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A ketogenic diet is a dietary intervention therapy in neurological disorders such as epilepsy and Autism spectrum disorder. A ketogenic diet may be an effective therapy for ASD because it might improve Autism spectrum disorder core symptoms and could benefit its comorbidities, including seizures. The efficiency of a ketogenic diet must be monitored using urinary ketones and serum beta-hydroxybutyrate (BHB). Some evidence showed that a ketogenic diet improved the core features of Autism spectrum disorder patients (Table 1). El-Rashidy et al. showed that a ketogenic diet improved autistic manifestations, which was demonstrated as improved scores on the Autism Treatment Evaluation Test (ATEC) scales and the Childhood Autism Rating Scale (CARS), especially sociability improvement. Lee et al. also reported that a modified ketogenic gluten-free diet with supplemental medium-chain triglycerides (MCTs) improved the social affect subdomain and total autism diagnostic observation schedule, 2nd edition (ADOS-2) scores, but it did not affect the restricted and repetitive behavior scores. A ketogenic diet improved social exploration and social interactions in an animal model of Autism spectrum disorder. It also ameliorates the comorbidities of Autism spectrum disorder more efficiently than the core symptoms of Autism spectrum disorder. A ketogenic diet improved the social communication of one of six Autism spectrum disorder patients, but it reduced the comorbidities of all six Autism spectrum disorder patients, including attention deficit hyperactivity disorder (ADHD), compulsive behavior, preoccupation with parts of objects, and abnormal sleep. It also decreased the frequency of seizures. A case report of an Autism spectrum disorder child found that a ketogenic diet improved the electroencephalogram results and increased the child's intelligence quotient. Although a ketogenic diet-induced decrease in seizures will lead to a better quality of life in patients with epilepsy, including Autism spectrum disorder, it is not associated with improvements in behaviors in Autism spectrum disorder patients. Antiepileptic drugs do not have a large effect on the behavioral symptoms in Autism spectrum disorder. | A ketogenic diet is a dietary intervention therapy in neurological disorders such as epilepsy and Autism spectrum disorder. A ketogenic diet may be an effective therapy for ASD because it might improve Autism spectrum disorder core symptoms and could benefit its comorbidities, including seizures. The efficiency of a ketogenic diet must be monitored using urinary ketones and serum beta-hydroxybutyrate (BHB). Some evidence showed that a ketogenic diet improved the core features of Autism spectrum disorder patients (Table 1). El-Rashidy et al. showed that a ketogenic diet improved autistic manifestations, which was demonstrated as improved scores on the Autism Treatment Evaluation Test (ATEC) scales and the Childhood Autism Rating Scale (CARS), especially sociability improvement. Lee et al. also reported that a modified ketogenic gluten-free diet with supplemental medium-chain triglycerides (MCTs) improved the social affect subdomain and total autism diagnostic observation schedule, 2nd edition (ADOS-2) scores, but it did not affect the restricted and repetitive behavior scores. A ketogenic diet improved social exploration and social interactions in an animal model of Autism spectrum disorder. It also ameliorates the comorbidities of Autism spectrum disorder more efficiently than the core symptoms of Autism spectrum disorder. A ketogenic diet improved the social communication of one of six Autism spectrum disorder patients, but it reduced the comorbidities of all six Autism spectrum disorder patients, including attention deficit hyperactivity disorder (ADHD), compulsive behavior, preoccupation with parts of objects, and abnormal sleep. It also decreased the frequency of seizures. A case report of an Autism spectrum disorder child found that a ketogenic diet improved the electroencephalogram results and increased the child's intelligence quotient. Although a ketogenic diet-induced decrease in seizures will lead to a better quality of life in patients with epilepsy, including Autism spectrum disorder, it is not associated with improvements in behaviors in Autism spectrum disorder patients. Antiepileptic drugs do not have a large effect on the behavioral symptoms in Autism spectrum disorder. | ||
After ketogenic diet treatment, some blood parameters changed, such as an upregulation of beta-hydroxybutyrate, high-density lipoprotein (HDL), low-density lipoprotein, and cholesterol and a downregulation of eosinophils. Only the HDL increase, eosinophil percentage, and white blood cell count decrease predicted the effects of a modified ketogenic diet treatment in Autism spectrum disorder patients. Why the effects of ketogenic diet vary so much from patient to patient in Autism spectrum disorder is not clear. The pro-inflammatory condition at baseline was associated with an effective ketogenic diet treatment, which was demonstrated by a reduction in eosinophils. | |||
A ketogenic diet seems effective in Autism spectrum disorder patients, but all of these clinical studies had small sample sizes, which is likely due to the difficulty of setting up randomized trials in Autism spectrum disorder children. Autism spectrum disorder patients also eat a narrower range of foods and exhibit more feeding problems. They refuse some food because of the presentation or the need for certain utensils. Therefore, it is difficult to introduce the ketogenic diet to Autism spectrum disorder children. The duration of these studies was 3–16 months, which is not sufficient to assess the side effects of ketogenic diet. In summary, more studies are needed to verify the precise role of ketogenic diet in Autism spectrum disorder patients. | |||