princ Pract 2020; 30:223-235. [PMID: 33040057 PMCID: PMC8280429 DOI: 10.1159/000512142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
Low-carbohydrate ketogenic diet (LCKD), originally used as a treatment for childhood epilepsy is currently gaining acceptance as a nutritional therapy for obesity and type 2 diabetes. In addition, this diet has a positive effect on body weight, blood glucose level, glycosylated hemoglobin, plasma lipid profile, and neurological disorders. This review focuses on the therapeutic effectiveness, negative effects, and the rationale of using LCKD for the treatment of type 2 diabetes. It is shown that LCKD contributes to the reduction in the intake of insulin and oral antidiabetic drugs in patients with type 2 diabetes. Furthermore, the data presented in this review reveal the efficacy and cost-effectiveness of LCKD in the management of type 2 diabetes.
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Affiliation(s)
- Hussain M Dashti
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
| | - Thazhumpal C Mathew
- Department of MLS, Faculty of Allied Health Science, Kuwait University, Kuwait, Kuwait,
| | - Naji S Al-Zaid
- Departments of Physiology, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
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11
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Abstract
PURPOSE OF REVIEW Ketogenic diets, which have been used to treat drug-refractory paediatric epilepsy for over 100 years, are becoming increasingly popular for the treatment of other neurological conditions, including mental illnesses. We aim to explain how ketogenic diets can improve mental illness biopathology and review the recent clinical literature. RECENT FINDINGS Psychiatric conditions, such as schizophrenia, depression, bipolar disorder and binge eating disorder, are neurometabolic diseases that share several common mechanistic biopathologies. These include glucose hypometabolism, neurotransmitter imbalances, oxidative stress and inflammation. There is strong evidence that ketogenic diets can address these four fundamental diseases, and now complementary clinical evidence that ketogenic diets can improve the patients' symptoms. SUMMARY It is important that researchers and clinicians are made aware of the trajectory of the evidence for the implementation of ketogenic diets in mental illnesses, as such a metabolic intervention provides not only a novel form of symptomatic treatment, but one that may be able to directly address the underlying disease mechanisms and, in so doing, also treat burdensome comorbidities (see Video, Supplementary Digital Content 1, http://links.lww.com/COE/A16, which summarizes the contents of this review).
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Affiliation(s)
- Nicholas G Norwitz
- Department of Physiology, Anatomy and Genetics, Oxford University, Oxford, UK
| | - Shebani Sethi
- Metabolic Psychiatry Clinic, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Christopher M Palmer
- Department of Postgraduate and Continuing Education, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
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12
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Grigolon RB, Gerchman F, Schöffel AC, Hawken ER, Gill H, Vazquez GH, Mansur RB, McIntyre RS, Brietzke E. Mental, emotional, and behavioral effects of ketogenic diet for non-epileptic neuropsychiatric conditions. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109947. [PMID: 32305355 DOI: 10.1016/j.pnpbp.2020.109947] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 01/20/2023]
Abstract
Ketogenic diet (KD) is comprised of a distinct macronutrient combination: i.e. 90% fat, 8% of protein and 2% of carbohydrates, typically characterized as a high-fat low-carbohydrate diet. KD's efficacy was largely established for treatment resistant epilepsy in children, but its mental, emotional and behavioral effects remain largely unknown. Nevertheless, the efficacious effects of KD in childhood epilepsy provide rationale for repurposing this approach for other brain-based disorders. Consequently, clinicians and researchers should be aware of the evidence regarding efficacy, as well as the benefits and risks of adopting this diet. Results from animals and humans studies provide equivocal evidence across multiple domains of psychopathology. Conceptually, KD shows promise to serve as an efficacious treatment for mental disorders.
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Affiliation(s)
- Ruth B Grigolon
- Post-Graduation Program in Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Fernando Gerchman
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Service of Endocrinology and Metabology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Alice C Schöffel
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Emily R Hawken
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Gustavo H Vazquez
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada; Mood Disorders Outpatient Clinic, Providence Care Hospital, Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Elisa Brietzke
- Post-Graduation Program in Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada; Centre for Neuroscience Studies (CNS), Queen's University, Kingston, ON, Canada.
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13
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MRI spectroscopic and tractography studies indicate consequences of long-term ketogenic diet. Brain Struct Funct 2020; 225:2077-2089. [PMID: 32681181 PMCID: PMC7473966 DOI: 10.1007/s00429-020-02111-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/02/2020] [Indexed: 01/04/2023]
Abstract
To maintain its functional abilities, the mature brain obtains energy from glucose produced in carbohydrate metabolism. When carbohydrates are eliminated from the diet, the energy comes from the oxidation of fatty acids. In this metabolic state called ketosis, ketone bodies are formed: β-hydroxybutyric acid (bHb), acetone, and acetoacetate as alternative source of energy passing through the blood–brain barrier easily. The ketosis state can be achieved through various strategies like caloric restriction, supplementation with medium-chain triglycerides, intense physical training, or ketogenic diet (KD). Using KD, drug-resistant epilepsy has been successfully treated in children and adults. It can also exert neuroprotective influences in cases of brain damage, glioblastoma multiforme, and Alzheimer's or Parkinson's diseases. Although many possible mechanisms of KD activity have been proposed, newer hypotheses appear with the research progress, mostly characterizing the brain under pathological but not normal conditions. Since different pathological conditions may affect the mechanism of KD action differently, additional research on the normal brain appears reasonable. For this purpose, young adult rats were treated with 4-month-lasting KD. Then, MRI structural measurements, spectroscopy, and tractography were performed. The procedures revealed significant increases in the concentration of glutamine, glutamate, glutathione and NAA, accompanied by changes in the pattern of neuronal connections of the striatum and hippocampal formation. This implies a possible involvement of these structures in the functional changes occurring in the brain after KD application. Thus, the investigations on the normal brain add important details concerning mechanisms underlying KD effects without their possible modification by a pathological status.
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Ketogenic therapy in neurodegenerative and psychiatric disorders: From mice to men. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109913. [PMID: 32151695 DOI: 10.1016/j.pnpbp.2020.109913] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/11/2020] [Accepted: 03/05/2020] [Indexed: 01/31/2023]
Abstract
Ketogenic diet is a low carbohydrate and high fat diet that has been used for over 100 years in the management of childhood refractory epilepsy. More recently, ketogenic diet has been investigated for a number of metabolic, neurodegenerative and neurodevelopmental disorders. In this comprehensive review, we critically examine the potential therapeutic benefits of ketogenic diet and ketogenic agents on neurodegenerative and psychiatric disorders in humans and translationally valid animal models. The preclinical literature provides strong support for the efficacy of ketogenic diet in a variety of diverse animal models of neuropsychiatric disorders. However, the evidence from clinical studies, while encouraging, particularly in Alzheimer's disease, psychotic and autism spectrum disorders, is limited to case studies and small pilot trials. Firm conclusion on the efficacy of ketogenic diet in psychiatric disorders cannot be drawn due to the lack of randomised, controlled clinical trials. The potential mechanisms of action of ketogenic therapy in these disorders with diverse pathophysiology may include energy metabolism, oxidative stress and immune/inflammatory processes. In conclusion, while ketogenic diet and ketogenic substances hold promise pre-clinically in a variety of neurodegenerative and psychiatric disorders, further studies, particularly randomised controlled clinical trials, are warranted to better understand their clinical efficacy and potential side effects.
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Kraeuter AK, Guest PC, Sarnyai Z. Protocol for the Use of the Ketogenic Diet in Preclinical and Clinical Practice. Methods Mol Biol 2020; 2138:83-98. [PMID: 32219741 DOI: 10.1007/978-1-0716-0471-7_4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Many age-related diseases are associated with metabolic abnormalities, and dietary interventions may have some benefit in alleviating symptoms or in delaying disease onset. Here, we review the commonly used best practices involved in applications of the ketogenic diet to facilitate its translation into clinical use. The findings reveal that better education of physicians is essential for applying the optimum diet and monitoring its effects in clinical practice. In addition, investigators should carefully consider potential confounding factors prior to commencing studies involving a ketogenic diet. Most importantly, current studies should improve their reporting on ketone levels as well as on the intake of both macro- and micronutrients. Finally, more detailed studies on the mechanism of action are necessary to help identify potential biomarkers for response prediction and monitoring, and to uncover new drug targets to aid the development of novel treatments.
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Affiliation(s)
- Ann-Katrin Kraeuter
- Laboratory of Psychiatric Neuroscience, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
- Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Zoltán Sarnyai
- Laboratory of Psychiatric Neuroscience, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.
- Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
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Sahagun E, Ward LM, Kinzig KP. Attenuation of stress-induced weight loss with a ketogenic diet. Physiol Behav 2019; 212:112654. [DOI: 10.1016/j.physbeh.2019.112654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/29/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022]
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Kraeuter AK, Guest PC, Sarnyai Z. The Therapeutic Potential of Ketogenic Diet Throughout Life: Focus on Metabolic, Neurodevelopmental and Neurodegenerative Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1178:77-101. [PMID: 31493223 DOI: 10.1007/978-3-030-25650-0_5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This chapter reviews the efficacy of the ketogenic diet in a variety of neurodegenerative, neurodevelopmental and metabolic conditions throughout different stages of life. It describes conditions affecting children, metabolic disorders in adults and disorderrs affecting the elderly. We have focused on application of the ketogenic diet in clinical studies and in preclinical models and discuss the benefits and negative aspects of the diet. Finally, we highlight the need for further research in this area with a view of discovering novel mechanistic targets of the ketogenic diet, as a means of maximising the potential benefits/risks ratio.
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Affiliation(s)
- Ann-Katrin Kraeuter
- Laboratory of Psychiatric Neuroscience, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.,Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Zoltan Sarnyai
- Laboratory of Psychiatric Neuroscience, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia. .,Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
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Zilberter T, Zilberter Y. Ketogenic Ratio Determines Metabolic Effects of Macronutrients and Prevents Interpretive Bias. Front Nutr 2018; 5:75. [PMID: 30214902 PMCID: PMC6125377 DOI: 10.3389/fnut.2018.00075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/07/2018] [Indexed: 12/30/2022] Open
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Duric NS, Assmus J, Gundersen D, Duric Golos A, Elgen IB. Multimodal treatment in children and adolescents with attention-deficit/hyperactivity disorder: a 6-month follow-up. Nord J Psychiatry 2017; 71:386-394. [PMID: 28345387 DOI: 10.1080/08039488.2017.1305446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Different treatment approaches aimed at reducing attention-deficit/hyperactivity disorder (ADHD) core symptoms are available. However, factors such as intolerance, side-effects, lack of efficacy, high new technology costs, and placebo effect have spurred on an increasing interest in alternative or complementary treatment. AIM The aim of this study is to explore efficacy of multimodal treatment consisting of standard stimulant medication (methylphenidate) and neurofeedback (NF) in combination, and to compare it with the single treatment in 6-month follow-up in ADHD children and adolescents. METHODS This randomized controlled trial with 6-month follow-up comprised three treatment arms: multimodal treatment (NF + MED), MED alone, and NF alone. A total of 130 ADHD children/adolescents participated, and 62% completed the study. ADHD core symptoms were recorded pre-/post-treatment, using parents' and teachers' forms taken from Barkley's Defiant Children: A Clinician's Manual for Assessment and Parent Training, and a self-report questionnaire. RESULTS Significant ADHD core symptom improvements were reported 6 months after treatment completion by parents, teachers, and participants in all three groups, with marked improvement in inattention in all groups. However, no significant improvements in hyperactivity or academic performance were reported by teachers or self-reported by children/adolescents, respectively, in the three groups. Changes obtained with multimodal treatment at 6-month follow-up were comparable to those with single medication treatment, as reported by all participants. CONCLUSIONS Multimodal treatment using combined stimulant medication and NF showed 6-month efficacy in ADHD treatment. More research is needed to explore whether multimodal treatment is suitable for ADHD children and adolescents who showed a poor response to single medication treatment, and for those who want to reduce the use of stimulant medication.
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Affiliation(s)
- Nezla S Duric
- a Department of Child and Adolescent Psychiatry , Helse Fonna , Haugesund , Norway
| | - Jørg Assmus
- b Centre for Clinical Research, Helse Bergen , Norway
| | - Doris Gundersen
- c Department of Research and Innovation , Helse Fonna HF , Haugesund , Norway
| | - Alisa Duric Golos
- d Department of Clinical Medicine , University of Sarajevo , Bosnia & Herzegovina
| | - Irene B Elgen
- e Department of Child and Adolescent Psychiatry , Haukeland University Hospital , Bergen , Norway.,f Department of Clinical Medicine , University of Bergen , Norway
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Jiang Y, Lu Y, Jia M, Wang X, Zhang Z, Hou Q, Wang B. Ketogenic diet attenuates spatial and item memory impairment in pentylenetetrazol-kindled rats. Brain Res 2016; 1646:451-458. [DOI: 10.1016/j.brainres.2016.06.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 06/01/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
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Scichilone JM, Yarraguntla K, Charalambides A, Harney JP, Butler D. Environmental Enrichment Mitigates Detrimental Cognitive Effects of Ketogenic Diet in Weanling Rats. J Mol Neurosci 2016; 60:1-9. [DOI: 10.1007/s12031-016-0753-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/08/2016] [Indexed: 01/30/2023]
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Packer RMA, Law TH, Davies E, Zanghi B, Pan Y, Volk HA. Effects of a ketogenic diet on ADHD-like behavior in dogs with idiopathic epilepsy. Epilepsy Behav 2016; 55:62-8. [PMID: 26773515 DOI: 10.1016/j.yebeh.2015.11.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/09/2015] [Accepted: 11/14/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Epilepsy in humans and rodent models of epilepsy can be associated with behavioral comorbidities including an increased prevalence of attention-deficit/hyperactivity disorder (ADHD). Attention-deficit/hyperactivity disorder symptoms and seizure frequency have been successfully reduced in humans and rodents using a ketogenic diet (KD). The aims of this study were (i) to describe the behavioral profile of dogs with idiopathic epilepsy (IE) while on a standardized nonketogenic placebo diet, to determine whether ADHD-like behaviors are present, and (ii) to examine the effect of a ketogenic medium chain triglyceride diet (MCTD) on the behavioral profile of dogs with idiopathic epilepsy (IE) compared with the standardized placebo control diet, including ADHD-like behaviors. METHODS A 6-month prospective, randomized, double-blinded, placebo-controlled, crossover dietary trial comparing the effects of the MCTD with a standardized placebo diet on canine behavior was carried out. Dogs diagnosed with IE, with a seizure frequency of at least 3 seizures in the past 3months (n=21), were fed the MCTD or placebo diet for 3months and were then switched to the alternative diet for 3months. Owners completed a validated behavioral questionnaire to measure 11 defined behavioral factors at the end of each diet period to report their dogs' behavior, with three specific behaviors hypothesized to be related to ADHD: excitability, chasing, and trainability. RESULTS The highest scoring behavioral factors in the placebo and MCTD periods were excitability (mean±SE: 1.910±0.127) and chasing (mean±SE: 1.824±0.210). A markedly lower trainability score (mean±SE: 0.437±0.125) than that of previously studied canine populations was observed. The MCTD resulted in a significant improvement in the ADHD-related behavioral factor chasing and a reduction in stranger-directed fear (p<0.05) compared with the placebo diet. The latter effect may be attributed to previously described anxiolytic effects of a KD. CONCLUSIONS These data support the supposition that dogs with IE may exhibit behaviors that resemble ADHD symptoms seen in humans and rodent models of epilepsy and that a MCTD may be able to improve some of these behaviors, along with potentially anxiolytic effects.
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Affiliation(s)
- Rowena M A Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.
| | - Tsz Hong Law
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK; Biomolecular Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Emma Davies
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Brian Zanghi
- Nestle Purina Research, One Checkerboard Square, 2RS, St Louis, MO 63164, USA
| | - Yuanlong Pan
- Nestle Purina Research, One Checkerboard Square, 2RS, St Louis, MO 63164, USA
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Woo HD, Kim DW, Hong YS, Kim YM, Seo JH, Choe BM, Park JH, Kang JW, Yoo JH, Chueh HW, Lee JH, Kwak MJ, Kim J. Dietary patterns in children with attention deficit/hyperactivity disorder (ADHD). Nutrients 2014; 6:1539-53. [PMID: 24736898 PMCID: PMC4011050 DOI: 10.3390/nu6041539] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022] Open
Abstract
The role of diet in the behavior of children has been controversial, but the association of several nutritional factors with childhood behavioral disorders has been continually suggested. We conducted a case-control study to identify dietary patterns associated with attention deficit hyperactivity disorder (ADHD). The study included 192 elementary school students aged seven to 12 years. Three non-consecutive 24-h recall (HR) interviews were employed to assess dietary intake, and 32 predefined food groups were considered in a principal components analysis (PCA). PCA identified four major dietary patterns: the "traditional" pattern, the "seaweed-egg" pattern, the "traditional-healthy" pattern, and the "snack" pattern. The traditional-healthy pattern is characterized by a diet low in fat and high in carbohydrates as well as high intakes of fatty acids and minerals. The multivariate-adjusted odds ratio (OR) of ADHD for the highest tertile of the traditional-healthy pattern in comparison with the lowest tertile was 0.31 (95% CI: 0.12-0.79). The score of the snack pattern was positively associated with the risk of ADHD, but a significant association was observed only in the second tertile. A significant association between ADHD and the dietary pattern score was not found for the other two dietary patterns. In conclusion, the traditional-healthy dietary pattern was associated with lower odds having ADHD.
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Affiliation(s)
- Hae Dong Woo
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
| | - Dong Woo Kim
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
| | - Young-Seoub Hong
- Department of Preventive Medicine, College of Medicine, Dong-A University, Dong-A University Hospital, 26, Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Dong-A University, Dong-A University Hospital, 26, Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Ju-Hee Seo
- Heavy Metal Exposure Environmental Health Center, Dong-A University, 32, Daesingongwon-ro, Seo-gu, Busan 602-714, Korea.
| | - Byeong Moo Choe
- Department of Psychiatry, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Jae Hong Park
- Department of Psychiatry, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Je-Wook Kang
- Department of Child and Adolescent Psychiatry, College of Medicine, Inje University Busan Paik Hospital, 75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea.
| | - Jae-Ho Yoo
- Department of Pediatrics, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Hee Won Chueh
- Department of Pediatrics, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea.
| | - Jung Hyun Lee
- Department of Pediatrics, Kosin University Gospel Hospital, 262, Gamcheon-ro, Seo-gu, Busan 602-702, Korea.
| | - Min Jung Kwak
- Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan 602-739, Korea.
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
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Murphy P. Use of the ketogenic diet as a treatment for epilepsy refractory to drug treatment. Expert Rev Neurother 2014; 5:769-75. [PMID: 16274334 DOI: 10.1586/14737175.5.6.769] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ketogenic diet is a high-fat, low-carbohydrate and low-protein diet used in the treatment of epilepsy that does not respond to antiepileptic drugs. The diet has been found to be very effective in treating intractable epilepsy in children. There is also some evidence that the diet is useful in treating drug-resistant epilepsy in infants, adolescents and adults. This paper traces the history and development of the ketogenic diet and reviews the clinical and animal research investigating its effects.
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Affiliation(s)
- Patricia Murphy
- University of Toronto, Department of Pharmacology, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
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25
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Ruskin DN, Masino SA. The nervous system and metabolic dysregulation: emerging evidence converges on ketogenic diet therapy. Front Neurosci 2012; 6:33. [PMID: 22470316 PMCID: PMC3312079 DOI: 10.3389/fnins.2012.00033] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 02/23/2012] [Indexed: 12/21/2022] Open
Abstract
A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system.
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Affiliation(s)
- David N Ruskin
- Neuroscience Program, Department of Psychology, Trinity College Hartford, CT, USA
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Srivastava S, Kashiwaya Y, King MT, Baxa U, Tam J, Niu G, Chen X, Clarke K, Veech RL. Mitochondrial biogenesis and increased uncoupling protein 1 in brown adipose tissue of mice fed a ketone ester diet. FASEB J 2012; 26:2351-62. [PMID: 22362892 DOI: 10.1096/fj.11-200410] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We measured the effects of a diet in which D-β-hydroxybutyrate-(R)-1,3 butanediol monoester [ketone ester (KE)] replaced equicaloric amounts of carbohydrate on 8-wk-old male C57BL/6J mice. Diets contained equal amounts of fat, protein, and micronutrients. The KE group was fed ad libitum, whereas the control (Ctrl) mice were pair-fed to the KE group. Blood d-β-hydroxybutyrate levels in the KE group were 3-5 times those reported with high-fat ketogenic diets. Voluntary food intake was reduced dose dependently with the KE diet. Feeding the KE diet for up to 1 mo increased the number of mitochondria and doubled the electron transport chain proteins, uncoupling protein 1, and mitochondrial biogenesis-regulating proteins in the interscapular brown adipose tissue (IBAT). [(18)F]-Fluorodeoxyglucose uptake in IBAT of the KE group was twice that in IBAT of the Ctrl group. Plasma leptin levels of the KE group were more than 2-fold those of the Ctrl group and were associated with increased sympathetic nervous system activity to IBAT. The KE group exhibited 14% greater resting energy expenditure, but the total energy expenditure measured over a 24-h period or body weights was not different. The quantitative insulin-sensitivity check index was 73% higher in the KE group. These results identify KE as a potential antiobesity supplement.
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Affiliation(s)
- Shireesh Srivastava
- Laboratory of Metabolic Control, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, USA
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Thio LL, Rensing N, Maloney S, Wozniak DF, Xiong C, Yamada KA. A ketogenic diet does not impair rat behavior or long-term potentiation. Epilepsia 2010; 51:1619-23. [PMID: 20132289 DOI: 10.1111/j.1528-1167.2009.02515.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The effect of the ketogenic diet on behavior and cognition is unclear. We addressed this issue in rats behaviorally and electrophysiologically.We fed postnatal day 21 rats a standard diet (SD), ketogenic diet (KD), or calorie-restricted diet (CR) for 2–3 weeks. CR controlled for the slower weight gain experienced by KD-fed rats. We assessed behavioral performance with a locomotor activity and a conditioned fear test. To evaluate possible parallel effects of diet on synaptic function, we examined paired-pulse modulation (PPM) and long-term potentiation (LTP) in the medial perforant path in vivo. KD-fed rats performed similarly to SD-fed rats on the behavioral tests and electrophysiologic assays. These data suggest that the KD does not alter behavioral performance or synaptic plasticity.
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Affiliation(s)
- Liu Lin Thio
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Slotkin TA. Does early-life exposure to organophosphate insecticides lead to prediabetes and obesity? Reprod Toxicol 2010; 31:297-301. [PMID: 20850519 DOI: 10.1016/j.reprotox.2010.07.012] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 07/30/2010] [Indexed: 12/18/2022]
Abstract
Human exposures to organophosphate insecticides are ubiquitous. Although regarded as neurotoxicants, increasing evidence points toward lasting metabolic disruption from early-life organophosphate exposures. We gave neonatal rats chlorpyrifos, diazinon or parathion in doses devoid of any acute signs of toxicity, straddling the threshold for barely-detectable cholinesterase inhibition. Organophosphate exposure during a critical developmental window altered the trajectory of hepatic adenylyl cyclase/cyclic AMP signaling, culminating in hyperresponsiveness to gluconeogenic stimuli. Consequently, the animals developed metabolic dysfunction resembling prediabetes. When the organophosphate-exposed animals consumed a high fat diet in adulthood, metabolic defects were exacerbated and animals gained excess weight compared to unexposed rats on the same diet. At the same time, the high fat diet ameliorated many of the central synaptic defects caused by organophosphate exposure, pointing to nonpharmacologic therapeutic interventions to offset neurodevelopmental abnormalities, as well as toward fostering dietary choices favoring high fat intake. These studies show how common insecticides may contribute to the increased worldwide incidence of obesity and diabetes.
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Affiliation(s)
- Theodore A Slotkin
- Department of Pharmacology and Cancer Biology, DUMC, Duke University Medical Center, Durham, NC 27710, USA.
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Balietti M, Casoli T, Di Stefano G, Giorgetti B, Aicardi G, Fattoretti P. Ketogenic diets: an historical antiepileptic therapy with promising potentialities for the aging brain. Ageing Res Rev 2010; 9:273-9. [PMID: 20188215 DOI: 10.1016/j.arr.2010.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 02/16/2010] [Accepted: 02/17/2010] [Indexed: 10/19/2022]
Abstract
Ketogenic diets (KDs), successfully used in the therapy of paediatric epilepsy for nearly a century, have recently shown beneficial effects also in cancer, obesity, diabetes, GLUT 1 deficiencies, hypoxia-ischemia, traumatic brain injuries, and neurodegeneration. The latter achievement designates aged individuals as optimal recipients, but concerns derive from possible age-dependent differences in KDs effectiveness. Indeed, the main factors influencing ketone bodies utilization by the brain (blood levels, transport mechanisms, catabolic enzymes) undergo developmental changes, although several reports indicate that KDs maintain some efficacy during adulthood and even during advanced aging. Encouraging results obtained in patients affected by age-related neurodegenerative diseases have prompted new interest on KDs' effect on the aging brain, also considering the poor efficacy of therapies currently used. However, recent morphological evidence in synapses of late-adult rats indicates that KDs consequences may be even opposite in different brain regions, likely depending on neuronal vulnerability to age. Thus, further studies are needed to design KDs specifically indicated for single neurodegenerative diseases, and to ameliorate the balance between beneficial and adverse effects in aged subjects. Here we review clinical and experimental data on KDs treatments, focusing on their possible use during pathological aging. Proposed mechanisms of action are also reported and discussed.
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Slotkin TA, Lassiter TL, Ryde IT, Wrench N, Levin ED, Seidler FJ. Consumption of a high-fat diet in adulthood ameliorates the effects of neonatal parathion exposure on acetylcholine systems in rat brain regions. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:916-22. [PMID: 19590683 PMCID: PMC2702406 DOI: 10.1289/ehp.0800459] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 02/03/2009] [Indexed: 05/08/2023]
Abstract
BACKGROUND Developmental exposure to a wide variety of developmental neurotoxicants, including organophosphate pesticides, evokes late-emerging and persistent abnormalities in acetylcholine (ACh) systems. We are seeking interventions that can ameliorate or reverse the effects later in life. OBJECTIVES We administered parathion to neonatal rats and then evaluated whether a high-fat diet begun in adulthood could reverse the effects on ACh systems. METHODS Neonatal rats received parathion on postnatal days 1-4 at 0.1 or 0.2 mg/kg/day, straddling the cholinesterase inhibition threshold. In adulthood, half the animals were switched to a high-fat diet for 8 weeks. We assessed three indices of ACh synaptic function: nicotinic ACh receptor binding, choline acetyltransferase activity, and hemicholinium-3 binding. Determinations were performed in brain regions comprising all the major ACh projections and cell bodies. RESULTS Neonatal parathion exposure evoked widespread abnormalities in ACh synaptic markers, encompassing effects in brain regions possessing ACh projections and ACh cell bodies. In general, males were affected more than females. Of 17 regional ACh marker abnormalities (10 male, 7 female), 15 were reversed by the high-fat diet. CONCLUSIONS A high-fat diet reverses neurodevelopmental effects of neonatal parathion exposure on ACh systems. This points to the potential for nonpharmacologic interventions to offset the effects of developmental neurotoxicants. Further, cryptic neurodevelopmental deficits evoked by environmental exposures may thus engender a later preference for a high-fat diet to maintain normal ACh function, ultimately contributing to obesity.
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Affiliation(s)
- Theodore A Slotkin
- Department of Pharmacology & Cancer Biology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Caton SJ, Yinglong B, Burget L, Spangler LJ, Tschöp MH, Bidlingmaier M. Low-carbohydrate high-fat diets: regulation of energy balance and body weight regain in rats. Obesity (Silver Spring) 2009; 17:283-9. [PMID: 19039316 DOI: 10.1038/oby.2008.529] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim of the current investigations was to examine the effects of a low-carbohydrate high-fat diet (LC-HFD) on body weight, body composition, growth hormone (GH), IGF-I, and body weight regain after stopping the dietary intervention and returning the diet back to standard laboratory chow (CH). In study one, both adolescent and mature male Wistar rats were maintained on either an isocaloric LC-HFD or CH for 16 days before having their diet switched. In study two, mature rats were maintained on either LC-HFD or CH for 16 days to determine the effects of the LC-HFD on fat pad weight. LC-HFD leads to body weight loss in mature rats (P < 0.01) and lack of body weight gain in adolescent rats (P < 0.01). Despite less body weight, increased body fat was observed in rats maintained on LC-HFD (P < 0.05). Leptin concentrations were higher (P < 0.05), and IGF-I (P < 0.01) concentrations were reduced in the LC-HFD rats. When the diet was returned to CH following LC-HFD, body weight regain was above and beyond that which was lost (P < 0.01). The LC-HFD resulted in increased body fat and had a negative effect upon both GH and IGF-I concentrations, which might have implications for the accretion and maintenance of lean body mass (LBM), normal growth rate and overall metabolic health. Moreover, when the LC-HFD ceases and a high-carbohydrate diet follows, more body weight is regained as compared to when the LC-HFD is consumed, in the absence of increased energy intake.
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Affiliation(s)
- Samantha J Caton
- Neuroendocrine Unit, Medizinische Klinik Innenstadt, Ludwig Maximilians University, Munich, Germany
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Stewart LS, Nylen KJ, Persinger MA, Cortez MA, Gibson KM, Snead OC. Circadian distribution of generalized tonic-clonic seizures associated with murine succinic semialdehyde dehydrogenase deficiency, a disorder of GABA metabolism. Epilepsy Behav 2008; 13:290-4. [PMID: 18514581 PMCID: PMC2574901 DOI: 10.1016/j.yebeh.2008.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 04/17/2008] [Accepted: 04/18/2008] [Indexed: 11/29/2022]
Abstract
Human succinic semialdehyde dehydrogenase (SSADH) deficiency is an autosomal recessive disorder of GABA metabolism associated with motor impairment and epileptic seizures. Similarly, mice with targeted deletion of the Aldh5a1 gene (Aldh5a1(-/-)) exhibit SSADH deficiency and seizures early in life. These seizures begin as absence seizures the second week of life, but evolve into generalized convulsive seizures that increase in severity and become lethal during the fourth postnatal week. The seizures are alleviated and survival is prolonged when the mutant animals are weaned onto a ketogenic diet (KD). The persistence of spontaneous, recurrent, generalized tonic-clonic seizures in KD-treated adult Aldh5a1(-/-) mice allowed us to quantify their daily (circadian) distribution using a novel behavioral method based on the detection of changes in movement velocity. Adult KD-treated Aldh5a1(-/-) mice exhibited a seizure phenotype characterized by fits of wild running clonus accompanied by jumping and bouncing. These hypermotor seizures were largely spontaneous and occurred daily in a nonrandom pattern. The seizure rhythm showed a peak shortly after dark phase onset (2008 hours) with near-24-hour periodicity. Age-matched wild-type littermates showed no evidence of abnormal motor behavior. These new data suggest that generalized tonic-clonic seizures in Aldh5a1(-/-) mice are more frequent during a specific time of day and will provide useful information to clinicians for the treatment of seizures associated with human SSADH deficiency.
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Affiliation(s)
- Lee S. Stewart
- Neurosciences and Mental Health Research Program, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8
| | - Kirk J. Nylen
- Neurosciences and Mental Health Research Program, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8
| | - Michael A. Persinger
- Behavioral Neuroscience Program, Department of Psychology, Laurentian University, Sudbury ON, Canada P3E 2C6
| | - Miguel A. Cortez
- Neurosciences and Mental Health Research Program, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8, Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8, Department of Pediatrics, Faculty of Medicine, University of Toronto, 190 Elizabeth Street, Toronto ON, Canada M5G 2C4
| | - K. Michael Gibson
- Division of Medical Genetics, Departments of Pediatrics and Pathology, University of Pittsburgh School of Medicine, Rangos Research Center, 3460 Fifth Avenue, Pittsburgh PA 15213, USA
| | - O. Carter Snead
- Neurosciences and Mental Health Research Program, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8, Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8, Department of Pediatrics, Faculty of Medicine, University of Toronto, 190 Elizabeth Street, Toronto ON, Canada M5G 2C4, Corresponding author. Address: Neurosciences and Mental Health Research Program, The Hospital for Sick Children, 555 University Avenue, Toronto ON, Canada M5G 1X8. Fax: +1 416 813 6334. E-mail address: (O.C. Snead, III)
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Murphy P, Burnham WM. The ketogenic diet causes a reversible decrease in activity level in Long-Evans rats. Exp Neurol 2006; 201:84-9. [PMID: 16750194 DOI: 10.1016/j.expneurol.2006.03.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Revised: 02/13/2006] [Accepted: 03/18/2006] [Indexed: 10/24/2022]
Abstract
Individuals with epilepsy also often exhibit symptoms of attention deficit hyperactivity disorder (ADHD). The ketogenic diet, which is a high fat, low protein, and low carbohydrate diet used in the treatment of intractable epilepsy, also appears to improve symptoms of ADHD in individuals with both disorders. Previous research suggests that the diet decreases the activity level of rats. The purpose of the present research was to further investigate the effects of the ketogenic diet on activity level, using an animal model. Two experiments were conducted. The first experiment examined the time frame and reversibility of the effect of the diet on activity level. The second experiment examined the relationship between activity level and anxiety level. In both experiments, adult male Long-Evans rats were placed on either a ketogenic diet or a control diet. The results of the first experiment show that the ketogenic diet can cause a decrease in activity level within 24 h and that the results are reversible. The results of Experiment 2 show that the decrease in activity level is not linked to a change in anxiety level. The ketogenic diet may be of use in the treatment of ADHD.
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Affiliation(s)
- Patricia Murphy
- Department of Pharmacology, University of Toronto, Medical Sciences Building, 1 King's College Circle, rm 4309, Toronto, Ontario, Canada M5S 1A8.
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Rhodes ME, Talluri J, Harney JP, Frye CA. Ketogenic diet decreases circulating concentrations of neuroactive steroids of female rats. Epilepsy Behav 2005; 7:231-9. [PMID: 16054440 PMCID: PMC3637968 DOI: 10.1016/j.yebeh.2005.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Revised: 05/25/2005] [Accepted: 05/27/2005] [Indexed: 11/29/2022]
Abstract
Ketogenic diet (KD) is used to manage intractable epilepsy; however, the mechanisms underlying its therapeutic effects are not known. Steroid hormones, such as progesterone and testosterone, are derived from cholesterol, and are readily 5alpha-reduced to dihydroprogesterone and dihydrotestosterone, which are subsequently converted to 5alpha-pregnan-3alpha-ol-20-one (3alpha,5alpha-THP) and 3alpha-androstanediol, neuroactive steroids that can influence seizures. The present study examined the effects of the KD on circulating concentrations of these neuroactive steroids, and their precursors, in intact female rats. Thirty-six, 22-day-old female Sprague-Dawley rats (weaned at 21 days) were fasted for 8 hours prior to placement on one of three dietary regimens for 6 weeks: ad libitum chow, calorie-restricted chow, or KD. After 6 weeks of the diet, when six rats in each dietary condition were in diestrus and six were in behavioral estrus, all rats were administered pentylenetetrazole (PTZ, 70 mg/kg, i.p.). The latency and incidence of seizures were recorded by an observer who was uninformed of the estrous cycle and dietary treatment conditions of the rats. Immediately after each test, trunk blood was obtained for later measurement of pregnane (progesterone, dihydroprogesterone, 3alpha,5alpha-THP) and androstane (testosterone, dihydrotestosterone, 3alpha-androstanediol) neuroactive steroid concentrations in plasma by radioimmunoassay. KD tended to lengthen the latency to, and significantly reduced the number of, PTZ-induced barrel roll seizures. KD also significantly reduced plasma levels of the pregnane (dihydroprogesterone, 3alpha,5alpha-THP) and androstane (dihydrotestosterone, 3alpha-androstanediol) 5alpha-reduced metabolites. These data suggest that levels of pregnane and androstane neuroactive steroids, or their precursors, may underlie some of the antiseizure effects of KD.
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Affiliation(s)
- Madeline E. Rhodes
- Department of Biology, University of Hartford, West Hartford, CT 06117, USA
- Department of Psychology, The University at Albany–Suny, Albany, NY 12222, USA
| | - Jayanth Talluri
- Department of Biology, University of Hartford, West Hartford, CT 06117, USA
| | - Jacob P. Harney
- Department of Biology, University of Hartford, West Hartford, CT 06117, USA
| | - Cheryl A. Frye
- Department of Psychology, The University at Albany–Suny, Albany, NY 12222, USA
- Corresponding author. Fax: +1 518 442 4867. (C.A. Frye)
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Murphy P, Likhodii S, Nylen K, Burnham WM. The antidepressant properties of the ketogenic diet. Biol Psychiatry 2004; 56:981-3. [PMID: 15601609 DOI: 10.1016/j.biopsych.2004.09.019] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Revised: 06/30/2004] [Accepted: 09/24/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND The ketogenic diet is used to treat epilepsy refractory to anticonvulsant medication. Individuals with epilepsy often have behavioral problems and deficits in attention and cognitive functioning. The ketogenic diet has been found to effect improvements in these domains. It has also been suggested that the ketogenic diet may act as a mood stabilizer. METHODS The present research used the Porsolt test, an animal model of depression, to determine whether the ketogenic diet has antidepressant properties. Porsolt test scores of rats on the ketogenic diet were compared with those of rats on a control diet. RESULTS The rats on the ketogenic diet spent less time immobile, suggesting that rats on the ketogenic diet, like rats treated with antidepressants, are less likely to exhibit "behavioral despair." CONCLUSIONS It is concluded that the ketogenic diet may have antidepressant properties.
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Affiliation(s)
- Patricia Murphy
- Department of Pharmacology, The University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, Canada M5S 1A8.
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