Satiating Effect of a Ketogenic Diet and Its Impact on Muscle Improvement and Oxidation State in Multiple Sclerosis Patients

Overview

Journal Nutrients

Date 2019 May 26

PMID 31126118

Citations 25

Authors

Maria Benlloch

Maria Mar Lopez-Rodriguez

Maria Cuerda-Ballester

Eraci Drehmer

Sandra Carrera

Jose Joaquin Ceron

Asta Tvarijonaviciute

Javier Chirivella

David Fernandez-Garcia

Jose Enrique de la Rubia Orti

Affiliations

Soon will be listed here.

Abstract

Background: It was previously established that Multiple sclerosis (MS) generates energy alterations at the mitochondrial level related to the loss of muscle mass. Ketone bodies, mainly beta-hydroxybutyrate (BHB), re-establish this energy alteration causing satiety, changes in body composition and a decrease in hormone-dependant hunger, such as ghrelin. The aim of this study was to establish possible improvements in body composition and the level of oxidation in patients with MS, by means of the satiating effect of a ketogenic diet.

Methods: A pilot study was carried out with 27 MS patients who were given a Mediterranean isocaloric and ketogenic diet for 4 months. Anthropometric measurements, as well as satiety and hunger perception (VAS scale), were taken. In addition, BHB and paraoxonase 1 (PON1), as an oxidation marker, were measured by spectrophotometric automated assays, and ghrelin was determined by an enzyme immunoassay in the serum. All measurements were taken before and after the intervention.

Results: A significant increase in satiety perception at lunch and dinner and of BHB in the blood was obtained. Hunger perception decreased significantly at lunch and dinner with similar levels of ghrelin. In addition, an important increase in lean mass and PON1 was observed. To our knowledge, this is the first study addressing improvements in body composition, oxidation state and metabolism in MS patients, based on the satiating effect of a Mediterranean isocaloric diet.

Conclusion: A ketogenic diet increases lean mass and decreases inflammation and oxidation possibly as a consequence of an increase in satiety and decrease in hunger in MS patients.

Citing Articles

Exploring the Therapeutic Potential: Bioactive Molecules and Dietary Interventions in Multiple Sclerosis Management.

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Is there evidence of a ketogenic effect of coconut oil? Commentary: Effect of the Mediterranean diet supplemented with nicotinamide riboside and pterostilbene and/or coconut oil on anthropometric variables in amyotrophic lateral sclerosis. A pilot....

Norgren J, Kareholt I, Sindi S Front Nutr. 2024; 10:1333933.

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Nutritional interventional studies in patients with multiple sclerosis: a scoping review of the current clinical evidence.

Tryfonos C, Chrysafi M, Vadikolias K, Berberoglou L, Vorvolakos T, Dimoliani S J Neurol. 2024; 271(4):1536-1570.

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Ketogenic Diet Improves Motor Function and Motor Unit Connectivity in Aged C57BL/6 Mice.

Padilla C, Harris H, Volek J, Clark B, Arnold W Res Sq. 2023; .

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Effect of the Mediterranean diet supplemented with nicotinamide riboside and pterostilbene and/or coconut oil on anthropometric variables in amyotrophic lateral sclerosis. A pilot study.

Carrera-Julia S, Estrela J, Zacares M, Navarro M, Vega-Bello M, de la Rubia Orti J Front Nutr. 2023; 10:1232184.

PMID: 37810917 PMC: 10556480. DOI: 10.3389/fnut.2023.1232184.

References

Latner J, Schwartz M . The effects of a high-carbohydrate, high-protein or balanced lunch upon later food intake and hunger ratings. Appetite. 1999; 33(1):119-28. DOI: 10.1006/appe.1999.0237. View

Cecil J, Francis J, Read N . Comparison of the effects of a high-fat and high-carbohydrate soup delivered orally and intragastrically on gastric emptying, appetite, and eating behaviour. Physiol Behav. 1999; 67(2):299-306. DOI: 10.1016/s0031-9384(99)00069-4. View

Flint A, Raben A, Blundell J, Astrup A . Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. Int J Obes Relat Metab Disord. 2000; 24(1):38-48. DOI: 10.1038/sj.ijo.0801083. View

Bitsch A, Schuchardt J, Bunkowski S, Kuhlmann T, Bruck W . Acute axonal injury in multiple sclerosis. Correlation with demyelination and inflammation. Brain. 2000; 123 ( Pt 6):1174-83. DOI: 10.1093/brain/123.6.1174. View

Date Y, Kojima M, Hosoda H, Sawaguchi A, Mondal M, Suganuma T . Ghrelin, a novel growth hormone-releasing acylated peptide, is synthesized in a distinct endocrine cell type in the gastrointestinal tracts of rats and humans. Endocrinology. 2000; 141(11):4255-61. DOI: 10.1210/endo.141.11.7757. View

Nakazato M, Murakami N, Date Y, Kojima M, Matsuo H, Kangawa K . A role for ghrelin in the central regulation of feeding. Nature. 2001; 409(6817):194-8. DOI: 10.1038/35051587. View

Krotkiewski M . Value of VLCD supplementation with medium chain triglycerides. Int J Obes Relat Metab Disord. 2001; 25(9):1393-400. DOI: 10.1038/sj.ijo.0801682. View

Ludwig D . The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002; 287(18):2414-23. DOI: 10.1001/jama.287.18.2414. View

Banks W, Tschop M, Robinson S, Heiman M . Extent and direction of ghrelin transport across the blood-brain barrier is determined by its unique primary structure. J Pharmacol Exp Ther. 2002; 302(2):822-7. DOI: 10.1124/jpet.102.034827. View

10.

Rudick R, Cutter G, Reingold S . The multiple sclerosis functional composite: a new clinical outcome measure for multiple sderosis trials. Mult Scler. 2002; 8(5):359-65. DOI: 10.1191/1352458502ms845oa. View

11.

Ball S, Keller K, Moyer-Mileur L, Ding Y, Donaldson D, Jackson W . Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics. 2003; 111(3):488-94. DOI: 10.1542/peds.111.3.488. View

12.

Keaney Jr J, Larson M, Vasan R, Wilson P, Lipinska I, Corey D . Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol. 2003; 23(3):434-9. DOI: 10.1161/01.ATV.0000058402.34138.11. View

13.

Parker B, Sturm K, MacIntosh C, Feinle C, Horowitz M, Chapman I . Relation between food intake and visual analogue scale ratings of appetite and other sensations in healthy older and young subjects. Eur J Clin Nutr. 2004; 58(2):212-8. DOI: 10.1038/sj.ejcn.1601768. View

14.

Johnstone A, Murison S, Duncan J, Rance K, Speakman J . Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr. 2005; 82(5):941-8. DOI: 10.1093/ajcn/82.5.941. View

15.

Kumleh H, Riazi G, Houshmand M, Sanati M, Gharagozli K, Shafa M . Complex I deficiency in Persian multiple sclerosis patients. J Neurol Sci. 2006; 243(1-2):65-9. DOI: 10.1016/j.jns.2005.11.030. View

16.

Zhao Z, Lange D, Voustianiouk A, MacGrogan D, Ho L, Suh J . A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC Neurosci. 2006; 7:29. PMC: 1488864. DOI: 10.1186/1471-2202-7-29. View

17.

Bough K, Wetherington J, Hassel B, Pare J, Gawryluk J, Greene J . Mitochondrial biogenesis in the anticonvulsant mechanism of the ketogenic diet. Ann Neurol. 2006; 60(2):223-35. DOI: 10.1002/ana.20899. View

18.

Nazarewicz R, Ziolkowski W, Vaccaro P, Ghafourifar P . Effect of short-term ketogenic diet on redox status of human blood. Rejuvenation Res. 2007; 10(4):435-40. DOI: 10.1089/rej.2007.0540. View

19.

Thompson J, Wu G . The effect of ketone bodies on nitrogen metabolism in skeletal muscle. Comp Biochem Physiol B. 1991; 100(2):209-16. DOI: 10.1016/0305-0491(91)90363-i. View

20.

Rodriguez I, Ballart J, Pastor G, Jorda E, Arija Val V . [Validation of a short questionnaire on frequency of dietary intake: reproducibility and validity]. Nutr Hosp. 2008; 23(3):242-52. View