A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder

PHYSIOLOGY & BEHAVIOR

卷:188

Article

Lee, Ryan W. Y.^1,2,3  Corley, Michael J.⁵  Pang, Alina⁵  Arakaki, Gaye⁶  Abbott, Lisa³  Nishimoto, Michael¹  Miyamoto, Rob³  Lee, Erica⁵  Yamamoto, Susan³  Maunakea, Alika K.⁵  Lum-Jones, Annette⁵  Wong, Miki^3,4 

[1] Shriners Hosp Children, Med Staff Dept, Honolulu, HI USA

[2] Univ Hawaii, Dept Pediat, John A Burns Sch Med, Honolulu, HI 96822 USA

[3] Shriners Hosp Children, Res Dept, Honolulu, HI USA

[4] Shriners Hosp Children, Nutr Serv Dept, Honolulu, HI 96826 USA

[5] Univ Hawaii, John A Burns Sch Med, Dept Nat Hawaiian Hlth, Honolulu, HI 96822 USA

[6] Shriners Hosp Children, Rehabil Dept, Honolulu, HI USA

关键词: Autism;    Ketogenic diet;    Neurodevelopment;    Therapy;    Intervention;    High fat;   

DOI  :  10.1016/j.physbeh.2018.02.006

来源: Elsevier

【 摘 要 】

Purpose: The ketogenic diet is a low-carbohydrate, moderate protein, high-fat diet that has emerged as a potential treatment for autism spectrum disorder. Autism spectrum disorder is a neurodevelopmental disorder of social communication, and restricted, repetitive behaviors and interests in need of novel therapies. An open-label clinical trial was done in Honolulu, Hawaii to test a modified ketogenic diet for improvement of core clinical impairments in children with ASD. Intervention: A modified ketogenic gluten-free diet regimen with supplemental MCT was completed in 15 children ages 2 to 17 years for 3 months. Clinical (ADOS-2, CARS-2) and biochemical measures were performed at baseline and 3-months on the ketogenic diet. Main outcome: Children administered a modified ketogenic gluten-free diet with supplemental MCT significantly improved core autism features assessed from the ADOS-2 after 3 months on diet (P = 0.006). No significant difference was observed in restricted and repetitive behavior score (P = 0.125) after 3 months on the diet protocol. Substantial improvement (> 30% decrease ADOS-2 total score) was observed in six participants, moderate improvement (> 3 units) in two participants, and minor/no improvement in seven participants. Ten participants assessed at a six-month time point sustained improvement in total ADOS-2 and social affect sub-domain scores comparing baseline and 6 months (P = 0.019; P = 0.023), but no significant improvement in restricted and repetitive behavior scores were noted (P = 0.197). Significant improvements in CARS-2 items after 3 months of the modified ketogenic protocol were observed in imitation, body use, and fear or nervousness (P = 0.031, P = 0.008, P = 0.039). The percent change on ADOS-2 score from baseline to 3 months was associated with baseline high-density lipoprotein levels (rho = 0.67, P = 0.007) and albumin levels (rho = 0.60, P = 0.019). Moreover, the percent change from baseline to 3 months in ADOS-2 scores was significantly associated with percent change in high-density lipoprotein levels (rho = 0.54, P = 0.049) and albumin levels (rho = 0.67, P = 0.010). Conclusions: A modified gluten-free ketogenic diet with supplemental MCT is a potentially beneficial treatment option to improve the core features of autism spectrum disorder and warrants further investigation.

【 授权许可】

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