Thread by @KetoCounselor

Twitter Thread Alert! 🧵It's time for a mini-review of the literature on the use of #ketogenic diets and #Autism. Now some of you identify as neurodivergent and are not interested in modifying these differences. #neurotwitter 1/29

You may also not want to participate in a discussion that sees these differences as pathology. If that is the case, this is not the thread for you. I am not interested in hosting that philosophical discussion in this thread. 2/29 #boundaries

This thread is for people who are experiencing distress around what they experience as symptoms, and they deserve to know all the ways they can feel better. And I am going to tell them. So with that caveat, let's begin.👇3/29

This first one looked at the role of the ketogenic diet on the behavior of children with Autism. It was a pilot prospective follow-up study carried out on 30 children (ages 4-10) with autistic behavior. 4/29

6 months long, with continuous administration for 4 weeks, interrupted by 2-week diet-free intervals. 7 participants could not tolerate the diet, but 5 did adhere to the diet for 1-2 months and then discontinued it. 5/29

Of the 18 who adhered to the diet, improvement was seen in ALL participants in several parameters of the Childhood #Autism Rating Scale. 6/29

2 participants experienced>12 units of improvement on the scale
8 participants experienced an average improvement of >8-12 units
8 other participants experienced minor improvement between 2-8 units 7/29

The data was preliminary (2005) but shows some evidence that the ketogenic diet can be used to treat autistic behavior as an additional or alternative therapy. I don't know if any drugs that can replicate these results. Do you? 8/29 doi.org/10.1177/088307…

Here is another one. A case-control study in 45 children with Autism Spectrum Disorder (ASD) that looked at the effect of a Modified-Atkins #ketogenic diet, a casein and gluten-free diet and a control group. 9/29

Those on the ketogenic diet improved as measured by the Childhood Autism Rating Scale scores AND Autism Treatment Evaluation Checklist scores. 10/29

The study found that the Modified Atkins #ketogenic diet was superior in Childhood Autism Rating Scale improvement compared to the gluten-free, casein-free diet. 11/29 doi.org/10.1007/s11011…

A small but recent (2018) clinical trial in 15 children with #Autism investigated the effect of a modified gluten-free #ketogenic diet supplemented with #MCT providing #ketosis for 3 months. 12/29

The children significantly improved in comparison scores, total scores, and social affect categories of the Autism Diagnostic Observations Schedule. They also improved imitation and body function measured on the Childhood Autism Rating Scale after 3 months. 13/29

At 6 months, 10 of the participants maintained this improvement of scores in the Autism Diagnostic Observation Schedule. However, no difference was observed for restricted and repetitive behaviors. 14/29

Caregivers reported improvement in sociability, focus, and hyperactivity. Which is a big win for these families. 15/29 doi.org/10.1016/j.phys…

Let's look at another study, published super recently and basically supports @ChrisPalmerMD 's theory that metabolism plays an important role #brainenergy 16/29

@ChrisPalmerMD Are individuals with autism at a higher associated risk of developing cardiometabolic diseases, including diabetes, hypertension, dyslipidemia, and macrovascular atherosclerotic disease? 17/29

@ChrisPalmerMD This systematic review and meta-analysis of 34 studies would say absolutely. jamanetwork.com/journals/jamap… 18/29

@ChrisPalmerMD Relative risks (RRs) of diabetes, hypertension, dyslipidemia, and atherosclerotic macrovascular disease among individuals with autism were the primary outcomes. 19/29

@ChrisPalmerMD Secondary outcomes included the RR of type 1 and type 2 diabetes, heart disease, stroke, and peripheral vascular disease. 20/29

@ChrisPalmerMD A total of 34 studies were evaluated and included 276,173 participants with autism and 7,733,306 participants without autism. 21/29

@ChrisPalmerMD Autism was associated with greater risks of developing diabetes overall (RR, 1.57; 95% CI), type 1 diabetes (RR, 1.64; 95% CI), and type 2 diabetes (RR, 2.47; 95% CI). 22/29

@ChrisPalmerMD Autism was also associated with increased risks of dyslipidemia (RR, 1.69; 95% CI) and heart disease (RR, 1.46; 95% CI). 23/29

@ChrisPalmerMD There was no significantly associated increased risk of hypertension (RR, 1.22; 95% CI) and stroke with autism (RR, 1.19; 95% CI). 24/29

@ChrisPalmerMD Meta-regression analyses revealed that children with autism were at a greater associated risk of developing diabetes and hypertension compared with adults. 25/29

@ChrisPalmerMD Is a ketogenic diet feasible in a child with autism? This article says yes, with the caveat that it is more difficult depending on disease severity. 16/19 doi.org/10.1111/jhn.13…
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@ChrisPalmerMD If you want to dive deep into the underlying mechanisms likely involved in these improvements, I recommend this book chapter ⬇️ 27/29

@ChrisPalmerMD CHENG, N., @MasinoSusan & RHO, J. M. (2022). Ketogenic Diet, Social Behavior, and Autism. Ketogenic Diet and Metabolic Therapies: Expanded Roles in Health and Disease, 154.
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@ChrisPalmerMD @MasinoSusan I hope this thread helps you on your journey to know all the ways you and/or your child can feel better! 29/29 #autism #ketogenic #research #brainhealthmatters