Treatment search

The ketogenic diet potentially helps in the treatment of multiple sclerosis, U.Va. researchers find – The Cavalier Daily

Researchers from the U.Va. Santé recently discovered that a ketogenic diet benefits patients with multiple sclerosis by reducing levels of fatigue and depression as well as improving overall quality of life.

Multiple sclerosis, a debilitating disease in which the immune system begins to attack the brain and spinal cord by eroding the protective covering – the myelin sheaths – over neurons, has significant effects on energy, physical functioning and mental health.

Looking for ways to combat this, Asst. Neurology professor Nicholas Brenton has led new research exploring how a modified Atkins diet – a less restrictive form of a ketogenic diet – has the potential to be a new standard of care for MS patients.

For almost a century, ketogenic diets have been hailed as a treatment for epilepsy, but their application to other conditions has only recently been explored. Preliminary research is currently underway on diseases like Alzheimer’s disease in relation to ketogenic diets in mouse and rat models.

Brenton came up with the concept because of his personal experience as an epileptologist, combined with the inspiration of a 2015 study who tested the response of rats with multiple sclerosis to a ketogenic diet. With promising results, the study convinced Brenton to consider applying the idea to human patients with multiple sclerosis.

Third-year college student Candace Moore, who works in a separate but related lab run by Asst. Biology professor John Campbell has experience in how neurons can profoundly affect appetite. Campbell Lab research on the brain-diet relationship more generally supports the idea that diets can be used as a treatment. Diseases often alter nutrient levels and concentrations needed in the body, and adjusting food intake can be beneficial in combating and maintaining healthy functioning.

“[I have learned that] diet affects [multiple sclerosis] more because MS is a disease that really targets the immune system,” Moore said.

However, there were other factors to consider. Ketogenic diets have been fatigue-relatedespecially in their early days, it was therefore important to Brenton to help his patients combat this and other side effects of ketosis – a state in which the body tends to burn fat instead of carbohydrates – induced by such regimes.

“No one at the time had looked at this diet and MS, mainly because of the restriction [ketogenic diets are]”Brenton said.

To conduct this study, Brenton’s team conducted a small trial on about 20 patients who were willing to try a dietary change in hopes of helping their multiple sclerosis. U.Va. Health nutritionist Diana Lehner-Gulotta held an introductory meeting with each of the patients, briefing them on the testing process and teaching them how to adhere to a very limited diet.

“[The patients] would have an initial visit with me that would usually last about an hour, where I would give them information about the Modified Atkins Diet and the types of foods they could and could not eat,” Lehner-Gulotta said.

Patients underwent an initial series of tests to establish their baseline energy levels, then underwent monthly blood tests to monitor physical changes throughout the study. Over the six-month period, researchers found that dietary change linked to decreased depression and fatigue in patients using the Beck Depression Inventory and Modified Fatigue Impact Scale.

The short-term timeline of six months for the diet leaves lingering questions behind.

“I think all of these diets need better study to really determine the precise benefits and risks MS patients may have when they [taking on a ketogenic diet] long-term,” Brenton said.

Due to the small scale of the original study, the team is now aiming to conduct a larger study with a larger number of participants. A larger study would aim to provide more precise data and would also create greater confidence in the reproducibility of the study.

Another major concern for future research is potential deficiencies caused by a long-term modified Atkins diet. Due to the very narrow scope of the diet, there is potential for deficiencies ranging from magnesium to vitamin A. Currently, patients are supervised by clinical staff and dietary staff to ensure this does not occur.

“I think we’re interested to see if in the future a more liberal form of this diet might have equally positive effects just because this diet is really restrictive and has side effects,” Lehner said. Gulotta.

Since this research represents the first study of ketogenic diets for multiple sclerosis, there are still many steps to be taken to establish ketogenic diets – or otherwise – as the standard of care for multiple sclerosis.

“We don’t know if it’s ketosis or if it’s low carb right now. [that] are there any diets that can help, so I would be more inclined to study what we have studied first, and then back off and try more lenient or less restrictive diets that are in the same area. “Brenton said.