Abstract
The classical ketogenic diet (cKD) is an isocaloric, high fat, very low-carbohydrate diet that induces ketosis, strongly influencing leptin and ghrelin regulation. However, not enough is known about the impact of a long-term cKD. This study evaluated the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adults affected by the GLUT1-Deficiency Syndrome or drug resistant epilepsy (DRE). We also investigated the relationship between the nutritional status, body composition and ghrelin and leptin variations. We carried out a longitudinal study on 30 patients: Twenty-five children and adolescents (15 females, 8 ± 4 years), and five adults (two females, 34 ± 16 years). After 12-monoths cKD, there were no significant changes in ghrelin and leptin, or in the nutritional status, body fat, glucose and lipid profiles. However, a slight height z-score reduction (from −0.603 ± 1.178 to −0.953 ± 1.354, p ≤ 0.001) and a drop in fasting insulin occurred. We found no correlations between ghrelin changes and nutritional status and body composition, whereas leptin changes correlated positively with variations in the weight z-score and body fat (ρ = 0.4534, p = 0.0341; ρ = 0.5901, p = 0.0135; respectively). These results suggest that a long-term cKD does not change ghrelin and leptin concentrations independently of age and neurological condition.
Highlights
The classic ketogenic diet is an isocaloric, high-fat, very low-carbohydrate and normal-protein diet
These results suggest that a long-term classical ketogenic diet (cKD) does not change ghrelin and leptin concentrations independently of age and neurological condition
The main aim of our longitudinal study was to investigate the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adult patients affected by glucose carrier protein type 1 (GLUT1)-DS or drug resistant epilepsy (DRE)
Summary
The classic ketogenic diet (cKD) is an isocaloric, high-fat, very low-carbohydrate and normal-protein diet. Nutrients 2019, 11, 1716 plus proteins (gr), generally equal to 3:1 or 4:1 [1] It has been used safely and effectively for decades as a recognized treatment for drug-resistant epilepsy (DRE) [2,3,4], in GLUT1-Deficiency Syndrome (GLUT1-DS) [5,6] and in pyruvate dehydrogenase complex deficiency (PDCD) [7,8]. The cKD produces the highest ketogenic effect among the various ketogenic diets (KDs) It induces a constant production of KBs, called ketosis, aimed at mimicking the starvation state while providing adequate calories to support growth and energy needs in childhood and adult age, respectively [2,14]
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