NN. Danial, AL. Hartman, CE. Stafstrom and LL. Thio (2013). How does the ketogenic diet work? Four potential mechanisms. Journal of child neurology, 28(8), 1027-33. https://doi.org/10.1177/0883073813487598

PubMed 23670253

[Abstract]
The ketogenic diet and its newer variants are clinically useful in treating epilepsy. They can also have antiepileptogenic properties and can eventually have a role in treating other neurologic and nonneurologic conditions. Despite being nearly a century old, identifying the molecular underpinnings of the ketogenic diet has been challenging. However, recent studies provide experimental evidence for 4 distinct mechanisms that could contribute to the antiseizure and other beneficial effects of these diets. These mechanisms include carbohydrate reduction, activation of adenosine triphosphate (ATP)-sensitive potassium channels by mitochondrial metabolism, inhibition of the mammalian target of rapamycin pathway, and inhibition of glutamatergic excitatory synaptic transmission.