Format

Send to

Choose Destination
NPJ Biofilms Microbiomes. 2019 Jan 23;5:5. doi: 10.1038/s41522-018-0073-2. eCollection 2019.

The ketogenic diet influences taxonomic and functional composition of the gut microbiota in children with severe epilepsy.

Author information

1
1Neuropediatric Department, Astrid Lindgren Children's Hospital, Karolinska Hospital, Stockholm, Sweden.
2
2Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA.
3
3Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden.
4
4Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
5
5Pediatric Gastroenterology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
6
6Department of Computer Science and Engineering, University of Washington, Seattle, WA 98195 USA.
7
7Blavatnik School of Computer Science, Tel Aviv University, 6997801 Tel Aviv, Israel.
8
8Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel.
9
9Santa Fe Institute, Santa Fe, NM 87501 USA.
10
10Center for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

Abstract

The gut microbiota has been linked to various neurological disorders via the gut-brain axis. Diet influences the composition of the gut microbiota. The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet established for treatment of therapy-resistant epilepsy in children. Its efficacy in reducing seizures has been confirmed, but the mechanisms remain elusive. The diet has also shown positive effects in a wide range of other diseases, including Alzheimer's, depression, autism, cancer, and type 2 diabetes. We collected fecal samples from 12 children with therapy-resistant epilepsy before starting KD and after 3 months on the diet. Parents did not start KD and served as diet controls. Applying shotgun metagenomic DNA sequencing, both taxonomic and functional profiles were established. Here we report that alpha diversity is not changed significantly during the diet, but differences in both taxonomic and functional composition are detected. Relative abundance of bifidobacteria as well as E. rectale and Dialister is significantly diminished during the intervention. An increase in relative abundance of E. coli is observed on KD. Functional analysis revealed changes in 29 SEED subsystems including the reduction of seven pathways involved in carbohydrate metabolism. Decomposition of these shifts indicates that bifidobacteria and Escherichia are important contributors to the observed functional shifts. As relative abundance of health-promoting, fiber-consuming bacteria becomes less abundant during KD, we raise concern about the effects of the diet on the gut microbiota and overall health. Further studies need to investigate whether these changes are necessary for the therapeutic effect of KD.

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center