Ketogenic diets for cancer, autism, dementia, and migraine?

Dietary Therapy
Wednesday, April 4, 2018

More than 10 years ago, I wrote in Keto News about some recent articles on using ketogenic diets for conditions other than epilepsy. At that time, this was a relatively new idea, with limited studies going back only to 2003 examining this idea. There had been three papers published on dietary therapy for autism, brain tumors, and Alzheimer’s disease that were new, exciting information to share.

In 2018, a decade later, this concept of using diets beyond epilepsy continues to grow very quickly.

Conferences

There have been two large ketogenic diet conferences in which the titles and subtitles of these meetings reflected how important this topic is:

5th Global Symposium on Ketogenic Therapies
 
  • 2nd Annual Conference on Nutritional Ketosis & Metabolic Therapeutics, February 1-4, 2016, Tampa, Florida. Red box in image: “...for the treatment and prevention of cancer, neurological diseases, and metabolic disorders, as well as for optimizing wellness and human performance.”
2nd Annual Conference on Nutritional Ketosis & Metabolic Therapeutics
 

Clinical Trials

Probably the hottest topics today are the use of dietary therapy for cancer, dementia, and headaches. Several ongoing clinical trials are listed online at clinicaltrials.gov for patients and their families to enroll in, including cancer (22 trials) and dementia (6 trials). At Johns Hopkins, we have two studies like this currently enrolling patients:

Support from Dietitians

Outside of enrolling in clinical trials, people can find support from dietitians, including several who are listed by The Charlie Foundation on their website.

Research

Three recent studies published in February have added to this body of literature:

  • Efficacy of modified Atkins ketogenic diet in chronic cluster headache: An open-label, single-arm, clinical trial. Di Lorenzo et al. 2018.
    From the well-published team from Milan and Rome, Italy, a group who are very interested in diet and headache, this article reports on using the modified Atkins diet for 12 weeks for 18 people with chronic cluster headaches. Fifteen of 18 adults treated either had full resolution of headaches or at least a 50% reduction. These results are impressive and worth more study at other centers.
  • A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Lee, et al 2018.
    Dr. Ryan Lee, his dietitian Miki Wong, and the team from Shriners Hospitals for Children in Honolulu report on their clinical trial for autism. These results were first presented as a poster at the Banff ketogenic diet meeting in 2016. Fifteen children with autism were given this unique diet for 3 months; there was no control group. Of note, these 15 were out of an initial group of 27 because 12 were not able to stick to the diet. However, the 15 children who did stay on this diet did well. Core autism features improved significantly in 6 and moderately in 2. Interestingly, there was an association between autism improvement and HDL and albumin levels, which deserves future research to find out why.
  • Investigating the Ketogenic diet as treatment for primary aggressive brain cancer: Challenges and lessons learned. Schwartz et al. 2018.
    Lastly, this article from the team in Lansing, Michigan, discusses their early results from 10 people started on a 3:1 ketogenic diet for a 6-week-trial period. They do not discuss outcomes, but highlight some of the various difficulties in doing a trial such as this, including
    1. The need for having a caregiver make the foods for a patient having medical problems
    2. Issues with acute hospitalizations leading to the diet being stopped by a hospital not familiar with it
    3. Hardships found with restricting calories, eating socially, and food palatability in this particular group of people.

References

  • Schwartz KA, Noel M, Nikolai M, et al. Investigating the Ketogenic diet as treatment for primary aggressive brain cancer: Challenges and lessons learned. Front Nutr. 2018;5:11.
  • Lee RWY, Corley MJ, Pang A, et al. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiol Behav. 2018;188:205-211.
  • Di Lorenzo C, Coppola G, Di Lenola D, et al. Efficacy of modified Atkins ketogenic diet in chronic cluster headache: An open-label, single-arm, clinical trial. Front Neurol. 2018;9:64.
  • Evangeliou A, Vlachonikolis I, Mihailidou H, et al. Application of a ketogenic diet in children with autistic behavior: Pilot study. J Child Neurol 2003;18:113-118.
  • Henderson ST. Ketone bodies as a therapeutic for Alzheimer’s Disease. Neurotherapeutics 2008;5:470-480.
  • Nebeling LC, Miraldi F, Shurin SB, Lerner E. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: Two case reports. J Am Coll Nutr 1995;14:202-208.

Learn More

Authored by: Eric Kossoff MD | Ketogenic Diet Editor on 4/2018

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