A Review of Ketogenic Dietary Therapies for Epilepsy and Neurological Diseases: A Proposal to Implement an Adapted Model to Include Healthy Mediterranean Products
Cinzia Ferraris,
Monica Guglielmetti,
Lenycia de Cassya Lopes Neri,
Sabika Allehdan,
Jamila Mohammed Mohsin Albasara,
Hajar Hussain Fareed Alawadhi,
Claudia Trentani,
Simone Perna,
Anna Tagliabue
Affiliations
Cinzia Ferraris
Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, 27100 Pavia, Italy
Monica Guglielmetti
Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, 27100 Pavia, Italy
Lenycia de Cassya Lopes Neri
Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, 27100 Pavia, Italy
Sabika Allehdan
Department of Biology, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
Jamila Mohammed Mohsin Albasara
Department of Biology, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
Hajar Hussain Fareed Alawadhi
Department of Biology, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
Claudia Trentani
Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, 27100 Pavia, Italy
Simone Perna
Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20122 Milano, Italy
Anna Tagliabue
Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, 27100 Pavia, Italy
Based on the growing evidence of the therapeutic role of high-fat ketogenic dietary therapies (KDTs) for neurological diseases and on the protective effect of the Mediterranean diet (MD), it could be important to delineate a Mediterranean version of KDTs in order to maintain a high ketogenic ratio, and thus avoid side effects, especially in patients requiring long-term treatment. This narrative review aims to explore the existing literature on this topic and to elaborate recommendations for a Mediterranean version of the KDTs. It presents practical suggestions based on MD principles, which consist of key elements for the selection of foods (both from quantitative and qualitative prospective), and indications of the relative proportions and consumption frequency of the main food groups that constitute the Mediterranean version of the KDTs. We suggest the adoption of a Mediterranean version of ketogenic diets in order to benefit from the multiple protective effects of the MD. This translates to: (i) a preferential use of olive oil and vegetable fat sources in general; (ii) the limitation of foods rich in saturated fatty acids; (iii) the encouragement of high biological value protein sources; (iv) inserting fruit and vegetables at every meal possible, varying their choices according to seasonality.
