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By Anil Minocha MD, author of Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Diet and brain function
Dietary modification has potential to modulate the manifestations and course of brain dysfunction.
Beneficial effect of certain diets in some and not in other patients with neuropsychiatric disorders suggests that no so single dietary regimen is likely to have beneficial impact due to multiplicity and complexity mechanisms underlying the causation of these diverse disorders with their complex and varied manifestations.
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Even with multiple mechanisms, the final pathways may be far fewer or as less diverse allowing for potential for dietary modifications for clinical benefit. One such final common pathway may be dysfunctional energy metabolic pathways.
According to Drs. Kossoff and Hartman from Departments of Neurology and Pediatrics at the Johns Hopkins Medical Institutions in Baltimore MD, dietary therapy for epilepsy continues to grow in popularity worldwide, with expanding use for adults and conditions other than epilepsy.
Ketogenic diet and variants
Various options being used include classic ketogenic diet, medium-chain triglyceride diet, modified Atkins diet, and low glycemic index diet. All of these diets are represent some sort of variants of ketogenic diet with classic ketogenic diets being the strictest.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Indications of ketogenic diet
High-fat, low-carbohydrate ketogenic diet is being increasingly popular for management of diverse neurological disorders like epilepsy, infantile spasms, chronic headache, traumatic head injury, Alzheimer’s disease, sleep disorders, cancer, autism, chronic pain, and multiple sclerosis. It should be noted that evidence in support of use of ketogenic diet for some of these conditions. is limited to animal or biochemical data.
Strong evidence exists for anticonvulsive and neuroprotective role of ketogenic diet and its use in patients with medically intractable epilepsy. In fact, a dietary manipulation may allow for discontinuation of not just the anti-seizure medications but even the dietary intervention itself in many cases without relapse of seizures.
Is It Leaky Gut or Leaky Gut Syndrome?
Levy and colleagues in a Cochrane DataBase Review 2012 concluded that the ketogenic diet results in short to medium term benefits in seizure control in children to the same degree as mainstream anti-seizure medications. However, Ketogenic diet is also accompanied by high degree of attrition suggesting poor tolerability. Limited evidence suggests that even Atkin’s diet with somewhat less restrictive diet based on same principles may have similar efficacy in epilepsy.
Contraindications of ketogenic diet
According to Drs. Caraballo and Vining ketogenic diet is not for everyone and in fact is harmful in many although uncommon metabolic disorders. These include:
- Primary carnitine deficiency
- Carnitine palmitoyltransferase I or II deficiency
- Carnitine translocase deficiency
- β-oxidation defects (long-chain acyl dehydrogenase deficiency
- Medium-chain acyl dehydrogenase deficiency
- Short-chain acyl dehydrogenase deficiency
- Long-chain 3-hydroxyacyl-coA deficiency
- Medium-chain 3-hydroxyacyl-coA deficiency)
- Pyruvate carboxylase deficiency
- Porphyria
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Mechanisms underlying ketogenic diet
Despite the widespread use of ketogenic diet and its variants from neurological dysfunction, the mechanisms for its beneficial effects need to be fully elucidated.
- Modulation of concentration and relative ratios of neurotransmitters like dopamine and serotonin
- Mitochondrial function
- Oxidative stress
- Purine (ATP, adenosine) metabolism: According to Dr. Greene from the Department of Psychiatry, University of Texas Southwestern Medical Center , Dallas, Texas, adenosine is at the front and center in linking nutrition and metabolism to neuronal activity.
Dr. Minocha's note of caution
Jury is still out on the long term health implications of ketogenic diet in population at large. 
Is It Leaky Gut or Leaky Gut Syndrome?
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
