Obesity is a recognized risk factor for multiple sclerosis (MS) and, dietary intake is one potentially modifiable environmental contributor to MS has garnered much interest from people living with MS. A recent study suggests that the ketogenic diet (KD) is safe and beneficial in reducing a few symptoms for people with MS when used for over 6 months.
The study findings were published in the Journal of Neurology, Neurosurgery & Psychiatry on 13 April 2022.

KDs are high-fat, low-carbohydrate diets that mimic a fasting state. KDs, in particular, may alter key aspects of MS pathogenesis via ketosis-induced upregulation of antioxidant pathways, reduced effector cell immunity, and enhanced CNS bioenergetics, which may provide an alternative energy source to vulnerable neurons. To further explore, Dr J Nicholas Brenton and his team conducted a study to assess the tolerability of a ketogenic diet in patients with relapsing multiple sclerosis and define the impact on laboratory and clinical outcome metrics.
In this prospective, intention-to-treat KD intervention, the researchers included sixty-five patients with relapsing MS and followed them for 6-months. They monitored adherence with daily urine ketone testing. At baseline, fatigue, depression and quality of life (QoL) scores were obtained in addition to fasting adipokines and MS-related clinical outcome metrics. They further repeated the baseline metrics at 3 and/or 6 months on diet.
Key findings of the study:
Upon analysis, the researchers found that the patients exhibited significant reductions in fat mass and showed a nearly 50% decline in self-reported fatigue and depression scores.
They also found that MS QoL physical health (67±16 vs 79±12) and mental health (71±17 vs 82±11) composite scores increased on diet.
They noted significant improvements in Expanded Disability Status Scale scores (2.3±0.9 vs 1.9±1.1), 6-minute walk (1631±302 vs 1733±330 ft) and Nine-Hole Peg Test (21.5±3.6 vs 20.3±3.7 s).
They further noted that serum leptin was lower (25.5±15.7 vs 14.0±11.7 ng/mL) and adiponectin was higher (11.4±7.8 vs 13.5±8.4 µg/mL) on the KD.
The authors concluded, "KDs are safe and tolerable over a 6-month study period and yield improvements in body composition, fatigue, depression, QoL, neurological disability and adipose-related inflammation in persons living with relapsing MS".
For further information:
DOI: http://dx.doi.org/10.1136/jnnp-2022-329074