We occasionally love sharing the latest in science. Our current topic is Ketone bodies to treat epilepsy in children.
KETONE BODIES TO TREAT EPILEPSY IN CHILDREN
Review of paper, “Chomtho, K., O. Suteerojntrakool, and S. Chomtho, Effectiveness of Medium Chain Triglyceride Ketogenic Diet in Thai Children with Intractable Epilepsy. J Med Assoc Thai, 2016. 99(2): p. 159-165.”
BACKGROUND
C8 Medium Chain Triglycerides (MCTs) exert one of their benefits via conversion to Ketone Bodies (KBs). KBs are compounds produced when specific fatty acids are broken down in the liver. The KBs are taken up by various tissues in a non-insulin dependent manner and used for energy or as signaling lipids (affecting pathways by acting as mediators). The common KBs include beta-hydroxybutyrate (BHB) and acetoacetate (AcAc). (See previous Science Letters for details on the metabolism of these molecules).
The original ketogenic diet (actually fasting) for epilepsy may date to biblical times when Jesus refers to fasting when a man suffers from what appear to be epileptic seizures (New Testament Matthew 17: 14-21; Mark 9: 14-29).
A more modern version of ketogenic diet (KD) was developed at John Hopkins hospital in the 1920s, as natural cure for drug-resistant epilepsy
Classical KDs have now been used to treat epilepsy for many years 1, 2, 6, 7, 11, 15-18, 22-26.
Traditional/Classical KDs are very high in fat (up to 90% of calories as fat) and extremely difficult to adhere to due to the very high fat content and sources of fat such as lard (see Figure below).
MCTs were thus first introduced in 1971 to improve the palatability of the classical KD for epilepsy, but there have been relatively few human studies to evaluate MCTs for treating epileptics 3, 4, 8-10, 12-14, 19-21.
Ketogenic diets and MCTs, especially C8 MCT oil, may improve clinical outcomes and reduce seizures because of defects in glucose uptake, and impairments in energy metabolism via defects in mitochondrial energy production via the Krebs cycle activity 22. The Krebs cycle or Citric Acid Cycle, followed by electron transport (ET) is the main way(s) to convert food and endogenous (internal) sources into usable energy, to meet the body’s energy needs.
The recent study by Chomtho et al. (2016) had some promising findings:
Adapted from: McMurtrie and Borges, Approved and new dietary options for the treatment of refractory epilepsy
MAJOR RESULTS: Chomtho et al. (2016)
In 16 Thai children with intractable epilepsy, MCTs (not clear on source) as part of a ketogenic diet, reduced seizure frequency at 1- and 3 months. 64.3% of the subjects achieved more than 50% seizure reduction at 3 months, and 29% of patients were seizure-free 5. Side effects were initial weight loss and slight nausea as children were getting adapted to the MCT-KD. Overall, 88% of children in the clinical trial and the majority of parents were very satisfied with the treatment.
CONCLUSIONS
The above results in this small trial were very encouraging and showed that MCT-KDs were feasible even in Asian culinary culture containing possibly high carbohydrates and starches as well as special spices. It is very impressive that after the clinical trial, almost a third of children were seizure-free. These children and their parents could lead less stressful lives. While most of us do not have to face this terrible decease, it is so wonderful that MCT oil helped children stay on the modified ketogenic diet and assisted them to regain their health.
Amongst MCTs, C8 MCTs are the most ketogenic, and would be expected to be particularly potent for use in children with epilepsy.
DISCLAIMER: The information above is for educational purposes only, please contact your medical provider regarding treatment of any medical condition including epilepsy.
REFERENCES
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