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Food for Thought

Hippocrates’ directive of “let food be thy medicine” has been around for millennia. But for Jong Rho, MD, chief of the Division of Neurology at Rady Children’s Hospital-San Diego and a professor in the Departments of Neurosciences, Pediatrics and Pharmacology at the University of California San Diego School of Medicine, it still rings true.  

Dr. Rho is a prolific researcher in areas including the connection between the ketogenic diet and a broad array of neurological disorders. Although it’s gained recent popularity for weight loss and endurance sports, the keto diet actually turns 100 this year, and its high-fat, low-carb makeup has been used to treat medically intractable epilepsy for its entire history. Dr. Rho notes that while it’s still not fully understood exactly how or why the keto diet works to reduce or eliminate seizures in patients with epilepsy, it pushes the body and brain to fuel up in a different way than they would from carbohydrates. It is effective for both adult and pediatric patients with epilepsy, even those who have been unsuccessful with traditional drug therapies. “The rigorous clinical studies of ketogenic diet effects in epilepsy exceed most drugs,” he says. “Whereas most drugs go through one or two clinical trials, we have 12 prospective controlled studies with diet in patients that have failed drug therapy. Most will respond.”

But a dietary approach shows great promise in brain-based disorders far beyond epilepsy. Dr. Rho explains that metabolic therapies, such as certain diets, “enhance the metabolism to render beneficial effects.” When it comes to the brain, which Dr. Rho notes makes up two to three percent of our bodyweight but uses about 20 percent of our energy just at rest, the fact that it relies so heavily on our food to function makes it a prime candidate for positive dietary influence. “If certain organs are much more energy-dependent than others, they’re most likely to respond to increased energy reserves” from metabolic adjustments — think the epilepsy symptom response to the keto diet. Autism spectrum disorder, depression, anxiety, bipolar disorder, schizophrenia and cognitive disorders such as Alzheimer’s all have growing evidentiary support for response to metabolic therapies; as do certain types of brain cancer, multiple sclerosis, chronic pain and even traumatic brain injuries. 

To keep such research advancing in the pediatric health care world, Rady Children’s and UC San Diego are collaborating on a new precision nutrition center, which will focus on identifying a child’s unique care needs and metabolic make-up and using dietary approaches to improve symptoms, whether in addition to or instead of pharmaceutical options. The core of the center will be housed at UC San Diego and will focus more on understanding the metabolic underpinnings of brain diseases, an approach that has nearly boundless implications for future care advances. On the Rady Children’s campus, Dr. Rho and colleagues are working on expanding dietary nutrition services across the entire patient population, and on piloting dietary therapeutic methods in new brain and mental health clinics. “It’s probably safe to say that diet is likely to influence every brain disorder. It’s just the clinical evidence hasn’t all been produced yet,” posits Dr. Rho. It is in the works, though, and some of the most exciting investigations are tapping into not just improving symptoms, but perhaps more importantly, into treating the underlying disease processes. “We have basic science that indicates diet can have neuroprotective effects, or protecting brain cells and preventing them from dying,” Dr. Rho says. “Now, we’re asking, ‘Can it do more than just symptom relief? Can it be disease-modifying or potentially curative?’”

If a diet-based care plan sounds like something of interest for your child, it’s important to start in the doctor’s office to ensure it’s an appropriate solution with a safe approach, consistent medical monitoring and proper nutritional balance. Dr. Rho advises checking in with your primary care physician or preventive health specialist about their specific needs first, after which they would be referred to the Division of Neurology as needed. From there, a specialist would review the child’s history and medical conditions and review dietary, pharmaceutical or surgical options to create a tailored care approach. 

For more information on Dr. Rho’s research and the Division of Neurology, visit our website.