Ketogenic diet - biochemical aspects and anticonvulsant mechanisms

Въведение: Кетогенна диета представлява нисковъглехидратна диета с повишен прием на мазнини. Още от създаването си се прилага за целите на медицината, за терапия с антиконвулсивен ефект при деца с епилепсия. Последните научни доклади дават данни за благоприятното й въздействие върху няколко мета-болитни, невродегенеративни разстройства, увеличава се и интересът към използването й в психиатрията. Цел: Целта на настоящата разработка е да представи характеристика на биохимичните аспекти на кетогенната диета, както и механизмите на антиконвулсивната й ефективност. Материали и методи: За целите на литературния обзор е направена справка с 28 научни статии на английски език. Резултати и обсъждане: Въпреки почти 100-годишното си приложение в клиничната практика причината за антиконвулсивния и другите терапевтични ефекти на кетогенната диета не са напълно изяснени. Основните метаболитни и биохимични изменения, които се на блюдават по време на кетогенното хранене, са формиране на високи нива на кетони, полиненаситени мастни киселини и γ-аминомаслената киселина GABA, която е основният инхибиторен невротрансмитер в мозъка на бозайниците. В същото време поради нисковъглехидратното хранене нивата на глюкозата в организма значително се понижават. Голям брой научни доклади от създаването на диетата до днес активно проучват биохимичните аспекти на тези изменения, както и ролята им в наблюдавания терапевтичен ефект от кетогенното хранене. Заключение: Кетогенната диета се прилага като успешна алтернативна или помощна терапия при голям брой пациенти по света. Механизмите на нейната ефективност предизвикват голям научен интерес, както и оптимизирането й за повече пациенти и техните семействата.Introduction: The ketogenic diet is a low-carbohydrate diet with increased fat intake. Since its inception, it has been applied for medical purposes for anticonvulsant therapy among children with epilepsy. Recent scientific reports provide evidence of its beneficial effects on several metabolic, neurodegenerative disorders, resulting in increased interest in its use in psychiatry. Aim: The aim of the article is to present the biochemical aspects of the ketogenic diet as well as the mechanisms of its anticonvulsant efficacy. Materials and Methods: For the purposes of the literature review, 28 scientific papers were reviewed. Results and Discussion: The cause of the anticonvulsant and other therapeutic effects of the ketogenic diet has not been fully elucidated, despite it being applied for almost 100 years. The major metabolic and biochemical changes observed during ketogenic feeding are the formation of high levels of ketones, polyunsaturated fatty acids and γ-aminobutyric acid GABA, which is the major inhibitory neurotransmitter in the mammalian brain. At the same time, glucose levels in the body significantly decrease as a result of the low-carbohydrate nutrition. A large number of scientific reports from the creation of the diet to today have been actively studying the biochemical aspects of these changes as well as their role in the observed therapeutic effect as a result of ketogenic nutrition. Conclusion: Ketogenic diet has being applied as a successful alternative or adjunct therapy among large number of patients worldwide. Its effective mechanisms provoke great interest, as well as its optimization for more patients and families

KETOGENIC DIET – FROM THE IMPLEMENTATION IN CLINICAL PRACTICE TO NOWADAYS

Introduction: The ketogenic diet (KGD) is a high-fat, adequate-protein, low-carbohydrate diet. In 1920`s the diet was developed to treat difficult-to-control epilepsy in children. Nowadays its efficacy has been proven in many other diseases, such as metabolic disorders, brain tumours, autism, Rett syndrome, and in other areas, it has been actively studied. Aim: The aim of this article is to represent the historical review of the therapeutic implication of KGD, as well as to reveal the contemporary clinical trends in which it is being used. Material and Methods: A literature review of 96 scientific reports in English has been made. Results and Discussion: The KGD was developed in the early 1920s. In the period 1970-1990, the therapeutic use of the diet was discontinued, due to the breakthrough of the new anticonvulsants for epilepsy. The interest in KGD was recovered after a meeting of the “American Epilepsy Society” in 1996. The diet demonstrates anticonvulsant efficacy in epilepsy therapy. According to a survey in 2013, the incidence of seizures among half of the number of children was reduced by at least a half, and 15% of them were completely discontinued. The diet is also used in the treatment of metabolic diseases, such as GLUT 1-deficiency syndrome, reducing the incidence of seizures, improving muscle coordination and concentration. It is also effective in pyruvate dehydrogenase deficiency syndrome by replacing the major energy source - glucose with ketones. Along with these, it is also used in patients with autism (in approximately 60% of patients it improves learning ability and social skills), Rett syndrome, Alzheimer's disease, Parkinson's disease, and others. Its mechanism of action is not fully clarified, as well as its degree of effectiveness in some areas. Conclusion: The ketogenic diet is widely implemented worldwide. It comprises a tremendous therapeutic potential that has been growing considerably during the past decades

The genomic history of southeastern Europe

Farming was first introduced to Europe in the mid-seventh millennium bc, and was associated with migrants from Anatolia who settled in the southeast before spreading throughout Europe. Here, to understand the dynamics of this process, we analysed genome-wide ancient DNA data from 225 individuals who lived in southeastern Europe and surrounding regions between 12000 and 500 bc. We document a west-east cline of ancestry in indigenous hunter-gatherers and, in eastern Europe, the early stages in the formation of Bronze Age steppe ancestry. We show that the first farmers of northern and western Europe dispersed through southeastern Europe with limited hunter-gatherer admixture, but that some early groups in the southeast mixed extensively with hunter-gatherers without the sex-biased admixture that prevailed later in the north and west. We also show that southeastern Europe continued to be a nexus between east and west after the arrival of farmers, with intermittent genetic contact with steppe populations occurring up to 2,000 years earlier than the migrations from the steppe that ultimately replaced much of the population of northern Europe.Iain Mathieson … Wolfgang Haak … David Reic