Susan Masino, Trinity College – Ketogenic Diet

On Trinity College Week: Can your diet help you avoid epileptic seizures?

Susan Masino, professor of applied science, looks into this question.

Dr. Masino is the Vernon Roosa Professor of Applied Science at Trinity College and a joint appointment in Neuroscience and Psychology. Her research focuses on promoting and restoring brain health, with a particular interest in adenosine, and on the relationship among metabolism, brain activity and behavior. For nearly 100 years a metabolic therapy called a “ketogenic diet” has been used to treat seizures, and recent mechanistic insights – including the role of adenosine – hold translational implications for brain health and diverse disorders.

In addition to her laboratory research Dr. Masino is interested in how public polices can improve brain health – with a special focus on New England’s amazing forests – and involved in local educational and environmental issues.

Ketogenic Diet

“Let thy food be thy medicine” is attributed to Hippocrates, an ancient Greek physician. Hippocrates recommended nature-based cures, and good food is fundamental to health. Various foods and diets are often in the news but one diet has treated epileptic seizures in adults and children for nearly 100 years. The ketogenic diet’s high-fat, low-carbohydrate, and adequate protein formula was developed to mimic fasting because it was observed that fasting stopped seizures. Epilepsy affects all ages, its prevalence is increasing, and people with epilepsy often suffer from depression, anxiety and sleep disturbance. Even today the ketogenic diet can stop seizures that are not controlled by any available medication, and some children can discontinue the diet and remain seizure-free. 

My interest in the ketogenic diet arose from my research on adenosine, an evolutionarily conserved molecule that links between cell energy – adenosine triphosphate – and ongoing brain activity. Adenosine protects your brain from injury, reduces anxiety, promotes sleep, reduces pain – and, like the ketogenic diet, adenosine can stop drug-resistant seizures. When I hypothesized that ketone-based metabolism increased adenosine I was unaware that it stopped seizures. Now, after many decades, we are starting to understand how a ketogenic diet works. This provides opportunities to identify alternatives and other neurological conditions where metabolic therapy may be beneficial – including pain, inflammation, autism, and Alzheimers. Perhaps most importantly either adenosine or the ketogenic diet can have multiple and lasting benefits and perhaps even reverse disease.

At this time we have few treatments and virtually no cures for neurological disorders. However they are associated with metabolic dysfunction. The brain is the most metabolically-demanding organ, and improving metabolic health can prevent disease and promote resilience. Brain health should be a priority for public policies – we need our best brains for ourselves and our families, our communities, and the planet.