The Ketogenic Diet Revisited: Beyond Ketones

 Even though different mechanisms of the KD have been reviewed the last few years  (i.e., focusing on the primary antiseizure mechanisms), we have compiled a  comprehensive overview of the ancillary pathways that are affected by the KD and discussed their pre-clinical and clinical evidence in epilepsy treatment. These include KD-induced changes of the endocrine system, epigenetic control, the gut microbiome, and the serine synthesis via PHGDH. Overall, this review and future studies will contribute to the identification of specific pathways of the KD.