Application of a modified ketogenic diet in relapsing-remitting multiple sclerosis: a pilot study
Author(s): ,
J.N. Brenton
Affiliations:
Neurology, Dept of Neurology, University of Virginia, Charlottesville, VA
,
B. Banwell
Affiliations:
University of Pennsylvania/Children`s Hospital of Philadelphia, Philadelphia, PA, United States
,
A.G.C. Bergqvist
Affiliations:
University of Pennsylvania/Children`s Hospital of Philadelphia, Philadelphia, PA, United States
,
D. Lehner-Gulotta
Affiliations:
Neurology, Dept of Neurology, University of Virginia, Charlottesville, VA
,
E. Leytham
Affiliations:
Neurology, Dept of Neurology, University of Virginia, Charlottesville, VA
M. Goldman
Affiliations:
Neurology, Dept of Neurology, University of Virginia, Charlottesville, VA
ECTRIMS Online Library. Brenton J. Oct 11, 2018; 228801; P958
J. Nicholas Brenton
J. Nicholas Brenton
Contributions
Abstract

Abstract: P958

Type: Poster Sessions

Abstract Category: Therapy - Others

Introduction: Dietary intake influences an individual's immune profile and response. The impact of diet in multiple sclerosis (MS) is clinically meaningful, with evidence supporting an association between diet and disability. Ketogenic diets (KDs) are high-fat, low-carbohydrate diets that attenuate pro-inflammatory pathways, reduce oxidative stress, and promote mitochondrial biogenesis. The tolerability of KDs in the MS population is unknown.
Objectives/aims: To provide evidence of tolerability of a KD in relapsing MS patients and elucidate effects of a KD on common MS co-morbidities.
Design/methods: Twenty patients with a diagnosis of relapsing-remitting multiple sclerosis that had been clinically- and radiographically-stable for at least 1 year were enrolled. Subjects were educated in-person by a trained dietitian on how to adhere to a modified KD (i.e. modified Atkins). Adherence to diet was objectively monitored by daily urine ketone testing. Patient-reported fatigue and depression outcome measures and fasting laboratory values for insulin resistance, liver function, electrolytes, and adipokines (leptin/adiponectin) were obtained at baseline (pre-diet) and after 6 months of treatment. Brain magnetic resonance imaging was obtained at baseline and 6 months.
Results: No subject experienced worsening clinical or radiographic disease while on diet. Improvements were noted in both fatigue (p=0.04) and depression scores (p=0.03), and reductions in body mass index (BMI) (p=0.003). Insulin resistance and serologic leptin levels were significantly reduced at 3 months, independent of BMI change (p=0.01). Longitudinal data collection is ongoing.
Conclusions: KDs in relapsing-remitting MS patients appears to be safe, feasible, and well-tolerated. A modified ketogenic diet improves common MS-comorbidities, such as fatigue and depression scores, while also serving to produce weight loss and reduce levels of serologic, pro-inflammatory adipokines.
Disclosure: Source of Funding: ZiMS Foundation
J. N. Brenton: nothing to disclose; B. Banwell: nothing to disclose; A. G. C. Bergqvist: nothing to disclose; D. Lehner-Gulotta: nothing to disclose; E. Leytham: nothing to disclose; M. D. Goldman: nothing to disclose

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