This presentation, from Prof Simon Heales, explores how biochemical markers can advance patient selection for ketogenic diet (KD) therapy, particularly for those with drug-resistant epilepsies.

While KDs offer significant benefits, not all patients achieve seizure control. This session examines the potential of biochemical insights to improve patient selection and predict KD responsiveness.

Key topics include:

• Peripheral ketogenesis: Why current studies have provided inconsistent results and the need for improved biomarkers.
• Energy metabolism and acetyl carnitine: The role of acetyl carnitine in enhancing brain energy metabolism, supporting the hypothesis that KDs may work by boosting cellular energy.
• Future biomarkers: The potential of markers like FGF-21, GDF-15, urine organic acids, and decanoic acid to better predict KD responsiveness.

By gaining a deeper understanding of the biochemical changes associated with KDs, clinicians can develop a comprehensive biomarker panel to improve patient selection and outcomes.