“Extreme activities are ready, whenever they are needed, to keep uniform the internal environment…. The organism is thrown into convulsions if the sugar supply runs too low, and the convulsions mark the acme of the manoeuvres which bring forth extra sugar from the hepatic reserves to restore the normal glycemic percentage.” Walter Bradford Cannon, and  Claude Bernard before him, taught that the body does what it must  to maintain  homeostasis (physiological balance). Our present culture may rely too heavily on drugs that force normalization, as if our bodies were enemies to be checked, cubed, and countered.

Daily blood and urine testing of my daughter Roberta shows euglycemia (fluctuations of blood sugar consistently within the normal fasting range) and euketonemia (urinary ketone range fluctuating between trace and moderate) functioning like a see-saw, blood sugar level higher when urinary ketone  level is lower, and vice versa. I believe that Roberta’s rare brain architecture (subcortical band heterotopia and mild lissencephaly) calls for high energy dietary management to prevent episodes of seizure-inducing glucose deficiency. If too few ketones are available there is no efficient compensation for energy deficit. On the other hand, too many ketones may induce harmful sub-clinical acidosis. ASEK diet is based on the “Goldilocks” principle of energy substrate that is “just right.”   To achieve energy homeostasis, mammalian milk fat may be Nature’s highest powered fuel.

Maintaining energy homeostasis is key to managing my daughter’s “Autilepsy” (comorbidity of epilepsy and autism – – see:  sfari.org/news-and-opinion/news/2011/scientists-probe-puzzling-overlap-of-epilepsy-and-autism). When Roberta was growing up, I sensed that relief from epilepsy and autism depended on a diet that would provide the “high octane” fuel she needed.

A set allowance of dairy cream and ghee (clarified butter aka anhydrous butter fat) provides the majority of ASEK diet calories. Palmitic acid, present in human and cow’s milk at ~23% and ~26% respectively, has been shown to convert to ketone bodies in cultured astrocytes,  supporting the hypothesis that blood ketone bodies may not be the sole suppliers of ketone bodies to the brain. Extra long chain saturated acids support myelination. Short chain triglycerides (SCTs) and medium chain triglycerides (MCTs) by-pass the liver, entering the portal vein for ready energy. Butyric acid, an SCT, influences cellular functions affecting the health of the colon (see:  Current Opinion in Clinical Nutrition and Metabolic Care 2012: 15(5):474-479: “Butyrate has the ability to inhibit histone deacetylases affecting gene regulation, immune modulation, cancer suppression, cell differentiation, intestinal barrier regulation, oxidative stress reduction, diarrhea control, visceral sensitivity, and intestinal motility modulation.”). Lauric acid is an active antimicrobial and anti-fungal agent. Approximately 64% of the fatty acids in clarified butter are saturated. All the SCTs, MCTs, and the long chain triglycerides (LCTs) myristic, palmitic, stearic and palmitoleic acids are saturated. Saturated fatty acids are used for energy. The monounsaturated oleic acid content of butter oil is approximately 28%. These proportions are comparable to those of human milk fat.

Comprehensive nutrition is key. Specific carbohydrate and protein food choices provide pre-formed docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and arachidonic acid (ArAc); choline, inositol, phosphatidylcholine (lecithin), phosphatidylserine, conjugated linoleic acids (CLAs), alpha lipoic acid, and other anti-oxidants; phytonutrients; potassium, selenium, magnesium and calcium, and trace minerals including lithium from sea-weed.