Short-term impact of a classical ketogenic diet on gut microbiota in GLUT1 Deficiency Syndrome: A 3-month prospective observational study

Clin Nutr ESPEN. 2017 Feb;17:33-37. doi: 10.1016/j.clnesp.2016.11.003. Epub 2016 Dec 18.

Abstract

Background&aims: The classical ketogenic diet (KD) is a high-fat, very low-carbohydrate normocaloric diet used for drug-resistant epilepsy and Glucose Transporter 1 Deficiency Syndrome (GLUT1 DS). In animal models, high fat diet induces large alterations in microbiota producing deleterious effects on gut health. We carried out a pilot study on patients treated with KD comparing their microbiota composition before and after three months on the diet.

Methods: Six patients affected by GLUT1 DS were asked to collect fecal samples before and after three months on the diet. RT - PCR analysis was performed in order to quantify Firmicutes, Bacteroidetes, Bifidobacterium spp., Lactobacillus spp., Clostridium perfringens, Enterobacteriaceae, Clostridium cluster XIV, Desulfovibrio spp. and Faecalibacterium prausnitzii.

Results: Compared with baseline, there were no statistically significant differences at 3 months in Firmicutes and Bacteroidetes. However fecal microbial profiles revealed a statistically significant increase in Desulfovibrio spp. (p = 0.025), a bacterial group supposed to be involved in the exacerbation of the inflammatory condition of the gut mucosa associated to the consumption of fats of animal origin.

Conclusions: A future prospective study on the changes in gut microbiota of all children with epilepsy started on a KD is warranted. In patients with dysbiosis demonstrated by fecal samples, it my be reasonable to consider an empiric trial of pre or probiotics to potentially restore the «ecological balance» of intestinal microbiota.

Keywords: Glucose Transporter 1 Deficiency Syndrome; Ketogenic diet; Microbiota.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Carbohydrate Metabolism, Inborn Errors / diagnosis
  • Carbohydrate Metabolism, Inborn Errors / diet therapy*
  • Carbohydrate Metabolism, Inborn Errors / microbiology
  • Child
  • Desulfovibrio / growth & development
  • Diet, Ketogenic* / adverse effects
  • Drug Resistant Epilepsy / diagnosis
  • Drug Resistant Epilepsy / diet therapy*
  • Drug Resistant Epilepsy / microbiology
  • Dysbiosis / microbiology
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Intestines / microbiology*
  • Male
  • Monosaccharide Transport Proteins / deficiency*
  • Pilot Projects
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Monosaccharide Transport Proteins

Supplementary concepts

  • Glut1 Deficiency Syndrome