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26-04-2011 | Diabetes | Article

Ketogenic diet alone can reverse diabetic nephropathy

Abstract

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MedWire News: Results from a study in mice suggest that consumption of a ketogenic diet may be sufficient to reverse the symptoms of diabetic nephropathy.

"Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes," said study author Charles Mobbs (Mount Sinai School of Medicine, New York, USA).

The team used mouse models of both Type 1 (Akita; n=28) and Type 2 (db/db; n=28) diabetes to test their theory that symptoms of diabetic nephropathy could be reduced or reversed by a ketogenic diet.

This hypothesis was based on the recent observation that the ketone 3-beta-hydroxybutyric acid (3-OHB) can reduce molecular responses to glucose and the prolonged exposure to 3-OHB that occurs during consumption of a ketogenic diet.

Following development of nephropathy symptoms, half of each group of mice were switched from their normal, relatively high carbohydrate diet (64% carbohydrate, 23% protein, 11% fat), to a ketogenic or low carbohydrate regime (5% carbohydrate, 8% protein, 87% fat) for 8 weeks.

Nephropathy, measured according to the albumin:creatinine ratio and expression of oxidative stress and toxicity induced genes, was completely reversed in the mice who consumed the ketogenic, but not the normal diet, at 8 weeks.

However, the researchers note that histological evidence of nephropathy (such as glomerular sclerosis) was only partially, although significantly, reduced in the mice given the ketogenic diet.

"Knowing how the ketogenic diet reverses nephropathy will help us identify a drug target and subsequent pharmacological interventions that mimic the effect of the diet," said Mobbs.

"We look forward to studying this promising development further," he added.

Writing in the journal PLoS ONE, the investigators say that although their results suggest that diabetic nephropathy could be reversed by a low-carbohydrate, high-fat diet, many questions need to be answered before clinical application can be considered in humans.

They acknowledge that the ketogenic diet is probably too extreme to be tolerated by adult diabetes patients long-term, but add that evidence suggests that a short exposure to such a diet could be enough to "reset" the pathological process involved in the development of diabetic nephropathy.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Helen Albert