Ketogenic diet and prolonged fasting improve health related quality of life and blood lipid profile in multiple sclerosis - a randomized controlled trial
Author(s): ,
M. Bock
Affiliations:
Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; Integrative Proteomics and Metabolomics, Berlin Institute of Health, Berlin, Germany; Charité - Universit
,
A. Michalsen
Affiliations:
Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
F. Paul
Affiliations:
Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany; Charité - Universitätsmedizin Berlin, NeuroCure Clinical Research Center
ECTRIMS Online Library. Bock M. 10/09/15; 116359; 2345
Markus Bock
Markus Bock
Contributions
Abstract
Abstract: P1509

Type: Poster LB

Abstract Category: Invited / Oral LB / Poster LB

Background: Ketone bodies mediate neuroprotection. Oxidation of ketone bodies is compensated by equal reduction in glucose oxidation in the brain under prolonged fasting (PF) or ketogenic diet (KD) conditions. Here we show that PF or KD are effective in ameliorating the health related quality of life (HRQOL) measures in relapsing remitting multiple sclerosis (RRMS).

Objectives: To determine the effect of KD and PF on Multiple Sclerosis Quality of Life-54 (MS-54) scale in compare to conventional diet in patients with RRMS.

Methods: We performed a randomized controlled trial and parallel group 6-month pilot study after ethical committee approval (NCT 01538355). 60 consecutive RRMS patients ingesting their usual diets were recruited from July 2011 to August 2012. The patients were on a disease modifying therapy or receiving no treatment. Ketonuria was monitored for compliance. One group of patients received a usual diet, another group of patients enhanced their usual diet with an initial 7-day fasting episode. A third group received an adequate KD from the outset of the study. We used MS-54 self-assessment questionnaires and measured the blood lipid profile.

Results: Results from 48 RRMS patients are reported here. The conventional diet had no clinically relevant effect on HRQOL. In contrast, patients in the PF and KD group showed clinically meaningful improvement on MS-54 scores with medium to large effect sizes (0.4 to 0.8; p< 0.05). When considering the blood lipids we found a significant decline in the Low Density Lipoprotein to High Density Lipoprotein ratio and in triglycerides (p< 0.001).

Conclusions: PF and KD are feasible in RRMS. We suggest that HRQOL and lipid profile improve by KD and PF in RRMS patients. Possibly a KD and PF could favorably influence the course of RRMS and when coupled with a pharmacological intervention even further improvements might accrue.

Disclosure:

Funding: Myelin Projekt Deutschland e.V., Germany and Familie-Ernst-Wendt Stiftung, Germany.

MB: Research support and personal compensation for activities with Novartis, Genzyme, Nutricia. No conflict of interest.

FP: Research support and personal compensation for activities with Alexion, Bayer, Chugai, Sanofi, MedImmune, Teva, Novartis, Merck, Biogen; Funding: BMBF Competence Network, DFG Exc 257 (NeuroCure), Guthy Jackson Charitable Foundation. No conflict of interest.

AM: nothing to disclose.

Abstract: P1509

Type: Poster LB

Abstract Category: Invited / Oral LB / Poster LB

Background: Ketone bodies mediate neuroprotection. Oxidation of ketone bodies is compensated by equal reduction in glucose oxidation in the brain under prolonged fasting (PF) or ketogenic diet (KD) conditions. Here we show that PF or KD are effective in ameliorating the health related quality of life (HRQOL) measures in relapsing remitting multiple sclerosis (RRMS).

Objectives: To determine the effect of KD and PF on Multiple Sclerosis Quality of Life-54 (MS-54) scale in compare to conventional diet in patients with RRMS.

Methods: We performed a randomized controlled trial and parallel group 6-month pilot study after ethical committee approval (NCT 01538355). 60 consecutive RRMS patients ingesting their usual diets were recruited from July 2011 to August 2012. The patients were on a disease modifying therapy or receiving no treatment. Ketonuria was monitored for compliance. One group of patients received a usual diet, another group of patients enhanced their usual diet with an initial 7-day fasting episode. A third group received an adequate KD from the outset of the study. We used MS-54 self-assessment questionnaires and measured the blood lipid profile.

Results: Results from 48 RRMS patients are reported here. The conventional diet had no clinically relevant effect on HRQOL. In contrast, patients in the PF and KD group showed clinically meaningful improvement on MS-54 scores with medium to large effect sizes (0.4 to 0.8; p< 0.05). When considering the blood lipids we found a significant decline in the Low Density Lipoprotein to High Density Lipoprotein ratio and in triglycerides (p< 0.001).

Conclusions: PF and KD are feasible in RRMS. We suggest that HRQOL and lipid profile improve by KD and PF in RRMS patients. Possibly a KD and PF could favorably influence the course of RRMS and when coupled with a pharmacological intervention even further improvements might accrue.

Disclosure:

Funding: Myelin Projekt Deutschland e.V., Germany and Familie-Ernst-Wendt Stiftung, Germany.

MB: Research support and personal compensation for activities with Novartis, Genzyme, Nutricia. No conflict of interest.

FP: Research support and personal compensation for activities with Alexion, Bayer, Chugai, Sanofi, MedImmune, Teva, Novartis, Merck, Biogen; Funding: BMBF Competence Network, DFG Exc 257 (NeuroCure), Guthy Jackson Charitable Foundation. No conflict of interest.

AM: nothing to disclose.

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