Can The Ketogenic Diet Treat Multiple Sclerosis (MS)?

Curated by Claudia Shannon / Research Scientist / ishonest

The ketogenic diet is high in fat, moderate in protein, and low in carbs. People on the diet typically get 85–90% of their calories from fat, 6–8% from protein, and 2–4% from carbs.

It induces a state of ketosis, in which the body relies on fat instead of glucose as its primary fuel source. The diet emerged in the 1920s as a treatment for children with epilepsy.

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According to one study, dietary treatments for epilepsy can be traced back as far as 460 B.C. The ketogenic diet was popular for almost two decades before the development of antiepileptic drugs.

Scientists have revisited the diet during the last couple of decades — and not just for treating epilepsy in children. Recent research suggests that following a ketogenic regimen could benefit people with other types of neurological disorders, including multiple sclerosis (MS).

Burning fat versus burning carbs

A ketogenic diet causes your body to rely on fat for energy rather than carbs.

Glucose is the body’s preferred fuel, but a change in metabolism occurs when you restrict your carb intake. Your liver starts producing molecules called ketone bodies, which appear to protect the cells of the nervous system — the site of damage in MS.

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Scientists don’t fully understand why ketones provide this protection. However, it’s thought that following a ketogenic diet may help treat MS through various mechanisms, including reducing inflammation and oxidative stress.

Benefits of a ketogenic diet

There are many potential benefits of eating a high fat, low carb diet with a moderate amount of protein, including:

  • The ketogenic diet has antioxidant and anti-inflammatory qualities.
  • It protects against various forms of cell death.
  • Ketones act as an alternative energy source during metabolic stress.
  • Ketosis reduces the toxic effects of the amino acid glutamate. High levels of glutamate are associated with demyelination, a type of nerve damage, and disease activity or relapse in people with MS.
  • It can also aid weight loss.

The neuroprotective qualities of the ketogenic diet may be especially desirable for people with a neurological disorder like MS.

Achieving ketosis

A typical ketogenic diet mostly comprises proteins and healthy fats, with minimal carbs. It should consist of whole, unprocessed foods, and carbs should ideally come from produce, nuts, or dairy.

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It’s important to talk with your healthcare provider before you start a new diet or exercise program. You may be referred to a dietitian to help monitor your progress, depending on your medical history.

What the research says

Researchers don’t fully comprehend what brings about the ketogenic diet’s neuroprotective qualities. One theory is that ketones produced by the liver provide more fuel to brain cells. This added energy may strengthen neurons against damage from oxidation or inflammation.

The ketogenic diet may also help improve the function of mitochondria, according to a literature review about progressive MS. Mitochondria are often referred to as the powerhouses of cells.

The ketogenic diet may lead to improved MS symptoms as well. Participants in one small study experienced decreased levels of fatigue and depression after 3– 6 months on the modified Atkins diet, which is a less restrictive version of the ketogenic diet.

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A long-term clinical trial on diet and MS began in 2017, and the results of it should enhance our understanding of the effects of a ketogenic diet on MS progression. All participants have relapsing-remitting MS (RRMS) and were asked to adopt either a ketogenic, fasting, or standard diet.

Finding the healthy fats

Eating a diet high in fat may sound counterintuitive to healthy living. The key lies in the types of fat you include.

Here are some tips for eating healthy fats that are encouraged in a ketogenic version of the Mediterranean diet:

  • Avocados, which are versatile sources of healthy fats and potassium, are great in guacamole, salad dressing, and smoothies. You can also use mashed avocados in place of mayonnaise as a spread on toast or sandwiches.
  • Use olive, sesame, or avocado oils for salad dressings and meal preparation.
  • Salmon and mackerel, as well as other fish and seafood, are high in omega-3 fatty acids.
  • Almonds, walnuts, pecans, and pistachios are all good sources of monounsaturated fats.
  • Pumpkin seeds and sunflower seeds are great snacks that contain polyunsaturated fats.
  • Chia seeds and ground flax seeds provide fiber, omega-3s, vitamins, and minerals.

Saturated fats, such as coconut oil, duck fat, and butter, are encouraged in the original ketogenic diet. This helps you consume enough overall fat daily.

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The ketogenic Mediterranean diet recommends a moderate intake of saturated fats and a higher intake of plant-based unsaturated fats.

Foods to avoid

To limit your carb intake, you have to be aware of what foods contain carbs. Most people must limit their carb intake to less than 50 grams per day to reach and maintain ketosis.

There are two main types of carbs: simple and complex.

Simple carbs are found in:

  • all forms of sugar
  • candy
  • milk, which contains lactose
  • fruit and vegetable juices
  • jellies and jams
  • desserts
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Complex carbs are found in:

  • beans
  • bread and pasta
  • starchy vegetables like potatoes
  • cereal and grains
  • whole fruits

Complex carbs typically contain more fiber and nutrients, making them the ideal choice for steady energy and overall health.

Takeaway

More research needs to be done before we know the benefits of a ketogenic diet for people with neurological disorders like MS.

Other diets may be worth considering for people trying to manage their MS. These include the low fat Swank diet, paleo diet, and modified paleo diet known as the Wahls diet.

Consult your doctor if you’re considering a dietary approach to help treat your MS.

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