Low‐fat versus ketogenic diet in Parkinson's disease: A pilot randomized controlled trial

Abstract

Background: Preliminary evidence suggests that diet manipulation may influence motor and nonmotor symptoms in PD, but conflict exists regarding the ideal fat to carbohydrate ratio. Objectives: We designed a pilot randomized, controlled trial to compare the plausibility, safety, and efficacy of a low‐fat, high‐carbohydrate diet versus a ketogenic diet in a hospital clinic of PD patients. Methods: We developed a protocol to support PD patients in a diet study and randomly assigned patients to a low‐fat or ketogenic diet. Primary outcomes were within‐ and between‐group changes in MDS‐UPDRS Parts 1 to 4 over 8 weeks. Results: We randomized 47 patients, of which 44 commenced the diets and 38 completed the study (86% completion rate for patients commencing the diets). The ketogenic diet group maintained physiological ketosis. Both groups significantly decreased their MDS‐UPDRS scores, but the ketogenic group decreased more in Part 1 (−4.58 ± 2.17 points, representing a 41% improvement in baseline Part 1 scores) compared to the low‐fat group (−0.99 ± 3.63 points, representing an 11% improvement) (P < 0.001), with the largest between‐group decreases observed for urinary problems, pain and other sensations, fatigue, daytime sleepiness, and cognitive impairment. There were no between‐group differences in the magnitude of decrease for Parts 2 to 4. The most common adverse effects were excessive hunger in the low‐fat group and intermittent exacerbation of the PD tremor and/or rigidity in the ketogenic group. Conclusions: It is plausible and safe for PD patients to maintain a low‐fat or ketogenic diet for 8 weeks. Both diet groups significantly improved in motor and nonmotor symptoms; however, the ketogenic group showed greater improvements in nonmotor symptoms. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Foods with Potential Prooxidant and Antioxidant Effects Involved in Parkinson’s Disease

“…The contradictory findings may be due to different types of fat used in the diet that are not always described. Some studies indicate that high cholesterol or a keto diet may lower the risk of developing PD or improve the motor and nonmotor symptoms of the disease [ 79 ]. Also, the consumption of PUFAs contributes to the neuroprotective anti-inflammatory capacity [ 80 – 82 ].…”

Influence of Energy Deficiency on the Molecular Processes of Substantia Nigra Pars Compacta Cell for Understanding Parkinsonian Neurodegeneration: A Comprehensive Biophysical Computational Model

“…In the proposed model, ketone metabolism (Morris, 2005) can be incorporated to make the model more robust to utilize different substrates as an energy source and understand the role of ketone bodies in PD pathogenesis (Phillips et al, 2018;Włodarek, 2019). Apart from ketone bodies, astrocytes also play an important role in maintaining neuronal energy demands (Jha and Morrison, 2018).…”

Uso de probióticos em pacientes com doença de Parkinson: a importância do eixo intestino-cérebro e dietoterapia – uma revisão de literatura

“…Dietas com mais proteínas, como dieta cetogênica ou sem glúten, têm sido propostas como intervenções para a DP, pois estudos mostram melhorias na função motora devido ao melhor controle glicêmico e menor toxicidade associada à intolerância alimentar (Kraeuter, Phillips, & Sarnyai, 2020;Phillips, Murtagh, Gilbertson, Asztely, & Lynch, 2018). Os efeitos de uma dieta pobre em gordura versus cetogênica foram comparados em pacientes com DP ao longo de oito semanas (Phillips et al, 2018). A dieta cetogênica reduziu a glicose no sangue e a hemoglobina glicada, aumentou o HDL, LDL e o colesterol total.…”

“…A dieta cetogênica reduziu a glicose no sangue e a hemoglobina glicada, aumentou o HDL, LDL e o colesterol total. Os pacientes apresentaram uma melhora significativa na Escala Unificada de Classificação da Doenças de Parkinson (EUCDP) em ambas as dietas em comparação com os valores basais (Phillips et al, 2018). No entanto, atualmente não há mais evidências em contextos clínicos controlados.…”