Autism and Ketogenic Diet: Benefits of Ketogenic Diet

Day by day, there is always something new that comes up in every different area. Technological advances, newly published researches, or basically people’s preferences are shaping these world. When it is about food and diet, people love to make changes and follow new trends. Also, some of these diets could be beneficial for some specific disorders and conditions. 

In this article, we are going to talk about one of those diets which is a ketogenic diet. You can find an answer to a couple of questions that in your mind that you are curious about. For example; What is the ketogenic diet? What is the relation between autism and ketogenic diet? Is there any benefit? If any, what are those benefits? What kind of foods you can consume? Is there any restriction? And you can find some cases to illustrate what is going on when people follow the ketogenic diet. 

The ketogenic diet is one of the popular forms of nutrition that gains importance in recent years. The ketogenic diet was originally used only to support the treatment of some diseases and disorders. Now it is used for weight loss. In fact, in a sense, it is still used in treatment. Because the weight problem is also a problem for many diseases.

In ketogenic diets, the distribution of dietary energy is quite different from other diets, it has low carbohydrate content, medium protein content, and high-fat content. In this regard, ketogenic diets, a nutritional program that consists of prohibitions usually included in diets, have therefore increased its popularity. People feel that following this diet is easier to follow compared to other nutritional programs. 

Ketogenic diet is used for both protective and therapeutic purposes in almost all neurological diseases, autism spectrum disorder, epilepsy, brain tumors, Alzheimer’s, ALS, depression, stroke, head trauma, Parkinson’s disease, migraine, sleep disorders, schizophrenia, anxiety, Attention Deficit and Hyperactivity Disorder (ADHD), anger uncontrollability, Irritable bowel syndrome, Reflux, obesity, heart and vascular diseases, acne, Type-2 diabetes, palpitations, respiratory failure, and cancer.

Ketogenic nutrition, which has been the subject of numerous studies and is still being investigated, has proven effects on reducing the symptoms of some diseases. In addition, it is known that this type of diet, which is also preferred as a slimming diet, has some damages on the body and it is a form of nutrition that is not highly sustainable and cannot be sustained for a long time. It is very difficult to apply and due to possible damages to the body, people who follow this diet are required to be constantly under medical supervision.



What is Ketogenic Diet?


The ketogenic diet has emerged for the treatment of resistant epileptic individuals and is still an effective treatment method used in epileptic individuals. Nowadays it is also used for weight loss and treatment of various diseases.

Our brain uses carbohydrates primarily in energy production. However, with the hunger or ketogenic diet, our brain uses fats, not carbohydrates, as energy sources, and ketones are formed as a result. The ketogenic diet also includes alternative diets such as the modified Atkins diet (MAD), the medium-chain triglyceride diet (MCT) and the low glycemic index diet (LGIT). Today, according to the type of ketogenic diet, the initial starvation phases are no longer applied and diet can be started at home without hospitalization.

Before starting the ketogenic diet, the person is evaluated in a multidisciplinary manner, information is given about the effects and side effects of the ketogenic diet, ketone measurement in blood or urine, and weighing and preparation of nutrients are provided. Three-day food consumption records are kept in detail, learning of food and consistency preferences and nutrition programs are prepared and followed according to the ketogenic diet type offered to the person. Contrary to popular belief, many recipes suitable for every taste can be created by means of programs used in the ketogenic diet and patient-dietitian communication.

The ketogenic diet can be defined as diets where carbohydrate and protein sources are very limited and most of the dietary content consists of fats. Many types of foods that are avoided in normal healthy eating plans are preferred as the main source of energy in these diets.

Due to the high-fat content, low carbohydrate, and protein content, these nutritional programs are difficult to implement daily life. More than that, it may be challenging and risky in terms of health. In this diet, which is very strict especially in terms of carbohydrates, carbohydrate sources such as bread, cereals, all kinds of food and sugar produced from flour are among the strict prohibitions.



A large part of the diet consists of one of the fat sources, cream, and mayonnaise-like foods. Because it is effective in reducing epileptic seizures in epilepsy patients, ketogenic diet applications can be performed in these patients during seizure periods. In addition, ketogenic diets may be used to assist in the treatment of certain metabolic diseases, Parkinson’s disease, Alzheimer’s disease, brain, and nervous system diseases, autism spectrum disorder, and some mental and mitochondrial diseases.

Autism and Ketogenic Diet


In a pilot study on autism, 60 percent of children who took a ketogenic diet for 6 months showed improvement. In addition, it has been reported to be an effective form of nutrition for regressing type 2 diabetes, cancer, epilepsy, and Alzheimer’s disease.

The ketogenic diet sample with a lipid/carbohydrate and protein ratio of 4/1 has been shown to completely control or reduce epileptic seizures in patients with severe epilepsy. However, there are few studies showing the improvement of symptoms in children with autism who have epilepsy on a ketogenic diet. Nevertheless, this diet is seen as promising in the treatment of autism symptoms.

Reports of five animal studies and two human studies have observed that the ketogenic diet for autism has found impressive results each time. In animals during ketogenic diet; Social deficits, mitochondrial dysfunction, decreased sociability, communication, increased repetitive behaviors, stress response deficits, and microbiome problems were significantly reduced in the autism model.

There is a case study which is conducted with a child with epilepsy and autism spectrum disorder. It indicates that the patient lost significant weight, improved both cognitive and behavioral symptoms of autism, and decreased the score on the Childhood Autism Rating Scale. In the non-autistic rating, IQ increased by 70 points and seizures ended completely after 14 months in the diet.

In a systematic review, researchers acknowledged the impressive results so far, but there is insufficient evidence to suggest that this diet is the first-line treatment for autism.



“There is a family who has a son with epilepsy and autism at the same time. Recently, they have seen a distinct improvement in their son’s condition. Then, they decided to follow different nutritional programs when he started having repeated seizures that cannot be controlled by medication. He has autism and epilepsy, which means his genes are mutated. So, out his sodium ion channels. He has problems regulating the conduction of nerve signals. 

It has been known that the ketogenic diet is a powerful treatment method. Especially for epilepsy, it has a lot of positive contributions. So, his epilepsy seizures have reduced in frequency thanks to this nutritional program. Also, parents start to observe changes in his autism symptoms. He is calmer, more concentrated, and more present now. Parents think that he even understands more.”

6 Ways the Keto Diet May Benefit Autism Spectrum Disorder


#1: Promotes Healthy Brain Function


Recent studies show that a keto diet enhances brain health and cognitive performance. On a keto diet, high ketone levels reduce brain inflammation and change gene expression for the better, which promotes healthy brain function and improves cognition. Eating a keto diet may improve a variety of symptoms of autism.

Healthy Brain Development: Eating plenty of foods and plenty of healthy fats can improve autistic behavior patterns and promote healthy brain development.

Normalized Brain Metabolism: It shifts your metabolism. It leads to significant improvements in brain areas that are underactive in autism.

Decreased Sensory Overwhelm: It is related to insulin resistance. It has beneficial effects on it and could help with sensory hypersensitivity in autism.

Better Motor Function: Helps to restore impaired motor function.



#2: Boosts Mood


Autism changes excitability and inhibition in the brain, which can lead to mood disorders such as anxiety and depression.

Aggression and Stable Mood: A keto diet works similarly to lithium and in that direction stimulates the brain. The mood works in a balancing way because it stimulates those areas of the brain. For example, it is the brain regions where individuals with autism are affected by aggression and mood swings. It helps boost the mood of people with autism.

Anxiety: It helps to decrease the level of anxiety, decreasing mood disturbance, and raising productivity levels.

Depression: It helps to boost positive mood and reduce hunger levels.



#3: Improves Gut Health


Your gastrointestinal tract (GI tract) is filled with trillions of bacteria, and they like to dabble in mind control. Your gut bacteria have a direct line of contact with your brain, and they produce neurotransmitters and other brain chemicals that can change your mood and brain function, as well as your body’s immune and inflammation responses.

Your gut bacteria influence mood and motivation. Because it basically affects serotonin and dopamine which are two neurotransmitters that influence those. People with autism tend to have disrupted the production of those neurotransmitters, and most of them experience gastrointestinal distress. Following a nutritional program is a very important case for them.

People with autism often have gut dysbiosis, an imbalance between good and bad gut bacteria. And the more damaging gut bacteria an autistic person has, the more severe their autism symptoms are. Gut flora alterations can contribute to depression, stress response, and autism severity. Eating a ketogenic diet starves bad gut bacteria and supports healthy gut bacteria, and also increases the production of beneficial short-chain fatty acids and the neurotransmitters serotonin and GABA.

#4: Reduces Inflammation and Autoimmunity


Inflammation, oxidative stress, and immune activation play critical roles in the formation and ongoing symptoms of autism. Children with autism are more likely to be overweight or obese compared to children without autism, and autism symptoms are more severe the more overweight a person is. Obesity also contributes to inflammation and autoimmune dysfunction, which can worsen symptoms of autism.

The ketogenic diet is both safe and beneficial nutritional program for overweight children, and that being in a state of ketosis caused no significant side effects. It also promotes healthy brain function, increases neuroplasticity, decreases oxidative stress, and reduces inflammation in the central nervous system. All of which could help relieve symptoms of autism that come from inflammation and oxidative stress.



#5: Restores Mitochondrial Function


Mitochondria are one of the smallest but also the most important parts of our body. They are the building blocks that provide energy to our cells. They create the energy necessary for our life. Especially in our brains, there is a high density of mitochondria. If they don’t work properly, our cells, in other words, our bodies, cannot supply the energy it needs to function. And, after all this information, we can say that mitochondrial dysfunction seems to be one of the main causes of autism.

The application of the keto diet strengthens the mitochondria by increasing brain antioxidants. Thus, it improves general brain cell functions. And even this diet helps you create new mitochondria in your brain and makes them more efficient. Therefore, it is recommended that individuals with autism follow this program. Thanks to the keto diet, mitochondria become stronger and improvements in symptoms of autism can be observed.

#6: Makes Mothers Healthier Before and During Pregnancy


If the mother is not healthy during pregnancy or does not take care of her health, the child is likely to have severe autism. Children of obese mothers are at risk of insulin resistance, decreased brain plasticity, and neurotransmitter disorder. Mothers with diabetes or high blood pressure are likely to give birth to children with autism spectrum disorders or other developmental delays.

Following the keto diet can reduce the likelihood of having an autistic child. Because a diet with low carbohydrates and high fat decreases body weight and increases insulin level. On the other hand, an unhealthy gut biome also increases the risk of autism, as mothers transfer the gut bacteria to their children during labor.



Application of Ketogenic Diets in Children with Autism Spectrum Disorder


Prohibitions


1. Wheat and everything made of wheat
2. Oats and everything made from oats
3. Everything made from rye and rye
4. Everything made from barley and barley
5. Bulgur and everything made from bulgur
6. Pasta
7. Awning and everything made from awning wheat
8. Everything made from starch and starch
9. Semolina and everything made from semolina
10. Everything made of vinegar and vinegar
11. Turnip juice and everything made from turnip juice
12. Couscous and everything made from couscous
13. Malt and everything made of malt
14. Baking powder, vanillin, and everything thereof
15. Artificial-natural food dyes and everything made of them
16. Milk and everything made of milk
17. Everything from yogurt and yogurt
18. Cheese and everything made of cheese
19. Everything made from margarine and margarine
20. Everything made from soy and soy
21. Everything made of apple and apple
22. Grapes and everything made of grapes
23. Everything from Kamut
24. Ice cream and everything made from ice cream
25. artificial-natural sweeteners and everything made of them
26. Corn and everything made of corn
27. Ketchup and mayonnaise and everything made of them
28. Everything made of potatoes and potatoes
29. Cut milk/curd and everything made of them
30. Legumes and everything made from legumes
31. Cereals and everything made of cereals
32. sausage-salami / hotdog and everything made of them (a fish-intensive diet is recommended instead)
33. Coriander, turmeric, black pepper, cumin, thyme, mint and everything made of them
34. Oranges, peanuts, chewing gum and everything made of them
35. Dried fruits and everything made of them
36. Refined white sugar and everything made of them
37. Aspirin
38. Eggs and everything made from eggs
39. Pears, bananas and everything made of them
40. Fast food products, canned goods, packaged snacks, and similar products
41. Playdough, glue, sticker (must not eat)
42. Those not produced ecologically for midwives and fruit products (other than those prohibited) (the amount of fruit must be limited)
43. Shellfish and Duck – Goose Meat
44. Offal
45. Food cooked in copper-aluminum-zinc containers
46. ​​Fermented foods (alcohol, beer, alcoholic foods, pickles, and all other fermented foods)
47. sunflower oil, corn oil, hazelnut oil, soybean oil and foods made from them (fish oil, olive oil, and coconut oil and MCT-medium chain triglyceride oil-Novartis (available from pharmacies) should be preferred. fresh coconuts and coconut milk should be consumed, evening primrose oil, flaxseed consumable-ketogenic products)
48. Tea and coffee products
49. Breakfast cereals, chips, fruit juices with refined sugar and other products (mineral water recommended)
50. Coke



Additional Vitamins


1. Vitamin E (d-alpha tocopherol succinate)
2. Vitamin B6
3. Folic Acid
4. Vitamin B12 (Methylcobalamin)
5. Magnesium (as Magnesium Aspartate)
6. Zinc (as Zinc Amino Acid Chelate)
7. Dimethylglycine HCl
8. L-Carnosine
9. Betaine HCl

You can also follow these helpful keto-friendly recipe suggestions to get your child on board with eating keto:


  • Breakfast: Keto pancakes or waffles, smoothies, eggs and bacon, breakfast tacos
  • Lunch or dinner: Sandwiches with low-carb bread, meatballs, keto pizza, chili, buffalo bites, keto enchiladas
  • Desserts or snacks: Fat bombs, nuts, seeds, nut or seed butter, jerky, or keto cookies

Measures


The results we see here are promising in many ways and give hope to future research for the natural treatment of schizophrenia through a ketogenic diet for mental illnesses. However, these are complex disorders and should be managed under the care of a qualified psychiatrist. Consult your psychiatrist and / or doctor before starting a new diet.

If you are already on psychotropic medication, you should discuss alternative medications with your doctor and never stop taking your medication without your doctor’s explicit instructions. Not much is known about the ketogenic diet during pregnancy, so it is best to consult your doctor in these cases.



Promising Published Case Studies and Clinical Trials for Autism


In recent years researchers and professionals have given importance to this topic. There have been promising case reports and preliminary clinical trials in the medical literature. There is a scientific base for significant improvements of children put on the ketogenic diet for autism spectrum disorder specifically.

According to a report in the Journal of Child Neurology in 2013, there is a case of a girl who was diagnosed with autism at the age of 4 and has developed epileptic seizures since adolescence. A milk-free ketogenic diet program was followed for seizure control. Epileptic seizures were not observed during the diet for several years. At the same time, her behavior and IQ also improved enormously, making her appear “non-autistic” in cognitive tests, moreover, morbid obesity, and lifetime gastro-intestinal problems were resolved.

There is a report published in 2017 described a clinical trial in Egypt in which 45 children, aged 3 to 8, with a diagnosed autism spectrum disorder, were placed for six months on one of three diets: 15 of them on a ketogenic diet; 15 of them on a gluten-free casein-free (dairy-free – GFCF) diet, and 15 of them on a well-balanced standard diet as a control. Children on both the ketogenic diet and the GFCF diet showed significant improvement in core features of the autism spectrum disorder, but those on the ketogenic diet had the greatest improvement in social functioning and cognitive abilities.

According to a report published in the journal, Metabolic Brain Disease in 2018, there was a six-year-old boy with autism and ADHD at the same time in Poland. His brain had a low uptake of glucose. So, he was placed on the ketogenic diet and within a month he showed a marked improvement in hyperactivity, attention span, communication skills, fear, anxiety and emotional reactions, and adaptability to change.

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