Plain language summary
A ketogenic diet is a high fat diet recommended as an alternative therapy for infants with refractory (uncontrolled) epilepsy. Research has demonstrated that gut microbiota is affected by diet, particularly diets high in fat. According to various studies on gut brain axis, the gut microbiota may also effect children’s neurodevelopment. The aim of this study is to investigate the difference in the gut microbiota of infants who have refractory epilepsy with healthy infants, and the effect of ketogenic diet on the gut microbiota. 14 subjects with refractory epilepsy, as well as 15 healthy male and 15 healthy female infants under 3 years were recruited for this study. On analysis the gut microbiota of healthy infants had greater microbial diversity in comparison to epileptic infants. The intervention of a ketogenic diet showed significant improvement in reducing the pathogenic bacteria and increasing beneficial Bacterioidetes, though the authors concluded that a ketogenic diet as an alternative treatment for epileptic seizures needs further research.
Abstract
AIM: To investigate whether patients with refractory epilepsy and healthy infants differ in gut microbiota (GM), and how ketogenic diet (KD) alters GM. METHODS A total of 14 epileptic and 30 healthy infants were recruited and seizure frequencies were recorded. Stool samples were collected for 16S rDNA sequencing using the Illumina Miseq platform. The composition of GM in each sample was analyzed with MOTHUR, and inter-group comparison was conducted by R software. RESULTS After being on KD treatment for a week, 64% of epileptic infants showed an obvious improvement, with a 50% decrease in seizure frequency. GM structure in epileptic infants (P1 group) differed dramatically from that in healthy infants (Health group). Proteobacteria, which had accumulated significantly in the P1 group, decreased dramatically after KD treatment (P2 group). Cronobacter predominated in the P1 group and remained at a low level both in the Health and P2 groups. Bacteroides increased significantly in the P2 group, in which Prevotella and Bifidobacterium also grew in numbers and kept increasing. CONCLUSION GM pattern in healthy infants differed dramatically from that of the epileptic group. KD could significantly modify symptoms of epilepsy and reshape the GM of epileptic infants.
Methodological quality
Allocation concealment
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Not applicable
