J. Albers, G. Kraja, D. Eller, K. Eck, D. McBrian and JM. Bain (2023). Assessing the feasibility of using the ketogenic diet in autism spectrum disorder. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 36(4), 1303-1315. https://doi.org/10.1111/jhn.13115

PubMed 36478324

[Abstract]
BACKGROUND: Evidence demonstrating efficacy of dietary interventions for autism spectrum disorder (ASD) remains inconsistent. Recent research on the ketogenic diet (KD) for the treatment of ASD has suggested a benefit. Children with ASD often demonstrate ritualised food-specific behaviours, taste and texture aversions, and an increased prevalence of food restrictions and allergies. There is a need to investigate how these features contribute to initiation and adherence of the KD. Two surveys were administered to assess the feasibility of utilising the KD for ASD.

METHODS: First, paper surveys were given to caregivers of children presenting to outpatient neurology clinics. Next, experienced clinicians were recruited and surveyed online using Qualtrics. Chi-squared analysis was used to compare ASD and non-ASD caregiver responses. Descriptive metrics were used to present clinician responses. Responses to each question were evaluated individually.

RESULTS: One hundred and fourteen surveys were collected from caregivers. There were no significant differences in (1) stated feasibility of adopting a new diet, (2) a carbohydrate restricted diet, (3) diet restrictions, (4) documented allergies or (5) personal/cultural restrictions between groups with and without ASD. Seventy clinician responses were collected. The majority (67.4%) indicated that feasibility for a child with ASD to adopt a KD for any reason depends on ASD severity. Some respondents 73% rated adherence to the KD as more difficult compared to age-matched controls, whereas 26% considered it similar. Multiple familial and child characteristics were rated as increasing the difficulty of successful KD.

CONCLUSIONS: The results of the present study suggest that it is feasible for children with ASD to adopt a KD, and success is highly individualised to child and family.