Jennifer E Lee1,2, Tyler J Titcomb3, Babita Bisht3, Linda M Rubenstein4, Rebecca Louison1, Terry L Wahls3,5. 1. Department of Psychology, Mount Mercy University, Cedar Rapids, Iowa, USA. 2. College of Nursing, The University of Iowa, Iowa City, Iowa, USA. 3. Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA. 4. College of Public Health, The University of Iowa, Iowa City, Iowa, USA. 5. Department of Extended Care and Rehabilitation Service Line, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Abstract
OBJECTIVE: To investigate the feasibility of a modified MCT-based ketogenic diet and its impact on plasma β-hydroxybutyrate and MS outcomes compared to a modified Paleolithic diet and usual diet in people with Multiple Sclerosis (MS). METHODS: Fifteen individuals with MS were randomized to 3 groups: 1) modified Paleolithic diet (Paleo; n = 6); 2) medium-chain triglyceride (MCT)-based ketogenic diet that included coconut as a fat source (Keto; n = 5); or 3) usual diet (Control; n = 4). Participants had blood drawn every 4 weeks to monitor nutritional ketosis. Participants completed 4-day weighed food records, measures of disability, fatigue, quality of life (QoL), cognitive function, and physical function at baseline and 12-weeks. RESULTS: Macronutrient intake significantly shifted toward a ratio indicative of a ketogenic diet in the Keto group at 12 weeks. Similarly, plasma β-hydroxybutyrate indicated nutritional ketosis in the Keto group, whereas neither macronutrient intake nor plasma β-hydroxybutyrate indicated nutritional ketosis in the Paleo and Control groups. The Paleo group had significant within group reductions in fatigue scores and maintained cognitive function scores compared to the Control group. The Keto group had significant reductions in fasting glucose and insulin compared to baseline values; however, no clinical outcomes significantly changed. CONCLUSIONS: Participants consuming the MCT-based ketogenic diet achieved nutritional ketosis; however, it was not associated with significant clinical improvement in this study whereas the modified Paleolithic diet was associated with significant clinical improvements. Larger randomized controlled trials are needed to determine the safety and efficacy of the modified Paleolithic and MCT-based ketogenic diets on MS.
OBJECTIVE: To investigate the feasibility of a modified MCT-based ketogenic diet and its impact on plasma β-hydroxybutyrate and MS outcomes compared to a modified Paleolithic diet and usual diet in people with Multiple Sclerosis (MS). METHODS: Fifteen individuals with MS were randomized to 3 groups: 1) modified Paleolithic diet (Paleo; n = 6); 2) medium-chain triglyceride (MCT)-based ketogenic diet that included coconut as a fat source (Keto; n = 5); or 3) usual diet (Control; n = 4). Participants had blood drawn every 4 weeks to monitor nutritional ketosis. Participants completed 4-day weighed food records, measures of disability, fatigue, quality of life (QoL), cognitive function, and physical function at baseline and 12-weeks. RESULTS: Macronutrient intake significantly shifted toward a ratio indicative of a ketogenic diet in the Keto group at 12 weeks. Similarly, plasma β-hydroxybutyrate indicated nutritional ketosis in the Keto group, whereas neither macronutrient intake nor plasma β-hydroxybutyrate indicated nutritional ketosis in the Paleo and Control groups. The Paleo group had significant within group reductions in fatigue scores and maintained cognitive function scores compared to the Control group. The Keto group had significant reductions in fasting glucose and insulin compared to baseline values; however, no clinical outcomes significantly changed. CONCLUSIONS: Participants consuming the MCT-based ketogenic diet achieved nutritional ketosis; however, it was not associated with significant clinical improvement in this study whereas the modified Paleolithic diet was associated with significant clinical improvements. Larger randomized controlled trials are needed to determine the safety and efficacy of the modified Paleolithic and MCT-based ketogenic diets on MS.
Authors: J Nicholas Brenton; Diana Lehner-Gulotta; Emma Woolbright; Brenda Banwell; A G Christina Bergqvist; Shanshan Chen; Rachael Coleman; Mark Conaway; Myla D Goldman Journal: J Neurol Neurosurg Psychiatry Date: 2022-04-13 Impact factor: 13.654
Authors: Tyler J Titcomb; Babita Bisht; David D Moore; Yashpal S Chhonker; Daryl J Murry; Linda G Snetselaar; Terry L Wahls Journal: Nutrients Date: 2020-06-20 Impact factor: 5.717
Authors: Terry L Wahls; Tyler J Titcomb; Babita Bisht; Patrick Ten Eyck; Linda M Rubenstein; Lucas J Carr; Warren G Darling; Karin F Hoth; John Kamholz; Linda G Snetselaar Journal: Mult Scler J Exp Transl Clin Date: 2021-07-31