Fewer carbs, more fat: ketogenic diet makes migraine patients' headaches disappear
The diet was originally developed for childhood epilepsy a century ago and is now studied to treat migraines.
Before the ketogenic diet became the latest low-carb diet trend, it was used to treat childhood epilepsy. Doctors had observed that fasting reduced the number of seizures, and eating mainly fat and little else mimicked the effect of starvation in the brain. In recent years, researchers have made similar positive observations with migraines. Cherubino Di Lorenzo studies the effect of a ketogenic diet on migraine patients and, in his latest paper (https://www.researchgate.net/publication/303711260_Cortical_functional_correlates_of_responsiveness_to_short-lasting_preventive_intervention_with_ketogenic_diet_in_migraine_A_multimodal_evoked_potentials_study), their brains at the Sapienza University of Rome.
Di Lorenzo: After we saw these effects, we decided to confirm our findings in a large population of patients. We studied two groups of migraineurs who visited the dietician for the weight-loss and evaluated the effect of a ketogenic and a non-ketogenic diet on their migraines. Our dietician strictly followed the protocol of an Italian Society of Medical Dieting (SDM) that says to restrict the ketogenic diet to one month, followed by a five month long non-ketogenic phase of dieting. We observed that the headaches dramatically improved only during the ketogenic phase of the diet, and worsened again at the end of that month. We concluded that the ketogenic diet was the reason for that improvement.
However, we are not sure that the reason why the ketogenic diet works so well in our patients is only due to the ketone body production. In fact, we have observed that in a majority of cases, our patients also show abnormal results in oral glucose tolerance tests both in the way their blood sugar and their insulin levels responds to sugar intake. Since carbs are a form of sugar, a low-carb diet could mitigate these responses. Our hypothesis is that the combination of ketone bodies and changed glucose response could lead to the outstanding therapeutic effect we have observed in our patients.
Di Lorenzo: There are not particular risks for patients who follow the diet. Apart from type I diabetes patients, there are not contraindications for it. As I mentioned, the ketogenic diet is better tolerated than common pharmacological prophylactic treatments.