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. 2023 Aug;36(4):1303-1315.
doi: 10.1111/jhn.13115. Epub 2023 Jan 22.

Assessing the feasibility of using the ketogenic diet in autism spectrum disorder

Jacob Albers  1   2 , Gearta Kraja  2 , Danielle Eller  2 , Karen Eck  2 , Danielle McBrian  2 , Jennifer M Bain  2
Affiliations

Assessing the feasibility of using the ketogenic diet in autism spectrum disorder

Jacob Albers et al. J Hum Nutr Diet. 2023 Aug.

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.

Keywords: autism; feasibility; ketogenic diet.

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References

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