Cybermedlife - Therapeutic Actions Dietary Modification - Low Carbohydrate-Ketogenic


Ketogenic Diet for the Management of Epilepsy Associated with Tuberous Sclerosis Complex in Children.

Abstract Title: Ketogenic Diet for the Management of Epilepsy Associated with Tuberous Sclerosis Complex in Children. Abstract Source: J Epilepsy Res. 2017 Jun ;7(1):45-49. Epub 2017 Jun 30. PMID: 28775955 Abstract Author(s): Soyoung Park, Eun Joo Lee, Soyong Eom, Hoon-Chul Kang, Joon Soo Lee, Heung Dong Kim Article Affiliation: Soyoung Park Abstract: BACKGROUND AND PURPOSE: In the present study, we reviewed the outcome of ketogenic diet (KD) use for the management of epilepsy in children with tuberous sclerosis complex (TSC). METHODS: A total of 12 children with intractable epilepsy associated with TSC who were treated with KD at our hospital between March 1, 2008 and February 28, 2015 were retrospectively enrolled. RESULTS: The mean age at the time of KD initiation was 73.1± 38.0 months. Patients were medically refractory to a mean of 4.8 ± 1.7 antiepileptic drugs. Nine patients (75.0%) had a history of infantile spasms. At 3 months after KD initiation, 10 patients (83.3%) had>50% seizure reduction. Moreover, 7 patients (58.3%) exhibited qualitative improvements in cognition and behavior after KD initiation, as reported by caregivers/parents. The mean duration of dietary therapy was 14.8± 12.8 months. Half of the patients in this study eventually underwent epilepsy surgery due to persistent seizures or seizure relapse. CONCLUSION: KD is an important non-pharmacological treatment option for patients with intractable epilepsy associated with TSC. KD may improve cognition and behavior in addition to reducing seizure frequency. Article Published Date : May 31, 2017

Changes in cerebral metabolism during ketogenic diet in patients with primary brain tumors: (1)H-MRS study.

Abstract Title: Changes in cerebral metabolism during ketogenic diet in patients with primary brain tumors: (1)H-MRS study. Abstract Source: J Neurooncol. 2017 Jan 10. Epub 2017 Jan 10. PMID: 28074323 Abstract Author(s): Moran Artzi, Gilad Liberman, Nachum Vaisman, Felix Bokstein, Faina Vitinshtein, Orna Aizenstein, Dafna Ben Bashat Article Affiliation: Moran Artzi Abstract: Normal brain cells depend on glucose metabolism, yet they have the flexibility to switch to the usage of ketone bodies during caloric restriction. In contrast, tumor cells lack genomic and metabolic flexibility and are largely dependent on glucose. Ketogenic-diet (KD) was suggested as a therapeutic option for malignant brain cancer. This study aimed to detect metabolic brain changes in patients with malignant brain gliomas on KD using proton magnetic-resonance-spectroscopy ((1)H-MRS). Fifty MR scans were performed longitudinally in nine patients: four patients with recurrent glioblastoma (GB) treated with KD in addition to bevacizumab; one patient with gliomatosis-cerebri treated with KD only; and four patients with recurrent GB who did not receive KD. MR scans included conventional imaging and (1)H-MRS acquired from normal appearing-white-matter (NAWM) and lesion. High adherence to KD was obtained only in two patients, based on high urine ketones; in these two patients ketone bodies, Acetone and Acetoacetate were detected in four MR spectra-three within the NAWM and one in the lesion area -4 and 25 months following initiation of the diet. No ketone-bodies were detected in the control group. In one patient with gliomatosis-cerebri, who adhered to the diet for 3 years and showed stable disease, an increase in glutamin + glutamate and reduction in N-Acetyl-Aspartate and myo-inositol were detected during KD. (1)H-MRS was able to detect ketone-bodies in patients with brain tumors who adhered to KD. Yet it remains unclear whether accumulation of ketone bodies is due to increased brain uptake or decreased utilization of ketone bodies within the brain. Article Published Date : Jan 09, 2017

A ketogenic diet rescues hippocampal memory defects in a mouse model of Kabuki syndrome.

Abstract Title: A ketogenic diet rescues hippocampal memory defects in a mouse model of Kabuki syndrome. Abstract Source: Proc Natl Acad Sci U S A. 2017 Jan 3 ;114(1):125-130. Epub 2016 Dec 20. PMID: 27999180 Abstract Author(s): Joel S Benjamin, Genay O Pilarowski, Giovanni A Carosso, Li Zhang, David L Huso, Loyal A Goff, Hilary J Vernon, Kasper D Hansen, Hans T Bjornsson Article Affiliation: Joel S Benjamin Abstract: Kabuki syndrome is a Mendelian intellectual disability syndrome caused by mutations in either of two genes (KMT2D and KDM6A) involved in chromatin accessibility. We previously showed that an agent that promotes chromatin opening, the histone deacetylase inhibitor (HDACi) AR-42, ameliorates the deficiency of adult neurogenesis in the granule cell layer of the dentate gyrus and rescues hippocampal memory defects in a mouse model of Kabuki syndrome (Kmt2d(+/βGeo)). Unlike a drug, a dietary intervention could be quickly transitioned to the clinic. Therefore, we have explored whether treatment with a ketogenic diet could lead to a similar rescue through increased amounts of beta-hydroxybutyrate, an endogenous HDACi. Here, we report that a ketogenic dietin Kmt2d(+/βGeo) mice modulates H3ac and H3K4me3 in the granule cell layer, with concomitant rescue of both the neurogenesis defect and hippocampal memory abnormalities seen in Kmt2d(+/βGeo) mice; similar effects on neurogenesis were observed on exogenous administration of beta-hydroxybutyrate. These data suggest that dietary modulation of epigenetic modifications through elevation of beta-hydroxybutyrate may provide a feasible strategy to treat the intellectual disability seen in Kabuki syndrome and related disorders. Article Published Date : Jan 02, 2017

Ketogenic diets improve behaviors associated with autism spectrum disorder in a sex-specific manner in the EL mouse.

Abstract Title: Ketogenic diets improve behaviors associated with autism spectrum disorder in a sex-specific manner in the EL mouse. Abstract Source: Physiol Behav. 2017 Jan 1 ;168:138-145. Epub 2016 Nov 9. PMID: 27836684 Abstract Author(s): David N Ruskin, Jessica A Fortin, Subrina N Bisnauth, Susan A Masino Article Affiliation: David N Ruskin Abstract: The core symptoms of autism spectrum disorder are poorly treated with current medications. Symptoms of autism spectrum disorder are frequently comorbid with a diagnosis of epilepsy and vice versa. Medically-supervised ketogenic diets are remarkably effective nonpharmacological treatments for epilepsy, even in drug-refractory cases. There is accumulating evidence that supports the efficacy of ketogenic diets in treating the core symptoms of autism spectrum disorders in animal models as well as limited reports of benefits in patients. This study tests the behavioral effects of ketogenic diet feeding in the EL mouse, a model with behavioral characteristics of autism spectrum disorder and comorbid epilepsy. Male and female EL mice were fed control diet or one of two ketogenic diet formulas ad libitum starting at 5weeks of age. Beginning at 8weeks of age, diet protocols continued and performance of each group on tests of sociability and repetitive behavior was assessed. A ketogenic diet improved behavioral characteristics of autism spectrum disorder in a sex- and test-specific manner; ketogenic diet never worsened relevant behaviors. Ketogenic diet feeding improved multiple measures of sociability and reduced repetitive behavior in female mice, with limited effects in males. Additional experiments in female mice showed that a less strict, more clinically-relevant diet formula was equally effective in improving sociability and reducing repetitive behavior. Taken together these results add to the growing number of studies suggesting that ketogenic and related diets may provide significant relief from the core symptoms of autism spectrum disorder, and suggest that in some cases there may be increased efficacy in females. Article Published Date : Dec 31, 2016

Potential Role of Metabolic Intervention in the Management of Advanced Differentiated Thyroid Cancer.

Abstract Title: Potential Role of Metabolic Intervention in the Management of Advanced Differentiated Thyroid Cancer. Abstract Source: Front Oncol. 2017 ;7:160. Epub 2017 Jul 25. PMID: 28791253 Abstract Author(s): Sri Harsha Tella, Anuhya Kommalapati, Mary Angelynne Esquivel, Ricardo Correa Article Affiliation: Sri Harsha Tella Abstract: Well-differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy that has an excellent prognosis with a 5-year survival rate of about 98%. However, approximately 50% of the patients with DTC who present with distant metastases (advanced DTC) die from the disease within 5 years of initial diagnosis even after getting the appropriate therapy. Apart from recent advancements in chemotherapy agents, the potential role of metabolic interventions, including the use of metformin, ketogenic diet, and high-dose vitamin C in the management of advanced cancers have been investigated as a less toxic co-adjuvant therapies. The role of vitamin C has been of interest again after a preclinical mice study showed that high-dose vitamin C is selectively lethal to KRAS and BRAF mutant colorectal cancer cells by targeting the glutathione pathway. This raises the possibility of utilizing high-doses of vitamin C in the treatment of aDTC where KRAS and BRAF mutations are common. Similarly, alteration of cellular metabolism by low-carbohydrate ketogenic diets can be an important therapeutic strategy to selectively kill cancer cells that mainly survive on glycolysis. Among thepotential adjuvant therapies proposed in this paper, metformin is the only agent that has shown benefit in human model of aDTC, the others have shown benefit but in preclinical/animal studies only and need to be further evaluated in large clinical trials. In conclusion, in addition to concurrent chemotherapy options, these metabolic interventions may have a great potential as co-adjuvant therapy in the management of aDTC. Article Published Date : Dec 31, 2016
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Therapeutic Actions DIETARY MODIFICATION Low Carbohydrate-Ketogenic

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Effect of low-carbohydrate-ketogenic diet on metabolic and hormonal responses to graded exercise in men.

Related Articles Effect of low-carbohydrate-ketogenic diet on metabolic and hormonal responses to graded exercise in men. J Physiol Pharmacol. 1996 Jun;47(2):361-71 Authors: Langfort J, Pilis W, Zarzeczny R, Nazar K, Kaciuba-Uściłko H Abstract Maximal oxygen uptake (VO2 max) and lactate threshold (LT) were measured during graded, incremental exercise in 8 healthy, untrained volunteers (aged 22 +/- 0.9 yrs) following 3 days on a control, mixed diet, or a ketogenic (50% fat, 45% protein and 5% carbohydrates) diet of equal energy content. Before and after exercise tests acid base balance, plasma beta-hydroxybutyrate (beta-HB), free fatty acid (FFA), and some hormone concentrations were determined. In comparison with the normal diet, the ketogenic diet resulted in: an increased VO2 max, decreased respiratory exchange ratio an a shift of LT towards higher exercise loads. Blood LA concentrations were lower before, during and after exercise. Post exercise blood pH, as well as pre-and post exercise base excess and bicarbonates were reduced. Resting beta-HB concentration was elevated to approx. 2.0 mM, and FFA to approx. 1.0 mM. During a 1 h recovery period beta-HB decreased to 0.85 mM (p < 0.01) after the ketogenic diet, while plasma FFA did not change after exercise under either conditions. Both the pre-and post-exercise levels of adrenaline, noradrenaline, and cortisol were enhanced, whilst plasma insulin concentration was decreased on the ketogenic diet. It is concluded that the short-term ketogenic diet does not impair aerobic exercise capacity, as indicated by elevated VO2 max and LT. This may be due to increased utilization of beta-HB and FFA when carbohydrate stores are diminished. Stimulation of the sympatho-adrenal system, and cortisol secretion with reduced plasma insulin concentration seem to be of importance for preservation of working capacity. PMID: 8807563 [PubMed - indexed for MEDLINE]