JNNP: Phase II study of ketogenic diet in relapsing multiple sclerosis, safety, tolerability and potential clinical benefit

Multiple sclerosis (MS) is influenced by genetic and environmental facto.

Dietary intake affects immune status and function, including development of the host immune system, protection against pathogens, and maintenance of immune respons.

Therefore, researchers are looking at dietary modifications as a way to influence immune-mediated diseases such as .

Ketogenic diets (KDs) are high-fat, low-carbohydrate, adequate protein diets that mimic a nutritionally fasted sta.

The term "ketogenic diet" generally refers broadly to any diet that reduces carbohydrate intake; however, in this article, KDs are referred to as ketosis-promoting KDs, which can be reliably measured in blood or uri.

The putative mechanisms by which KDs benefit neuroinflammatory diseases are by providing a more efficient energy source .


, fatty acids), reducing oxidative damage associated with metabolic stress, increasing mitochondrial biogenesis pathways, and reducing proinflammatory cytokine producti.

The putative mechanisms by which immune KDs benefit neuroinflammatory diseases are by providing a more efficient energy source .


, fatty acids), reducing oxidative damage associated with metabolic stress, increasing mitochondrial biogenesis pathways, and reducing proinflammatory cytokine producti.

Animal studies highlight the broad neuroprotective and therapeutic properties of KDs and fasting die.

kD may affect adipocyte-derived cytokines (adipokines) such as leptin and adiponect.

Adipokines are important links between metabolic function, inflammation, and immune respons.

Research on KDs in MS patients is limit.

While KDs may be beneficial in MS patients, the strict nutritional parameters of KD, including metabolic acidosis, nephrolithiasis, hyperlipidemia, and partial malnutrition, carry potential ris.

The research group previously conducted a preliminary feasibility study of a modified Atkins KD (KDMAD) in a cohort of 20 patients with relapsing .

As a first step study, tolerability or efficacy could not be determin.

Guided by this trial, a next phase II trial was designed and completed to demonstrate tolerability of monitored KD over 6 months, with secondary assessments of the effect of KD on clinical outcomes and pro-inflammatory leptin leve.

The article was published in the Journal of Neurology, Neurosurgery & Psychiatr.

The article was published in the Journal of Neurology, Neurosurgery & Psychiatr.

Journal of Neurology, Neurosurgery & Psychiatry

Sixty-five patients with relapsing-remitting MS between the ages of 12 and 55 were included in the stu.

Consider that MS affects 3%-5% of patients before age 18, including 22 young adults with .

Most children with MS are between the ages of 12 and 1 As a result, they are still undergoing maturational changes in physical habits, hormonal changes associated with puberty, and potential changes in immune functi.

Despite these well-established considerations, the clear imperative to include pediatric patients in studies is further underscored by data showing a strong association between childhood
obesity and multiple sclerosis ris.

The study included two pediatric subjects (aged 15 and 17 at enrollment) who represented 3% of the entire study coho.

But there is a clear imperative to include pediatric patients in studies , further underscored by data showing a strong association between childhood
obesity and multiple sclerosis ris.

The study included two pediatric subjects (aged 15 and 17 at enrollment) who represented 3% of the entire study coho.

child

Research Process

Subjects must demonstrate clinical disease stability on their current disease-modifying treatment, if any, and an Expanded Disability Status Scale (EDSS) score of ≤0 for at least 6 months prior to enrollment, taking into account the use of dynamic test measur.

Subjects were excluded if they had progressive MS, had KD within the past 6 months, were pregnant/planning to become pregnant, or were underweight, according to Centers for Disease Control (CDC) guidelines

For patients with comorbidities that may aggravate KD (eg , hypercholesterolemia , kidney stones), written permission from the attending physician is required before registrati.

Guidelines For patients with comorbidities that may aggravate KD (eg , hypercholesterolemia , kidney stones), written permission from the attending physician is required before registrati.

Therefore only the last 45 subjects were test.

Changes from Baseline Exam to 6 Months in Patient Reports and Clinical Outcomes

83% of participants adhered to KD during the stu.

KDMAD is a well-tolerated dietary intervention that reduces weight, reduces fatigue and depression, and improves quality of life in patients with relapsing .

KDMAD is a well-tolerated dietary intervention that reduces weight, reduces fatigue and depression, and improves quality of life in patients with relapsing .

BrentonJN ,Lehner-GulottaD ,WoolbrightE BrentonJNBrenton Lehner-GulottaDLehner-Gulotta WoolbrightEWoolbright, et alPhase II study of ketogenic diets in relapsing multiple sclerosis: safety, tolerability and potential clinical benefitsJournal of Neurology, Neurosurgery & PsychiatryPublished Online First:13 April 202 Published Online First: doi:11136/jnnp-2022-329074doi:leave a message here