6 months of keto diet shows promising trends for Angelman children
But more study needed after eating less sugar, more fats proves inconclusive
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Following a low-sugar, high-fat eating plan — known as a ketogenic, or keto, diet — may benefit children with Angelman syndrome, though more research is needed to know for sure, according to the findings of a new study from Spain.
In the small trial, dubbed DIANE, children with Angelman were assigned to follow a ketogenic eating plan or their normal diet for about six months, with a battery of neurological and cognitive assessments done before and after its start. The results showed that youngsters on the keto diet showed trends toward improvement in some measures.
“Global improvements were identified in several variables evaluated at six months in the [keto] group, and no serious adverse reactions attributable to the diet were reported,” the researchers wrote.
However, the differences were not statistically significant — meaning that, mathematically, there’s a nonnegligible probability that these differences could be due to random variation, rather than a therapeutic effect from the diet.
Given that the findings are not definitively conclusive one way or the other, the researchers called for additional studies with more patients to further explore the potential benefits of ketogenic diets for people with Angelman.
“Although a trend toward greater evolutionary improvement was observed in the [ketogenic diet] group compared to the habitual diet group, these differences were not statistically significant … and cannot be solely attributed to the low-[sugar] ketogenic diet,” the researchers wrote.
The study, “Efficacy and tolerability of a low-glycemic-index ketogenic diet in Angelman syndrome: findings from the DIANE study,” was published in the Orphanet Journal of Rare Diseases.
Angelman syndrome is a genetic disorder that’s marked by abnormalities in behavior and development. Patients also often experience seizures. With no cure, treatment for Angelman focuses on managing disease symptoms and supporting patients and their families to allow the best possible quality of life.
A ketogenic diet involves consuming more fats and very little sugar, while ensuring adequate intake of protein and other essential nutrients. The goal of this dietary strategy is to shift the body into a state known as ketosis, where cells primarily burn fat for energy instead of sugar. This metabolic shift can help reduce stress on certain nerve cells, and as such, the ketogenic diet is an established treatment used to control certain forms of epilepsy, or disorders characterized by seizures.
Some data suggest a keto diet may help reduce seizure risk
There are some data suggesting that a ketogenic diet may be effective for Angelman patients to help reduce the risk of seizures. However, evidence for the potential benefit of this dietary strategy in children remains limited. To learn more, scientists in Madrid conducted a small clinical trial that ultimately involved 17 children with Angelman.
In the trial, nine of the youngsters followed a ketogenic diet, designed with the aid of a nutritional specialist, for about six months. Another eight children, serving as controls, followed their typical diet for the same duration. At the start and end, these pediatric patients underwent a battery of assessments, including the Bayley Scales of Infant and Toddler Development-III, a measure of development.
In children on the ketogenic diet, scores related to cognitive and communication abilities tended to improve relative to those seen in patients who didn’t follow a special diet. However, the difference between the groups was not statistically significant.
”These preliminary results do not support recommending the low-[sugar] ketogenic diet as a generalized treatment for cognitive improvement in AS patients. Further studies with larger sample sizes and robust designs are needed to evaluate the potential impact of this intervention in this [pediatric] population.
Rates of qualitative improvement in measures of brain electrical activity were also higher among patients on the keto diet; however, these differences also weren’t significant. Over the course of the six-month study, seizures were reported in one child following the ketogenic diet and one child in the control group.
In parent-rated measures, parents of children who followed the ketogenic diet tended to report less stress than parents of children in the control group, but again, the differences weren’t statistically significant.
Overall, the researchers said this study identified some promising trends. However, because none of the differences were statistically significant, it’s impossible to say for sure whether these trends are true benefits from the diet or just random chance. As such, the scientists called for additional, larger studies to further investigate the effects of this type of diet for children with Angelman.
“These preliminary results do not support recommending the low-[sugar] ketogenic diet as a generalized treatment for cognitive improvement in AS patients. Further studies with larger sample sizes and robust designs are needed to evaluate the potential impact of this intervention in this population,” the researchers wrote.
