30septembre

Ketogenic diets are prophylactic against malaria

Fat kills sporozoites in hepatocytes

People living in the poorest countries are the most afflicted to malaria and this may be related to nutrition. Their basic staple is rich in carbohydrates (starch). The main source of energy is thus glucose, but not lipids and ketone bodies. Glucose is food for Plasmodium which needs 60 times more of this fuel than the healthy erythrocyte. Fatty, ketogenic diet will provide less nutrients to the parasite although this has not been explored in depth. Breastfeeding seems to contribute to the immunity of newborns during 6 months and breast milk is rich in fat. Breast milk is also rich in taurine. The effect of fatty ketogenic diet might also explain many anecdoctical results on the effect of lipids on Artemisia annua efficiency. In 2009 at the 2d Symposium on Tropical Diseases at Luxembourg, D Rezelman showed that the addition of arachid oil enhanced the efficiency of Artemisia annua extract by a factor 3 in mice. The Brewer Science Library reports that some physicians recommend to take artemisinin with whole milk, cod liver oil, almond oil or flaxseed oil. At the ICEI malaria conference at Roma in April 2010 B Isacchi from the Universitate di Firenze showed that olive extract enhanced the effectiveness of artemisinin. In 2011 clinical trials run by IFBV-BELHERB in Dagana, Senegal showed that a mixture of Artemisia annua leaf powder and peanut butter gave cure rates > 95%. Dr F Roelofsen (personal communication, 2012) showed that when Artemisia annua leaves mixed with 10% fatty yoghurt gave a higher AUC and an extension of half-life for artemisinin from 30 minutes to 2-3 hours. There are several pathways to explain the positive effect of lipids delivered in conjunction with tea. It is possible that an oil rich diet has an effect on the erythrocyte membrane lipid composition, stimulation of calcium channels and permeability. A Pagnan, R Corrocher, G Ambrosio. Effects of an olive-oil-rich diet on erythrocyte membrane lipid composition and cation transport systems. Clinical Science (1989) 76, 87-93 87 Lipids may increase the bioavailability of lipophilic substances like artemisinin or essential oils. This effect has been documented for lumefantrine Ashley EA, Stepniewska K, Lindegårdh N, Annerberg A, Kham A, Brockman A, Singhasivanon P, White NJ, Nosten F. How much fat is necessary to optimize lumefantrine oral bioavailability? Trop Med Int Health. 2007 Feb;12(2):195-200. The positive effect of a ketogenic diet on malaria is known since 60 years. In a trial in India, of 10 rats, 8 weeks old, 5 received a standard diet and 5 a ketogenic diet containing 93% per cent., butter. After a week, all were inoculated with Plasmodium berghei. The number of parasites observed daily and at the peak of infection was much less in the rats given the ketogenic diet. S P Ramakrishnan. Studies on Plasmodium berghei Vincke and Lips 1948. 16. Effect of ketogenic diet on the course of blood-induced infection of rats. Indian Journal of Malariology 1954 Vol.8 pp.85-88 Mother’s milk is rich in fats: 4.4 % versus 3.3% in bovine milk. A fatty diet kills the sporozoites in the hepatocytes by mediating oxidative stress. V Zusarte-Luis, MM Mota. Dietary alterations modulate susceptibility to Plasmodium infection. Nature Microbiology Letters, 25 Sept 2017 Cats and dogs are immune against malaria and this may be related to the fact that they can only survive on a diet with meat. More recently this was confirmed in a French paper Vincent Robert, Catherine Bourgouin, Delphine Depoix, Catherine Thouvenot, Marie-Noëlle Lombard and Philippe Grellier Malaria and obesity: obese mice are resistant to cerebral malaria Malaria Journal 2008 7:81 DOI: 10.1186/1475-2875-7-81 PubMed searches with "obesity" and "malaria" yielded 107,545 and 46,653 references, respectively. However, association of the two terms produced only 17 entries, indicating that the two communities of researchers occupy distinct scientific niches that do not overlap. Finally, a search in the French database of all recorded malaria cases (about 45,000) was eloquent: the bodyweight of the studied patients was simply not recorded Current dietary prescriptions by the American Diabetes Association, the American Heart Association, the National Cholesterol Education Program are 30% fat, 60 % carbohydrates. Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat. Recent research now finds that low-carbohydrate, ketogenic diet is effective for improving glycemia, reducing obesity and body weight. William S Yancy, Marjorie Foy, Allison M Chalecki, Mary C Vernon and Eric C Westman. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutrition & Metabolism 2005 2:34 DOI: 10.1186/1743-7075-2-34 A review paper confirms these findings. It revisits the meaning of ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician's hand. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2014 May;68(5):641. Diabetes, malaria and diet are fields which needs much more research.

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