Role of ketogenic diet in autism

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Ketogenic diet is reputed to be “neuro-protective” against brain dysfunction and is popular for use against epilepsy. At the same time, it is being touted for a variety of nervous system disorders like brain trauma, cognitive impairment, Alzheimer's and even cancer.

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Mitochondrial dysfunction and energy dys-metabolism have been implicated in pathogenesis of autism and ketogenic diet has been shown to help in such disorders.

Dr. Evangeliou and colleagues from the University of Crete in Greece studied the impact of ketogenic diet in kids with autism spectrum disorders. The results of the study were published in the Journal of Child Neurology.

Autism-ketogenic diet study subjects:

30 subjects
Autistic behavior
Age 4-10 years

Autism-ketogenic diet study design:

Ketogenic diet for 4 weeks alternating with 2 weeks of ketogenic diet free periods
Ketogenic diet variant consisting of medium chain triglyceride was used
Total study time 6 months
Childhood Autism Rating Scale recorded

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Subjects excluded:

Inability to tolerate ketogenic diet= 7
Subjects discontinued diet after starting= 5

Results of Autism-ketogenic diet study:

18 subjects completed the study
2 subjects displayed significant improvement (more than 12 units of the Childhood Autism Rating Scale)
8 subjects had “average” improvement (> 8-12 CARS units)
8 subjects had “minor” improvement i.e. 2-8 CARS units

Take-home: Ketogenic diet may be a consideration in select kids especially with coexisting autism and seizure disorders.

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Dr. Minocha's note of caution:

Interpret the results with caution since this is not a randomized controlled trial.
Ketogenic diet has potential for harm if not undertaken under physician guidance.
Kids with autism are picky eaters and do not easily adapt to altered dietary and other life-style patterns. As such, compliance can be problem.
Study was carried out in Crete, the largest of Greek islands, where prevalence of autism is high and because of smaller genetic pool may have higher genetic component in the pathogenesis. As such, results may or may not be applicable to racially/genetically diverse societies
Ketogenic diet is contraindicated in many medical conditions.

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