If doing “therapeutic keto,” do the resulting gut biome changes contribute to the therapeutic benefit or should the gut biome be sustained through periodic refeeding of the biome via prebiotics, postbiotics , resistant starches?
A nutritionist just told me that the changes to the gut in therapeutic keto for epilepsy increases GABA production in the brain and that is believed to be at least part of the benefit. I can NOT find the study stating this.
nature.com/articles/s41522-...
“There have been a number of studies trying to elucidate the mechanisms of action of KD. Evidence for the involvement of the microbiome in seizure susceptibility and KD treatment has recently been presented in animal models. KD demonstrated anti-seizure efficacy in two epilepsy mouse models but not when the mice were raised germ-free.22Seizure susceptibility could be transferred by fecal microbial transplants (FMTs) in rats.23This finding was supported by a single case study where a patient became seizure-free for at least 20 months after an FMT for Crohn’s disease.“
So what changes are observed? ********Are the genus that are reduced with KD the same that PD patients have more of than healthy controls? ******
“The relative abundance of the genus Bifidobacterium was significantly decreased in patients after 3 months on KD. The species B. longum and B. adolescentis were significantly reduced but a similar trend was also observed for other bifidobacteria such as B. bifidum and B. catenulatum (data not shown).”
****Genes involved in carbohydrate metabolism are reduced with the keto diet. *****. So not just the bacteria but genes are being “reduced”
”Bifidobacteria are common to the healthy human gastrointestinal tract. They metabolize complex carbohydrates and possess one of the largest predicted glycobiomes25 including genes encoding for a specific hexose fermentation pathway called fructose-6-phosphate shunt or “bifid” shunt.26 This pathway is superior in the energy output produced to pathways used by other fermentative gut bacteria and provides a growth advantage for bifidobacteria in the presence of complex carbohydrates. These facts may explain the concomitant proportional decrease of bifidobacteria and genes involved in carbohydrate metabolism during KD.”
“population, their conclusion concurs with ours—a concern about detrimental effects of KD on gut health. They identify a potential need for recommendations on probiotic or prebiotic supplementation. Interestingly, probiotic treatment lead to a >50% reduction in the number of seizures in 28.9% of epilepsy patients in a recent study.”
**** but where the children with receiving the probiotic treatment also on keto? If no, that’s a leap, this is not evidence of the keto diet needing probiotic supplementation but evidence of the biome being altered being beneficial.***
Keto reduces seizures by upwards of 50% in approx 50% of children with epilepsy. Why only 50% of the children? Did the children who did not have seizure reduction or less of it, not have the same microbiome changes as those who had success with keto?
Does this then apply to PD? That keto might help 50% of PWP?
“52Thus supplementing patients on KD with such fibers might seem advisable. The prebiotics inulin, lactulose, FOS, and galacto-oligosaccharides have been investigated in several human trials, and studies suggest that these carbohydrates preferentially increase bifidobacteria and decrease E. coli and enterococci.53 This might prevent undesired changes in the gut microbiota in our patients. However”
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