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Chapter 5

"A Ketogenic Diet and the Treatment of Autism Spectrum Disorder"

by Dr. Lee Gwang-jo · ✓ Free

"A Ketogenic Diet and the Treatment of Autism Spectrum Disorder"

A Ketogenic Diet and the Treatment of Autism Spectrum Disorder

Qinrui Li, Jingjing Liang, Na Fu, Ying Han, & Jiong Qin (2021). Frontiers in Pediatrics, 9, 650624.

Dr. Lee The third paper we'll examine is "A Ketogenic Diet and the Treatment of Autism Spectrum Disorder" (Li et al., 2021). It is a review paper on ketogenic diets and ASD. The authors introduce 7 studies that report improvement (Table 5-2). Across age groups from 2 to 17, the seven papers report improvements in cognition, social skills, and language; some report cessation of seizures and reductions in autism symptoms. As mechanisms behind the autism improvement effects, the authors propose improved energy metabolism, anti-inflammatory and antioxidant action, neurotransmitter regulation, autophagy promotion, and gut microbiome modulation (Figure 5-11). Among the neurotransmitters, they report that GABA — the inhibitory neurotransmitter — is increased.

Table 5-2. Seven studies reporting autism improvement effects

Subjects	Diet	Duration	Outcome	Source
Children with autism and epilepsy	Gluten- and casein-free ketogenic	14 months	Improvement in cognition, social skills, language; seizures stopped	J Child Neurol. (2013) 28:975–82
6-year-old child	Ketogenic	16 months	Improved behavior and intelligence; increased glucose uptake throughout cortex	Metab Brain Dis. (2018) 33:1187–92
15 children (2–17 yr)	MCT-modified ketogenic, gluten-free	3 months	Improvement in autistic symptoms; restricted/repetitive scores unchanged	Physiol Behav. (2018) 188:205–11
45 children (3–8 yr)	G1: Atkins-modified ketogenic; G2: gluten- & casein-free; G3: standard	6 months	Improvement in ATEC and CARS scores in Groups 1 and 2	Metab Brain Dis. (2017) 32:1935–41
6 patients with autism	Ketogenic	—	1 dramatic improvement (CARS 41 → 21); others modest	Front Hum Neurosci. (2013) 7:858
30 children (4–10 yr)	Ketogenic	6 months	CARS improvement in 18	J Child Neurol. (2003) 18:113–8
Severely developmentally disabled male	Modified Atkins	1 year	Seizures stopped; autism symptoms improved; behavioral problems disappeared	Duodecim. (2010) 126:557–60

[Figure 5-11]

Pathways through which the ketogenic diet may improve autism spectrum disorder.

Ketogenic diet → Gut-microbiome modulation (↑ beneficial bacteria) · Energy metabolism (↑ ATP) · Anti-inflammatory/Antioxidant · Neurotransmitter regulation (↑ GABA) · mTOR signaling inhibition (↓ seizures).

References marked with [number] in the text will be organized and added later.

※ Detailed sources and academic references can be checked in the book Appendix.

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