Ketogenic diet may improve disability and quality of life

A new study has found that a ketogenic diet is safe and tolerable over 6 months in patients with relapsing multiple sclerosis (MS) and has potential benefits. In a study with 65 participants, a ketogenic diet yielded improvements in body composition, fatigue, depression, quality of life, and neurological disability.

High-fat, low-carbohydrate ketogenic diets mimic a fasting state and have previously been shown to affect immune regulation, as explained by Dr J. Nicholas Brenton (University of Virginia Medical Center, VA, USA) [1]. To investigate the possible therapeutic potential of ketogenic diets, an open-label, uncontrolled study was set up that included 65 MS patients. They followed a ketogenic diet for 6 months and adherence was monitored on a daily basis by urine ketone testing. Patient-reported fatigue, depression, and quality-of-life scores were measured at baseline, as well as MS-related clinical outcome metrics. Baseline study metrics were repeated at 3 and 6 months while on a ketogenic diet.

Adherence to the ketogenic diet during the full study period was 83%. A ketogenic diet was associated with reductions in fat mass after 6 months compared with baseline (32.0 vs 41.3 kg; P<0.001) and a significant decline in fatigue and depression scores. MS quality-of-life physical (67 vs 79; P<0.001) and mental (71 vs 82; P<0.001) composite scores also improved. Additionally, Expanded Disability Status Scale scores (2.3 vs 1.9; P<0.001), 6-minute walk (1,631 vs 1,733 feet; P<0.001), and 9-hole peg test (21.5 vs 20.3 seconds; P<0.001) also improved following ketogenic diet. Dr Brenton concluded: “Our data justifies the need for future studies of ketogenic diets as a complementary therapeutic approach for the treatment of MS.”

Another important (observational) study of the effect of diet in MS demonstrated a significant association between Mediterranean diet score and MS-related disability and brain atrophy [2]. The authors suggested the possibility of a neuroprotective mechanism, based on the observed strength of the relationship in progressive disease and partial mediation by third ventricle width. These results pave the way for interventional clinical trials.

1. Brenton JN, et al. Ketogenic diet as a strategy for improved wellness and reduced disability in relapsing multiple sclerosis. S40.007, AAN 2022, 02–07 April, Seattle, USA.
2. Katz Sand I, et al. Mediterranean diet score is associated with disability and brain atrophy in multiple sclerosis. S14.002, AAN 2022, 02–07 April, Seattle, USA.

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Posted on 2 June 202225 March 2024