Who invented the ketogenic diet?

No, the ketogenic diet is not a newfangled phenomenon for losing weight. It is not a crash diet or a passing trend.

The ketogenic diet, or KD, has been used to treat childhood and adolescent epilepsy for nearly one hundred years. Already in ancient times, it had been found that fasting could reduce the frequency of seizures in epilepsy sufferers. In the 5th century B.C., the Greek physician Hippocrates noted in his records that patients’ conditions improved when they completely abstained from food. However, this knowledge was then not used for a long time.

In 1911, the French physicians Guillaume Guelpa and Auguste Marie published a scientific paper on the effect of abstaining from food in epilepsy: “La lutte contre l’épilepsie par la désintoxication et par la rééducation alimentaire” (“The fight against epilepsy by detoxification/withdrawal and nutritional re-education”). However, fasting could not be maintained indefinitely and as soon as it was interrupted, the seizures returned. Therefore, a method was sought to mimic the biochemical effects of fasting without having to completely abstain from food. In 1921, American physician Russell M Wilder first performed a ketogenic diet on child and adolescent patients at the Mayo Clinic in Minnesota. It was he who coined the term ” ketogenic diet”. This diet, like fasting, resulted in seizure reduction. Its advantage was that it made it possible to supply the patient with energy and nutrients.

From then on, the ketogenic diet was used at the Mayo Clinic as a regular treatment for childhood and adolescent epilepsy and spread across America. With the development of drugs for epilepsy (anticonvulsant drugs, anticonvulsants) especially phenytoin in 1938, KD increasingly took a back seat and for decades was seen only as a very last resort. It was used when the patient had so-called pharmacoresistant epilepsy, i.e., did not respond to any medication at all.

This is illustrated by a look at the studies published on KD in the last century. A search of a large database of scientific publications (PubMed) that I performed on Dec. 11, 2014, yielded 1287 hits. Specifically, I searched for “ketogenic diet”[Title/Abstract], which is any study that has the term “ketogenic diet” in the title or abstract. Looking at the distribution of studies over the years 1931-2014, it becomes clear that KD was known for a long time, but only came back into the focus of science since 1995. From that point on, the number of studies increased sharply until today. Most studies focus on the effect of the ketogenic diet on epilepsy, but KD has also been used and studied as a therapy for pyruvate dehydrogenase deficiency and GLUT-1 deficiency syndrome for some time. In recent years, other areas of application have also been continuously propagated: For example, metabolic syndrome, neurodegenerative diseases and cancer.

Sometimes you get that impression. But is there anything to it? So that you can judge this, I will present you in the next articles about ketogenic diet scientific research and explain the biochemical background of this diet. What actually happens in the metabolism?