Abstract, published in Epilepsy Research
The ketogenic diet has been used to treat intractable epilepsy for many years, yet the mechanism(s) underlying its effectiveness have not been completely explained. Emerging evidence indicates that the ketogenic diet may correct or otherwise alter a gut microbiota whose fecal microbial composition is different from that in healthy individuals.
Recent studies in animal seizure models also reveal an altered gut microbiome, and, interestingly, changes in the composition of the microbiota after ingestion of a ketogenic diet. The effectiveness of the ketogenic diet in these animal models appears to be absolutely dependent on the presence of gut microbiota. Further evidence suggests that effectiveness of the ketogenic diet in controlling seizures may rely on the ability of specific bacterial populations to alter a particular chemical modification of amino acids, the building blocks of proteins, and thus alter their movement into the central nervous system. These studies suggest new directions for research in patients with epilepsy.