Exploring the Ketogenic Diet as Adjunctive Therapy in Multiple Sclerosis: A Review

Area of Science:

• Neuroimmunology
• Metabolic Disorders
• Dietary Interventions

Background:

• Multiple sclerosis (MS) is a chronic autoimmune CNS disease causing inflammation and neurodegeneration.
• Current disease-modifying therapies (DMTs) offer limited benefits for cognitive symptoms and overall disease burden.
• The ketogenic diet (KD) is a high-fat, low-carbohydrate approach with potential therapeutic applications.

Purpose of the Study:

• To explore the potential of the ketogenic diet (KD) as an adjunctive therapy for multiple sclerosis (MS).
• To review the proposed mechanisms of KD action in MS, including anti-inflammatory and neuroprotective effects.
• To identify challenges and future research directions for KD in MS management.

Main Methods:

• Review of recent research on ketogenic diet (KD) mechanisms and effects in multiple sclerosis (MS).
• Analysis of KD's impact on inflammatory pathways, mitochondrial function, and oxidative stress.
• Evaluation of KD's influence on fatigue, cognition, quality of life, gut microbiome, and myelin repair.

Main Results:

• Ketone bodies, like β-hydroxybutyrate, may modulate inflammation and enhance mitochondrial function.
• KD is associated with potential improvements in fatigue, cognition, and quality of life in MS patients.
• KD may positively influence gut microbiome, insulin sensitivity, and myelin repair processes.

Conclusions:

• The ketogenic diet (KD) presents a promising adjunctive strategy for multiple sclerosis (MS), potentially improving various symptoms and biomarkers.
• Challenges including dietary adherence, nutrient deficiencies, side effects, and cardiovascular risks require careful consideration.
• Long-term safety, standardized protocols, and personalized strategies are crucial for integrating KD into comprehensive MS care.