Ketogenic diet as a therapeutic approach in autism spectrum disorder: a narrative review

The ketogenic diet (KD) originated in the 1920s. It is a dietary model that is low in carbohydrates, adequate in protein, and high in fat content. The diet mimics starvation and increases the production of ketone bodies, leading to ketosis in metabolism. KD is used as an anticonvulsant treatment approach in patients with drug-resistant epilepsy. In addition, it is thought that a KD may have therapeutic potential in the treatment of neurological disorders, including autism spectrum disorders (ASD). Numerous recent studies have demonstrated that a KD can improve behavioural parameters in individuals with ASD. This review aims to address the potential mechanisms of action of the KD and to examine the effects of the KD on individuals diagnosed with ASD. It is likely that this role is mediated through improvements in energy metabolism, reduction of pro-inflammatory cytokine levels, control of neurotransmitters, gene expression and modulation of the gut microbiota. Based on the available evidence, a KD appears to be a safe and effective treatment for ASD.