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Traumatic brain injury (TBI) is a major cause of mortality and morbidity in children and young adults. It initiates multiple cascades of events that lead to acute metabolic dysfunction and cellular energy crisis. TBI remains one of the most common and important causes of acquired epilepsy nowadays. The ketogenic diet (KD) is a specialized high-fat low-protein and low-carbohydrate diet which mimics the anticonvulsive effects of fasting, which were known to suppress seizures. KD is used primarily in children with seizures refractory to standard anticonvulsive drugs (AEDs). Many studies on the anticonvulsant effects of a KD have been performed. Unfortunately, the mechanism of action of the ketogenic diet remains unclear. Although the ketogenic diet is the best dietary therapy for epilepsy, there are other possible approaches including overall restriction of caloric intake. Dietary restriction seems a promising alternative to classic ketogenic diet, possibly because it is associated with higher levels of ketone bodies, which are themselves neuroprotective. Caloric restriction (CR) is defined as a decrease in energy intake without lowering nutritional value. CR improves behavioral outcomes after ischemic brain injury in rats and could possibly act as a neuroprotective factor in global ischemia. It has been also shown that chronic administration of CR may provide protection in the event of TBI. The aim of this research was to study the changes in susceptibility to pilocarpine-induced epileptic seizures in rats with mechanical brain injury. In 30-day-old male Wistar rats (P30), mechanical brain injury was performed. Immediately after, the calorically unrestricted ketogenic diet (KD) and calorically restricted standard laboratory rat chow diet (CR) were introduced. In order to check how the ketogenic diet and caloric restriction alone influence the epileptic seizure susceptibility, two groups of 30-day-old rats were fed KD and CR untill postnatal day 60. At that time, seizures were induced by pilocarpine injection. During the following 6-h period, the animals were continuously observed and motor seizures intensity were rated on a 6-point scale. We have found that KD, both alone or administered to animals with history of experimental brain injury, significantly increases the maximum intensity of pilocarpine-induced seizures, compared to CR fed healthy and injured controls, respectively. Surprisingly, KD and CR seem to have opposite effects in healthy animals as well as animals with a history of experimental brain injury. We have found that KD increases the maximum intensity of pilocarpine-induced seizures, compared to both calorically restricted and unrestricted normal diets. CR, on the other hand, decreases the seizure-genic effect of pilocarpine. This results in a continuum in which calorically restricted animals exhibit the weakest, and KD-fed animals the strongest seizures. To our knowledge, the effects of calorically-restricted and ketogenic diets on pilocarpine-induced seizures have not been previously studied. In other well established models of epilepsy, KD either attenuates or has little effect on seizure intensity.
Background. The ketogenic diet (KD) has been used for almost 100 years in the treatment of drug-resistant epilepsy in children - and adults. The intestinal microbiome has a climax character, and the main factor changing its composition and functions is the diet. Both increased biodiversity and the production of short-chain fatty acids (SCFAs) are important indicators of gut barrier function. SCFAs are synthesized by microorganisms through the fermentation of dietary fibre provided with the diet. They are an important element in signal transduction from the digestive system to other tissues. To date, there is little research to determine how the use of KD alters the SCFAs profile of the human stool. Objective. To assess the SCFAs profile in the stool of healthy and active KD users. Material and methods. Study group: amateur athletes following KD. Control group: amateur athletes following a regular diet (carbohydrates min. 50%); gender: men and women aged 18-60. Material: stool sample (1x10 g). SCFAs content was determined in stool samples using gas chromtography method. Participants completed a Food Frequency Questionnaire (FFQ) and a 72-hour food diary. Results. There research has shown differences in the amount of SCFAs, as far as the results obtained from the two groups are concerned. The discrepancies referred to the levels of acetic, butyric, iso-butyric, valeric, and isovaleric acids. Spearman's rank correlation analysis showed a strong relationship between the consumption of selected dietary components (vegetables, fruits, red meat, poultry, fish, nuts and seeds, sugar, sugar substitutes, fats) and the SCFAs content in the stool of the study group. Conclusions. High consumption of cruciferous and leaf vegetables, berries and nuts on a ketogenic diet may have a positive effect on the profile of short-chain fatty acids produced by the gut microbiome. Changing the diet towards a greater supply of plant products may prevent proteolytic fermentation and reduce the negative effects of microbiome changes caused by an oversupply of protein and fat in the ketogenic diet.
Ketogenic Diet is effective in the treatment of epilepsy in both children and adults. KD increases the effectiveness of conventional therapies and can be applied for the treatment of other diseases. Simultaneously, KD is cheaper and does not possess as many adverse effects as conventional medicine.
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