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Breaking News: Ketogenic Diet, Epilepsy and the Gut- Microbiome

Hello everyone,

As discussed in our previous breaking news post, today we will look at the role of the ketogenic diet and its effect on microbiota.

The gut-microbiota plays an important role in regulating the host physiology. Perturbations in the gut- microbiota has been observed in neuropsychiatric diseases such as autism, anxiety, depression etc. Recent studies have shown that the gut-microbiota of patients with epilepsy differ from that of healthy individuals.  Interventions such as purgation, which are known to alter the gut-microbiota has been advocated for the treatment of epilepsy since the time of Hippocrates.

Hippocrates

“Let food be thy medicine and medicine be thy food.”
― Hippocrates 2400 BC (Before Christ) or 2400 BCE (Before Common Era)

Diet is one of the most important factors which determines the gut-microbiota, which are highly individual and extremely sensitive to changes in the diet. Special diets or a drastic change in dietary habits modulates the gut-microbiota.

Recently the effect of ketogenic diet on gut-microbiota has evoked immense interest in the scientific community. The disruption of the fine balance between the beneficial microbes and pathogenic microbes in the gut contributes to pathogenesis of many diseases. This phenomenon is called ‘dysbiosis’. Studies have shown that ketogenic diet reverses the epilepsy associated dysbiosis and restores the gut-microbiome. Ketogenic diet administration resulted in an increase in the levels of bacteroides, namely, prevotella and bifidobacteria in the gut. These bacteria are known to produce metabolites which posess anti-epileptic activity and promote brain health. One of the studies conducted in China found that there is a difference between the effect of the ketogenic diet on the gut-microbiota of responders and non-responders in a group with epilepsy. It was observed that ketogenic diet increased the levels of certain bacteria such as Clostridiales, Ruminococcacecae, Lachniospiraceae etc. in the non-responders. The role of these bacterial groups in epilepsy  is as yet unclear. Elucidating  the effect of the ketogenic diet on the gut microbiota would be thus beneficial by aiding us in-

1. Predicting the response of patients to ketogenic diet

2. Designing newer interventions which target the gut-microbiome (such as probiotics). However, most of these studies have been conducted on a small group of patients. Therefore,  validation and implementation of such strategies entail larger clinical trials.

Dr. J. Nathan’s KD centre in  Mumbai has collected pre and post_KD stool samples which are being assessed in an on-going trial with the help of the Manipal Medical College and Hospital. This is being carried out by a young, enthusiastic and dynamic PhD student Magith guided by Dr Radhakrishnan and Dr. Nathan. We should know the results soon.

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