Wikipedia ketogenic diet
This article is about a dietary therapy for epilepsy. Most commonly, ketoacidosis is diabetic ketoacidosis (DKA), resulting from increased fat metabolism due to a shortage of insulin. Alcoholic ketoacidosis (AKA) presents infrequently, but can occur with acute alcohol intoxication, most often following a binge in alcoholics with acute or chronic liver or pancreatic disorders. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant drugs. Red blood cells do not contain mitochondria and are therefore entirely dependent on glycolysis for their energy requirements. However, the brain makes immediate use of ketones for lipid synthesis in the brain. Fatty acids are very high energy fuels, and are taken up by all metabolizing cells which have mitochondria. Fatty acids can only be metabolized in the mitochondria. This occurs between meals, during fasting, starvation and strenuous exercise, when blood glucose levels are likely to fall. The ketone bodies pass into the brain and replace glucose as an energy source. The diet forces the body to burn fats rather than carbohydrates. In the liver oxaloacetate is wholly or partially diverted into the gluconeogenic pathway during fasting, starvation, a low carbohydrate diet, prolonged strenuous exercise, and in uncontrolled type 1 diabetes mellitus. However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. If the diet is changed from one that is high in carbohydrates to one that does not provide sufficient carbohydrate to replenish glycogen stores, the body goes through a set of stages to enter ketosis.
Ketone bodies: acetone, acetoacetic acid, and beta-hydroxybutyric acid. However, if there is very little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. This might affect, for example, the muscles, the senses, consciousness, or a combination. In all other tissues the fatty acids that enter the metabolizing cells are combined with co-enzyme A to form acyl-CoA chains. This results in the complete combustion of the acetyl-CoA to CO 2 and water. Fats stored in adipose tissue are released from the fat cells into the blood as free fatty acids and glycerol when insulin levels are low and glucagon and epinephrine levels in the blood are high. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain-function. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. The ketogenic diet is a high- fat, adequate- protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. During the initial stages of this process, blood glucose levels are maintained through gluconeogenesis, and the adult brain does not burn ketones. For information on ketogenic diets as a lifestyle choice or for weight loss, see Low-carbohydrate diet and No-carbohydrate diet.
