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Ketogenic Diet Safe, Feasible in MS

A ketogenic diet is safe, feasible, and well tolerated in subjects with relapsing multiple sclerosis (MS) and is associated with improved fatigue and depression while also promoting weight loss and reducing serologic proinflammatory adipokines, a new study suggests.

“We wanted to study a ketogenic diet in MS, as it has been associated with anti-inflammatory and antioxidant effects — both of which may be of benefit in MS — and it has been linked to quality-of-life benefits such as improvements in fatigue, which is a major issue for MS patients,” lead author J. Nicholas Brenton, MD, University of Virginia, Charlottesville, told Medscape Medical News.

Brenton noted that ketogenic diets are high-fat, low-carbohydrate diets that mimic a fasting state and promote more efficient use of energy. “The body uses fat rather than carbohydrates for energy and fat is a much more efficient energy source,” he said. “The MS brain is undergoing attack and the death of nerve cells could be caused by an energy shortage.”

The diet, which has been linked to reduced seizures, has been used for many years in the treatment of epilepsy.

The current study was published online April 12 in Neurology Neuroimmunology & Neuroinflammation.

The open label, uncontrolled study included 20 patients with relapsing MS who followed a ketogenic diet for 6 months with adherence monitored by daily urine ketone testing.

Fatigue and depression scores and fasting adipokines were obtained at baseline and after 6 months on the diet. Patients also underwent brain MRI before and after following the diet.

Results showed that 19 (95%) of the 20 patients adhered to the diet for 3 months and 15 (75%) adhered for 6 months.

The diet was associated with reductions in body mass index (BMI) and total fat mass (P < .0001), and fatigue (P = .002) and depression scores (P = .003) were improved. Serologic leptin was significantly lower at 3 months (P < .0001) and there was a nonsignificant trend for increasing serologic adiponectin levels on the diet.

Fasting insulin and hemoglobin A1c levels were significantly decreased at both 3 and 6 months on the diet. But lipid profiles showed a significant increase in LDL and cholesterol at 3 months, although this increase declined at 6 months and was no longer significant.

Although the study was not designed nor powered to evaluate the effect of diet on MS, no patient experienced worsening MS disease on the diet, and there was a significant decrease in Expanded Disability Status Scale scores at 6 months secondary to improved sensory and bowel/bladder symptoms.

“Our primary goal was to show that following the ketogenic diet for several months was safe and feasible for stable MS patients, and we have shown this,” Brenton commented. “The diet does not seem to be detrimental for stable MS patients — it does not exacerbate the disease.”

“A small study like this for just a few months is not going to show a benefit in terms of slowing disease in a stable MS population,” he noted. “There were, however, some quality of life benefits. We saw a meaningful reduction in fatigue. Many MS patients complain of fatigue and the fatigue scores were quite high at baseline in our cohort and were significantly reduced with the ketogenic diet.”

The researchers also saw a reduction in depression scores, Brenton added. “The majority of our patients had mild levels of depression and the depression scores were reduced with the ketogenic diet.”

A supplementary analysis showed that fatigue and depression were reduced more in patients who were compliant with the diet vs those who were not.

“Fatigue and depression are very common in MS patients, so anything that reduces this will be very helpful. However, the reduction in fatigue and depression could have been due to the loss of weight in these patients,” Brenton said.

A strength of the study, Brenton pointed out, was the objective measurement of compliance. “Most diet studies rely on patient recall of their food intake, which can be unreliable, but we asked the patients to measure their urine ketone levels every day,” he said. “They did this with strips marked with the day’s date which they had to photograph and email to us every day, so we felt confident that the adherence measures were correct.”

The criteria for compliance required patients to have detectable levels of ketones in the urine on 85% of the days.

“Although we had a small sample size, we achieved an adherence of 75% at 6 months, which is relatively good for a ketogenic diet study,” Brenton noted.

Brenton believes the daily urine testing was helpful in maintaining compliance with the diet. “Patients liked having a goal of detecting ketones every day. They were excited when they achieved higher values — this acted as a marker for how well they were eating.”

He cautioned that many of the patients were overweight or obese and for some of them their primary objective was to lose weight — which they did, with BMI reduced by 3 points on average. This could have led to the improvement in fatigue and depression.

“This was a highly motivated population. There was a real interest in enrolling in the study. We recruited very quickly and we had to turn away many patients,” Brenton reported.

His team is now conducting a larger-scale study of the ketogenic diet in about 60 MS patients. That larger study will investigate whether the diet affects immune cells and the gut microbiome, which is believed to interact with the immune system in MS.

Needs Medical Supervision

Although this study suggests ketogenic diet is safe for a few months in MS patients, and it represents an intriguing new approach, Brenton warns against MS patients trying the diet without medical supervision.

“Our patients were closely monitored by a dietitian. I would recommend that if patients wanted to follow this diet they should have their family doctor involved,” he said.

“This diet raises LDL cholesterol levels and so may not be appropriate for patients with cardiovascular disease,” he cautioned. “A professional should be intermittently following pertinent lab values. We excluded patients at high risk of heart disease from this study. Another side effect can be kidney stones — particularly at risk are those patients who have suffered from kidney stones prior to the diet.”

However, Brenton said a less restrictive, low carbohydrate diet does make sense for many people. “One benefit of this study is that we trained our patients to restrict carbohydrates, look at labels, and calculate carbohydrate content of foods. And even those who didn’t stay on the ketogenic diet cut down their carbohydrate intake quite substantially. Most of us eat far too much carbohydrate.”

“Right now, my advice to patients is follow a well-balanced, healthy diet, which often involves reducing baseline carbohydrate intake,” he added.

A ketogenic diet is not going to be the one diet that is right for everyone, Brenton concluded.

“There are many different diets being researched in MS,” he noted. “With diet studies for MS, as with and other conditions, it is probably going to be a case of identifying specific diets for specific patients.”

This study was funded through private foundational funding provided by the ziMS Foundation. Brenton has served as a consultant for Novartis.

Neurol Neuroimmunol Neuroinflamm. Published online April 12, 2019. Full text

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Ketogenic diet for multiple sclerosis (MS)

Ketogenic diets could modify the immune response and thus change the course of MS. Animal experiments confirm this, but what about humans?

Neurology Blog
By Dr. Sophie Christoph

Ketogenic diets could modify the immune response and thus change the course of MS. Animal experiments confirm this, but what about humans?

Obesity is a known risk factor for MS and diet is a potentially modifiable factor that could influence disease progression. Recent studies suggest a link between eating habits and the degree of disability or symptom severity suffered (sources 1 and 2). In a large cross-sectional study, the quality of diet and an active lifestyle were also associated with lower fatigue, depression, cognitive impairment, and less pain.

An alternative energy source for vulnerable neurons

Ketogenic diets mean a lot of fat with few carbohydrates and thus imitate a state of fasting. There is a shift in metabolism away from energy production by glycolysis towards beta-oxidation of fatty acids as the primary energy source, resulting in ketone bodies. We do not want to make a metabolic physiology lecture out of it, but only name some essential mechanisms through which a ketogenic diet could have a beneficial effect:

  • Less ROS (reactive oxygen species) are formed.
  • In addition, ketone bodies, which are transported across the blood-brain barrier, regulate antioxidant signaling pathways and increase energy production in brain tissue.
  • Recent studies in animals and humans have shown that ketogenic diets reduce inflammatory biomarkers in blood and cerebrospinal fluid.

In the mouse model of experimental autoimmune encephalitis, a ketogenic diet led to the reversal of motor disability, improved learning, and memory, higher hippocampal volumes, and remyelination of periventricular lesions (source 3). This was associated with suppressed production of inflammatory cytokines and increased neuronal repair processes.

Ketogenic diet improves fatigue, depression, and weight in MS patients

The results of a small pilot study (source 2) in 20 patients with relapsing-remitting MS were published in July 2019 in Neurology, the official journal of the American Academy of Neurology (AAN). Adherence to a modified Atkins diet was verified by a daily ketone test in urine. After 6 months, a decrease in body fat and BMI (p < 0.0001) and an improvement in the scores for fatigue (p = 0.002) and depression (p = 0.003) were observed. After 3 months, leptin concentrations in serum (a proinflammatory adipokine) had decreased significantly (p < 0.0001).

Alternative models of MS: Ketogenic diet also improves the neurodegenerative component of MS

There is growing evidence that neurodegeneration plays an important role in MS in addition to neuroinflammation, even if there is no consensus as to whether neurodegeneration triggers inflammation or vice versa – or whether both mechanisms exist in parallel. Mitochondrial dysfunction appears to be central to the neurodegenerative component of MS pathogenesis. This results in lower availability of ATP, which could promote axonal atrophy and degeneration. In vitro and animal studies, a ketogenic diet has been shown to improve mitochondrial function and thus promote axonal survival by promoting ATP production and mitochondrial biogenesis, bypassing disturbed processes within mitochondria, increasing levels of antioxidants, and reducing oxidative damage (source 4).

Normalization of the microbial disorder in MS under a ketogenic diet

Various studies have reported significant differences in the concentration, diversity, and composition of intestinal bacteria in MS patients and their influence on immune regulation. After approximately 3 months on a ketogenic diet, this condition also improved in MS patients (source 5).

There is still very little evidence of this in humans, but we can look forward to further, hopefully, larger and more controlled studies.

Sources:
1. Fitzgerald, K. C. et al. Diet quality is associated with disability and symptom severity in multiple sclerosis. Neurology 90, e1-e11 (2018).
2. Brenton, J. N. et al. Pilot study of a ketogenic diet in relapsing-remitting MS. Neurol Neuroimmunol Neuroinflamm 6, (2019).
3. Kim, D. Y. et al. Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis. PLoS ONE 7, e35476 (2012).
4. Storoni, M. & Plant, G. T. The Therapeutic Potential of the Ketogenic Diet in Treating Progressive Multiple Sclerosis. Mult Scler Int 2015, 681289 (2015).
5. Swidsinski, A. et al. Reduced Mass and Diversity of the Colonic Microbiome in Patients with Multiple Sclerosis and Their Improvement with Ketogenic Diet. Front Microbiol 8, 1141 (2017).

Should You Try a Keto Diet if You Have an Autoimmune Disease?

July 9th, 2019

• Free eBook: 35 Gut Recovery Recipes

Ketogenic (or “keto”) diets have become tremendously popular in the past few years, leading many members of our community to ask, “Should you try a keto diet if you have an autoimmune disease?”

In this article, I’ll cover everything you need to know about the ketogenic diet. I’ll also discuss important points to keep in mind if you have an autoimmune disease and want to try keto, including how to support your liver and optimally metabolize fat!

What is a Keto Diet?

The ketogenic diet is a low-carb, high-fat diet. It triggers the body’s natural metabolic process known as “ketosis.” Consuming minimal amounts of carbohydrates deprives your body of its natural fuel source, glucose, forcing it to use stored fat as fuel instead.1 As stored fat is broken down, your liver produces “ketones,” a type of fatty acid, and sends them into your bloodstream where your muscles and other tissues use them as fuel.2 Ketosis normally occurs in a fasting state, however it can also occur in the absence of glucose and in the presence of medium-chain triglycerides (MCTs), such as those found in coconut.3

As you can see, keto diets contain far fewer carbs and more than double the amount of fats typically consumed in standard diets or even Paleo diets. You also want to make sure you are consuming only moderate amounts of protein—on the low end of what you’d normally eat on standard and Paleo diets—because too much protein can kick you out of ketosis.

History of the Keto Diet

I want to point out that although keto diets have seen a recent resurgence, they are not “new” in any sense of the word. The ketogenic diet was developed during the 1920s as an alternative therapy for children with epilepsy, while fasting was used as a way to treat disease for thousands of years.4Now people use the keto diet primarily to lose weight, increase energy, and optimize brain function. However, given its success in reducing the number of seizures in epileptic patients, more research has emerged exploring the ability of the ketogenic diet to treat a range of neurologic disorders and other types of chronic illnesses.

Health Benefits of a Keto Diet

With the development of prescription medications for seizures, the ketogenic diet fell off the radar. Now that it is regaining traction in mainstream society, researchers are beginning to look more closely at the keto diet for its ability to mitigate the symptoms of a number of disorders, including neurodegenerative diseases, obesity, diabetes, cancer, and even some autoimmune conditions.

Neurodegenerative Disease

There is already solid evidence that the ketogenic diet reduces seizures in children, sometimes as effectively as medication.5 It has been found to be especially effective when patients do not respond well to drug treatments.6

New research indicates the benefits of keto extend to a broad range of neurodegenerative disorders. This includes Alzheimer’s, Parkinson’s, and multiple sclerosis (MS). It may also be protective in traumatic brain injury and stroke.7 One theory for keto’s neuroprotective effects is that the ketones produced during ketosis provide additional fuel to brain cells, which may help those cells resist damage from inflammation caused by these diseases.8

Additionally, animal studies showed the ketogenic diet’s ability to reduce oxidative stress and inflammation. It also increased ATP production, and improved learning, memory, and motor ability.9,10 ATP production is critical for neural development, signaling, and controlling the immune system.

Obesity and Type 2 Diabetes

Your body burns stored fat when in ketosis so the keto diet can be an effective tool for weight loss. A study on the long-term effects of ketogenic diets in obese patients found that it significantly reduced body weight and body mass index. It also decreased levels of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol.11

In addition to promoting weight loss and its associated benefits, low-carb diets also improve insulin sensitivity. For anyone with type 2 diabetes, the keto diet may be an ideal option. According to a study conducted by the University of Michigan, eating three low-carb meals within 24 hours reduced insulin resistance by more than 30%.12

Cancer

Ketogenic diets may be one of the few treatments that show promise for cancer. Cancer cells feed off of glucose. When you deprive your body of glucose by adopting a very low- to no-carb diet, you are “starving” the cancer cells.13

As early as 1987, studies on ketogenic diets resulted in reduced tumor growth and improved survival. Ketosis by fasting also showed to help alleviate side effects of chemotherapy, and improve the effectiveness of radiation. Advanced cancer patients may also benefit from a keto diet in terms of quality of life. They may experience improved moods and reduced insomnia.14

Autoimmune Disease

The keto diet reduces inflammation and modulates the immune response. It could be an effective tool for reversing symptoms of autoimmunity. Ketogenic diets also increase glutathione levels, which is your body’s most powerful detoxifier.15 People with autoimmunity are notoriously low in glutathione, and I’ve found in both my patients and myself that supplementing with glutathione is extremely beneficial.

The Keto Diet and Autoimmunity

If you have any of the above conditions, by all means give keto a try! If you have an autoimmune disease and are following The Myers Way®, you know the most important part is cutting out the toxic and inflammatory foods that lead to autoimmunity. You can definitely do a ketogenic version of that! The Myers Way® already eliminates gluten, grains, and legumes. It is very low-carb to begin with, especially if you are following the Candida Breakthrough® or SIBO protocols. This will give you a head start when transitioning to a keto diet. However, there are a few important factors to consider before trying keto if you have an autoimmune disease.

Hormones, Thyroid Function, and Ketosis

Though I am not opposed to a keto diet, I personally did not do well on it. I’ve found that for many of my patients with autoimmunity, it is not always the right choice. This is particularly true of women and those with thyroid dysfunction. Many women, especially those going through perimenopause, find the keto diet difficult. Their hormones are fluctuating so much that they need carbohydrates to support and balance them. Ketosis can also strain your adrenals. As their adrenals are already shot, perimenopausal women and those with thyroid dysfunction can experience issues with keto. The same goes if you are overly stressed. Chronic stress puts your adrenals into overdrive for extended periods of time leaving you in a state of adrenal fatigue. You would want to address your stress levels before attempting a keto diet in order to prevent total adrenal burnout.

If you don’t respond well to keto, don’t beat yourself up! It may be all the rage right now and maybe your husband lost 20 pounds by going keto. That does not mean it will work for you. I do find that men tend to tolerate the keto diet much better than women. Everyone and their body are unique. It comes down to listening to your body and knowing what’s right for you.

Top Supplements to Support Yourself on a Keto Diet

If you have autoimmunity and are interested in pursuing a ketogenic diet, there are a few ways you can support your transition.

Paleo Protein and Collagen

When transitioning to a keto diet I recommend adding Paleo Protein and Collagen Protein to your diet. Paleo Protein is a low-carb, clean source of complete protein that you can blend right into a smoothie. Collagen Protein is a zero-carb source of protein that you can stir into any hot or cold beverage. It’s perfect for smoothies, juices, tea, or even water!

Adrenal Support

Women and anyone with thyroid dysfunction or chronic stress can benefit from supplementing with Adrenal Support when following a keto diet. Adrenal Support promotes optimal stress response, adrenal health, and stress hormone production.

Multivitamin

Keeping an eye on your thyroid hormone levels is especially critical when transitioning to a keto diet. Balance and optimize your levels with a multivitamin to ensure you are getting enough selenium, iodine, and zinc. All of these nutrients are necessary to support optimal thyroid function.

Enzymes

If your body is not used to consuming a high-fat diet, it could take time for your digestion to adjust. Digestive enzymes will help your body break down fat to ease you into the transition.

Liver Support

Keto can be hard on the liver because it is primarily the liver that metabolizes fat for energy. For that reason, I recommend anyone following a keto diet to take Liver Support in order to optimize liver functioning.

This may be just the beginning of your keto diet journey. If that’s the case, I want to provide you with information to make the most of it! You can use this resource as a guide for how to follow The Myers Way® while transitioning to a keto diet.

Article Sources

Dr. Terry Wahls, a clinical professor of medicine at the University of Iowa Carver College of Medicine in Iowa City, Iowa, U.S.A., where she teaches internal medicine residents in primary care clinics, in addition to being a physician is also a multiple sclerosis (MS) patient. First diagnosed in 2000, around the time she began working at the university, by 2003 Dr. Wahls says she had transitioned to secondary progressive multiple sclerosis, and underwent chemotherapy in an attempt to slow the disease. She also began using a tilt-recline wheelchair because of weakness in her back muscles. At this point, she had resigned herself to eventually becoming bedridden due to the disease’s ravages — an outcome she wanted to forestall for as long as possible.

Dr. Wahls, who also does clinical research and has published more than 60 peer-reviewed scientific abstracts, posters, and papers, says that thanks to her academic medical training, she knew that animal model research of diseases is often 20 or 30 years ahead of clinical practice, and hoping to find something to arrest her descent into becoming bedridden, she used PubMed.gov to search scientific articles about the latest multiple sclerosis research.

In so doing, she relearned biochemistry, cellular physiology, and neuroimmunology to understand the articles. Unfortunately, she found that most studies underway were testing drugs years away from FDA approval, and it occurred to her to search for vitamins and supplements that helped any kind of progressive brain disorder. She gradually created a list of nutrients important to brain health and began taking them as supplements, and while the steepness of her decline slowed, she was still getting worse.

In 2007, Dr. Wahls discovered The Institute of Functional Medicine, an organization devoted to helping clinicians use the latest scientific discoveries to take better care of those with complex chronic diseases by addressing the underlying causes of disease, and using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms.

As a result of this discovery, Dr. Wahls developed a longer list of vitamins and supplements that were good for my brain, and I had an important epiphany: “What if I redesigned my diet so that I was getting those important brain nutrients not from supplements but from the foods I ate? I used what I had learned from the medical literature, Functional Medicine, and my knowledge of the Hunter-Gatherer diet — the most nutritious of any diet — to create my new food plan. At that same time, I also learned about neuromuscular electrical stimulation and convinced my physical therapist to give me a test session. It hurt a lot, but I also felt euphoric when it was finished, likely because of the endorphins my body released in response to the electrical stimulation. In December 2007, I began the Wahls Protocol.”

Dr. Wahl adopted the nutrient-rich paleo diet, gradually refining and integrating it into a regimen of neuromuscular stimulation. First, she walked slowly, then steadily, and then she biked eighteen miles in a single day.

Dr. Wahls says the results “stunned” her physician, her family, and her, and within a year she was able to walk through the hospital without a cane and even complete an 18-mile bicycle tour.

The Wahls Protocol is based on Functional Medicine and the Wahls Paleo diet, Dr. Wahls restored her health and now pedals her bike five miles to work each day.

Dr. Wahls’ experiences resulted in a book, “The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine” coauthored with Eve Adamson, in which she shares details of the protocol that allowed her to reverse many of her symptoms, and get back to her life.

Dr. Wahl’s adopted the nutrient-rich paleo diet, gradually refining and integrating it into a regimen of neuromuscular stimulation. First, she walked slowly, then steadily, and then she biked eighteen miles in a single day. In November 2011, Dr. Wahls shared her remarkable recovery in a TEDx talk that immediately went viral. In The Wahls Protocol, she shares the details of the protocol that allowed her to

reverse many of her symptoms, get back to her life, and embark on a new mission: to share the Wahls Protocol with others suffering from the ravages of multiple sclerosis and other autoimmune conditions.

Dr. David Perlmutter, MD, author of the #1 New York Times bestseller “Grain Brain:Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar–Your Brain’s Silent Killers,” notes that “In The Wahls Protocol, Dr. Wahls provides elegant first hand validation that diet truly represents the most powerful medicine. This book is totally supported by the most leading edge research and provides a beacon of hope

when compared to the ever changing landscape of pharmaceutical recommendations for multiple sclerosis.”

In “Grain Brain,” Dr. Perlmutter, a board-certified neurologist and American College of Nutrition Fellow, declares war on a common foodstuff, attributing a bewilderingly wide assortment of maladies to the consumption of gluten, a substance found in bread and other staples North American diet. Contrasting modern humans against idealized humans of the distant past, Dr. Perlmutter concludes that the former, whose average life expectancy at birth is about twice that of their Paleolithic ancestors, have gone off the proper track. He addresses the objection that gluten has been part of the human diet for many millennia by asserting that recent changes to crops (such as chemical adulterants and mineral depletion of soils) have transformed a once-safe food into a “terrible scourge.”

Another resource referenced by Dr. Wahls is “The Paleo Answer: 7 Days to Lose Weight, Feel Great, Stay Young” by Loren Cordain, whose best-selling The Paleo Diet and The Paleo Diet Cookbook have documented the diet he contends humans were genetically designed to eat: meats, fish, fresh fruits, vegetables, nuts and other foods that mimic the diet of our Paleolithic ancestors. In The Paleo Answer, Mr. Cordain details a prescriptive 7-day plan with recommended meals, exercise routines, lifestyle tips, and supplement recommendations, as well as insights from the author’s research over the last decade, such as why he contends vegan and vegetarian diets are not healthy and why dairy, soy products, potatoes, and grains can be harmful to our health.

For more on low carb ketogenic (Paleo) diets as disease-fighter protocols, see this article by The Examiner’s Joanne Eglash

Sources:
Dr. Terry Wahls, MD
The Institute of Functional Medicine
Amazon.com
The Examiner

Image Credits:
Dr. Terry Wahls, M
D

The Keto Diet: Are There Any Benefits for People With MS?

The ketogenic diet isn’t just about weight loss, though that’s certainly the main reason many people are interested in it today. It was developed as a treatment for epilepsy in the 1920s, after physicians observed that fasting reduced seizure activity. Its origins may date back much further, however: There’s some evidence that ancient civilizations used versions of the ketogenic diet as an epilepsy treatment. The diet is still used today by some people with epilepsy, particularly children, whose seizures aren’t controlled with medication.

Called the keto diet for short, the ketogenic diet is high in fat, very low in carbohydrates, and moderate in protein. According to the Harvard T.H. Chan School of Public Health, when following the keto diet, about 70 to 80 percent of daily calories should come from fat, 10 to 20 percent from protein, and 5 to 10 percent from carbohydrate.

In contrast, the Dietary Guidelines for Americans recommend consuming no more than 20 to 35 percent of daily calories from fat, 45 to 65 percent from carbohydrate, and 10 to 35 percent from protein for a generally healthy diet.

Consuming very low amounts of carbohydrate causes the body to burn fat for energy (rather than carbohydrate), which in turn causes the formation of chemicals called ketones as a by-product. The ketogenic diet is so called because following it causes the body to generate ketones. This process of breaking down fat and creating ketones is called “ketosis.”

Even after all these years, the precise mechanism for the ketogenic diet’s antiseizure activity remains unknown. There’s also some evidence that following the diet may help people with type 2 diabetes lower their blood sugar levels, possibly by encouraging weight loss.

And what about multiple sclerosis (MS)? Could the keto diet have any effect on the course of MS? A few researchers have been investigating this question in recent years, and here’s what they’ve found.

Research Findings on the Keto Diet and MS

It’s important to note that the human studies mentioned here are small, involving fewer than 20 people.

Changes the Gut Microbiome

A study published in June 2017 in the journal Frontiers in Microbiology examined the gut microbiome of 10 people with MS before following the keto diet and after they had followed the keto diet for six months. Before the keto diet, the researchers found the concentration of “numerically substantial biofermentative bacteria” was low among people with MS. After six months of the keto diet, their gut microbiome resembled that of the healthy control group in the study.

Protects the Brain, at Least in Mice With MS

An earlier animal study published in the journal PLoS One explored the effects of the keto diet on memory impairment and inflammation of the central nervous system in mice with a mouse version of MS (called EAE). The study found that the keto diet suppressed motor and memory dysfunction but did not prevent the onset of EAE in those mice that followed the keto diet before being injected with a substance that causes EAE in mice.

Reduces Fatigue and Depression

A study published in July 2019 in the journal Neurology: Neuroimmunology & Neuroinflammation found that a type of keto diet called the modified Atkins diet improved fatigue and depression in people with multiple sclerosis. According to J. Nicholas Brenton, MD, lead author of the study and assistant professor of neurology and pediatrics at the University of Virginia in Charlottesville, the diet also led to improved stamina and contributed to weight loss and decreased levels of pro-inflammatory leptin. The study was small (19 people), but Dr. Brenton says it appears that the keto diet is safe for people with MS and that the disease did not get worse for any of the participants while on the diet.

Benefits Include Weight Loss, Less Fatigue, Better Exercise Habits

A follow-up article published in May 2019 in the journal Neurology looked at patient experiences with the keto diet, including their perceived benefits of following it. Of the 18 participants, 83 percent of the participants chose weight loss as a diet benefit, 72 percent chose fatigue improvements, just over 55 percent chose better exercise habits, 50 percent more stamina, and 45 percent a reduction of MS symptoms. All of the participants said they’d recommend the keto diet to a colleague.

Decreases Hunger and Inflammation While Increasing Lean Body Mass

A study published in May 2019 in the journal Nutrients examined the satiating (satisfying) effect of following the keto diet as well as its effects on muscle mass and level of oxidation in 27 people with multiple sclerosis. Oxidation is the normal process of cell decay, but excessive levels of oxidation, or oxidative stress, can lead to inflammation and tissue damage. The researchers found that following a ketogenic diet for four months reduced subjects’ perception of hunger before and after lunch and dinner — although not before and after breakfast — and additionally led to an increase in lean mass, decrease in fat mass, and lowered levels of oxidation and inflammation.

Theories on Why the Keto Diet Might Help People With MS

Experts don’t yet know specifically what it is about the keto diet that leads to the changes observes in study subjects with MS — that’ll likely be the focus of future research — but there are a few theories:

Following the Diet Reduces Inflammation

MS is an inflammatory disease that causes damage to the central nervous system. Research shows that the keto diet decreases inflammation and levels of oxidative stress, which may help to alleviate MS symptoms, Brenton says.

“Additionally, fat — as opposed to carbohydrate — is a more efficient source of energy for the brain, which may be particularly important in a brain that is battling inflammation, as is the case in MS,” he says.

People With MS May Respond Better to Ketones Than to Glucose

But inflammation isn’t the only cause of MS symptoms. As Mary Rensel, MD, staff neurologist and director of wellness and pediatric MS at the Cleveland Clinic’s Mellen Center for MS in Ohio, points out, people with MS also experience neurodegeneration, which contributes to progressive disability.

“One of the questions in MS is ‘What’s hurting the nerves?’ and one of the possible answers is that mitochondria are not working correctly,” Dr. Rensel says. Mitochondria are the “energy producers” within the cells, and according to Rensel, they may not use glucose correctly in people with MS. (Glucose is the primary fuel derived from carbohydrate.) These people may respond better to ketone bodies, which are produced as a result of ketosis.

“If you go into ketosis, you produce different energy makers — ketone bodies — and they get through the blood-brain barrier so they can get access to the brain and be used as an energy source,” Rensel says. An article published in 2015 in the journal Multiple Sclerosis International explored the reasons a ketogenic diet may have neuroprotective properties for people with MS and concludes that it is worth studying as a possible treatment for progressive MS, in which neurodegeneration is the primary problem.

Weight Loss Improves Quality of Life for People With MS

Another reason the diet may help is it frequently leads to weight loss.

“It seems that people who are obese and have a poor diet may be at an increased risk of getting MS,” Rensel says. “And when you have MS, obesity and poor diet can lead to more progressive disability, so may indeed increase the risk of getting it or the course of it.”

Brenton agrees that a healthy body weight, whether achieved through the keto diet or another method, is beneficial. “I do believe that weight loss can positively impact many comorbid symptoms of MS — including pain, fatigue, and mood disorders,” he says.

Risks and Side Effects of the Keto Diet

With all of these potential benefits, why aren’t neurologists recommending the keto diet to all people with MS?

For one thing, it’s notoriously difficult to stick to.

“Ketogenic diets take effort to adhere to, and these types of diets will not fit into every individual’s life situation,” Brenton says. A meta-analysis published in January 2015 in the Journal of Clinical Neurology found that across 12 studies, only 45 percent of adults with intractable epilepsy were able to stick with it.

The National Multiple Sclerosis Society also notes that going on a low-carb diet can lead to fatigue, which is already a common problem in people with MS.

Brenton adds that in his research, the most common side effect of the keto diet was constipation, with about 25 percent of the study participants reportedly being affected by it. Twenty-two percent of the participants reported menstrual irregularities, and 17 percent experienced diarrhea.

More Questions Than Answers About Keto and MS

The completed studies about the effectiveness of the keto diet for people with MS have been promising but too small to draw broad conclusions.

“It’s interesting, but not necessary for everyone to follow this minute,” Rensel says. “At this very moment, we don’t know the perfect diet for multiple sclerosis patients.”

Those studying the keto diet for MS agree that more research is needed. “While I think there are many benefits these diets can offer to MS subjects, there needs to be more research into the ‘hows’ and ‘whys’ of these diets,” Brenton says. “Were the benefits to our patients purely secondary to weight loss, or does this diet offer something more? The way to answer this question will be through a randomized, controlled study.”

If you’re interested in following the keto diet to help manage your MS symptoms, be sure to speak with your physician first to discuss the pros and cons.

“At this point in time, I still think diet for MS needs to be evaluated on case-by-case basis,” Brenton says.

Fasting or keto: possible treatment for multiple sclerosis

Principle Study: Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms

If you want to stay on top of the latest nutrition research, check out the Examine.com Research Digest.

Multiple sclerosis (MS) is an autoimmune disorder characterized by muscle weakness and numbness, as well as problems with vision and bladder control. It is caused by the immune system attacking nerve-insulating myelin sheaths, which disrupts the communication between the brain and peripheral parts of the body. The disease is generally classified as either primary progressive MS or relapsing-remitting MS.

Primary-progressive MS is characterized by a progressively worsening neurological function that is evidenced by continuous symptoms, although these may change over time. Relapsing-remitting MS is characterized by clearly defined episodes that are separated by periods of remission from the disease. During remission there is a complete absence of symptoms with no apparent progression of the disease.

Oligodendrocytes are glial cells that help create the myelin sheath around nerve axons in the central nervous system (CNS). These cells are critical for the development of the brain and ensure correct functioning of the nerve cells. The myelin sheath they produce acts as insulation that protects long nerve projections (known as axons) and facilitates the conduction of nerve signals.

During MS there is a loss of myelin in defined areas—known as lesion sites—in the brain and spinal cord. The process leading to lesions is summarized in Figure 1. MS is characterized by a large array of invading immune cells, such as T-cells (tissue-infiltrating immune cells), B-cells (cells that secrete antibodies) and macrophages (a type of white blood cell that engulfs other cells and molecules). These cells attack and degrade the myelin sheath, the myelin-producing oligodendrocytes, and the nerve axon. Lesion sites develop over time and initially result in clinically benign symptoms, but they progress to significant disabilities.

The long-term impact of MS treatments is unclear, as most MS drugs manage symptoms and do not reverse neurological damage. Although they have shown efficacy, these immunosuppressive drugs often come with severe side effects. Effective and safe treatments are in high demand and are required to mitigate autoimmunity, but also to stimulate regeneration and restore lost functionality.

Some studies on animal models of MS have suggested that various forms of dietary restriction, such as calorie restriction, intermittent fasting and the ketogenic diet, protect neurons and reduce inflammation. Studies have also shown that periodic fasting can improve cognitive function and reduce oxidative stress. A new study utilizing a diet that mimics fasting was tested to determine its effects on autoimmunity and inflammation.

Multiple sclerosis is an autoimmune disorder of the central nervous system during which the immune system attacks and destroys the myelin sheath around nerve axons. Most treatments for multiple sclerosis are immunosuppressive and do not alleviate autoimmunity or regenerate the damage already caused. New research hopes to determine the role diet and nutrition could have on overcoming multiple sclerosis.

Who and what was studied?

Many researchers use a disease model known as experimental autoimmune encephalomyelitis (EAE) to study multiple sclerosis. This is a demyelinating disease of the CNS in mice and shares many clinical similarities with MS. To induce EAE, animals are injected with myelin antigens mixed with compounds to stimulate the immune system into autoimmunity.

In this study, mice were immunized as described to induce EAE between eight and fourteen days post-injection. At the onset of EAE symptoms, the mice were put onto a diet called a fasting mimicking diet (FMD). The feeding schedule consisted of 50% of their normal calorie intake on day one and 10% of their normal calorie intake on day two and three. The mice returned to a normal diet on days four through seven. This cycle was repeated three times. In between each cycle, there was a four day period where mice were given their normal diet. The total test period was 29 days and mice were analyzed on a daily basis for clinical symptoms.

To ascertain the effect of a similar diet in relapsing-remitting MS patients, a randomized parallel-design clinical pilot trial was carried out. Patients were randomly allocated to three different groups, with 20 patients in each group. One group was provided seven days of FMD followed by six months of the Mediterranean diet. In the second group, patients were tested on a ketogenic diet (KD) for six months. Both groups were controlled against a third group, in which participants were told to maintain their normal diet for six months.

Similar to the mouse studies, the human FMD involved a very low calorie diet of 800 kcal on day one, followed by just 200-350 kcal on day two to day eight. Food was stepwise reintroduced on day nine to eleven. Participants in the KD group were advised to eat less than 50 grams of carbohydrates, more than 160 grams of fat, and less than 100 grams of protein daily. The primary outcomes included quality of life analysis, as well as composite scores for physical and mental health parameters. Participants also had blood taken for analysis of circulating white blood cells.

Scientists tested the effects of the fasting mimicking diet as a treatment on a mouse model that replicates MS. Furthermore, this diet was tested on human participants suffering from relapsing-remitting MS to determine whether it was effective, safe, and feasible.

What were the findings?

The effect of FMD against the development of EAE in mice was examined in the context of disease severity. The application of three cycles of FMD reduced disease severity regardless of when FMD was started. If FMD was applied after 10% of the animals developed EAE, there was a delay in disease onset and a significantly reduced incidence rate, from 100% down to 45.6%. If FMD was applied after 100% of the population had EAE, there was a complete reversal of symptoms in 21.7% of the population.

To examine the ability of FMD to reduce autoimmunity, circulating white blood cells were measured. FMD caused a temporary 40-50% reduction in all white blood cell types. In addition, spinal cord sections showed that mice treated with FMD had a 75% reduction in markers for inflammation (CD11b+ cells) compared to mice on the control diet. Myelin-specific effector T-cells (CD4+ and CD8+ T-cells), which migrate into the CNS and initiate demyelination, were also reduced after the FMD diet. By counting cells in spinal cord sections, CD4+ cells were shown to be reduced from 8.6% to 1.5% and CD8+ cells were reduced from 1.3% to 0.4%.

There was a reduction in demyelination in FMD-treated mice, which was hypothesized to be due to enhanced oligodendrocyte regeneration. Oligodendrocytes are the cells that produce the myelin sheath in the CNS. Quantitative analysis of spinal cord sections showed that there was significant reduction of 30.4% in the number of mature oligodendrocytes in mice in the control group compared to the mice in the FMD group.

To investigate whether the results in the animal study could be replicated in humans, a randomized pilot trial was carried out in participants suffering from relapsing-remitting MS. Patients that were prescribed either a fasting mimicking diet or a ketogenic diet showed meaningful improvements in health-related quality of life scores after three months, with specific results shown in Figure 2. This included a clinically significant five point improvement over the threshold in overall quality of life of those in the FMD group. In addition, the FMD group had positive changes of ten, two and four points over the threshold in change in health, physical health, and mental health scores, respectively.

The KD group on the other hand were observed to only have improvements in the overall change in health scores. Here, there was a clinically significant eleven point improvement over the threshold. The scores for quality of life, physical and mental health hovered around clinical significance and although the mean was below, the error extended beyond the clinically significant threshold.

To analyse the immune response in relapsing-remitting MS patients, blood samples were collected from each group. There was a slight reduction in lymphocytes and white blood cell counts with a significant reduction of approximately 20% in total lymphocyte count in 72% of the FMD group. However, this lymphocyte reduction reverted back to normal three months after switching to the Mediterranean diet. With regard to the ketogenic diet group, there was no significant change in lymphocyte count from the baseline level.

FMD administered for three cycles was effective at ameliorating symptoms in a mouse model of MS. FMD mediated these effects through immune suppression and oligodendrocyte regeneration. When tested in patients with relapsing-remitting MS, there were clinically significant improvements in health and disability scores after three months.

What does the study really tell us?

Three cycles of a fasting-mimicking diet treatment reduced disease severity in an animal model of MS. This diet likely worked by reducing the number of circulating immune cells that migrate to lesion sites and cause demyelination. As previously shown, prolonged fasting comes with a substantial stress burden, as well as longevity-enhancing benefits. By cycling periods of fasting and feeding, several cell types associated with multiple systems are regenerated. With promising results in the animal model, the researchers extrapolated that this diet may be clinically relevant for humans with MS.

When FMD or KD was given to relapsing-remitting MS participants, it was observed to be safe and well-tolerated with high compliance rates. There were positive changes in health-related quality of life scores as well as improvements in physical and mental scores in the FMD group. However, these mild improvements were the result of a single cycle of FMD and so further studies on multiple FMD cycles in MS patients would be necessary to determine whether FMD could be more effective. The KD group on the other hand was not as effective as FMD at improving physical or mental scores, but there was a significant change in the overall health score. This suggests that KD has at least some positive effects on those with relapsing-remitting MS.

By cycling feeding and fasting, biomarkers for autoimmunity and inflammation were reduced in an animal model of MS. Translation into humans resulted in only mild improvements. However, this occurred after only one fasting cycle. Further cycles of the FMD may support the use of this regime for people suffering from relapsing-remitting MS.

Big picture

In mammals, the cycling between fasting and fed states changes the levels of circulating nutrients and growth factors. As such, metabolic processes change between energy-consuming (anabolic) and energy-producing (catabolic) pathways. A main driver in regulating this is the mTOR signaling pathway, which integrates a variety of environmental cues to regulate metabolic homeostasis. In nutrient-rich conditions, mTOR is activated. In nutrient-limiting conditions, it is inhibited. mTOR has been shown to play a key role in controlling glucose and lipid homeostasis through its signaling cascade.

Various forms of dietary restriction have been shown to be robust interventions that increase the lifespan of a variety of organisms, from yeast to monkeys. The protective mechanism is hypothesized to be mediated through the aforementioned mTOR signaling pathway, which has many downstream actions that could be relevant in cancer, obesity, diabetes, and neurodegeneration. It is therefore possible that FMD benefits autoimmunity through modulation of the mTOR pathway. Although plausible, this is speculative.

It is also possible that FMD causes an anti-inflammatory effect through the up-regulation of a protein known as AMPK, as shown in Figure 3. AMPK is a highly conserved energy sensor that senses fluctuations in glucose availability and activates a signaling cascade that is involved in breaking down fat and suppressing inflammation. With the fasting-induced shift from glucose to fat oxidation—as is observed during fasting or carbohydrate restriction—AMPK stimulation may repress inflammatory responses, such as those present in conditions like MS or in chronic lifestyle diseases like diabetes and obesity. Stimulation of the AMPK pathway has been demonstrated to be important for the activation of anti-inflammatory signaling pathways and thus is a promising pharmacological target for many disorders associated with inflammation.

All living organisms depend on dynamic mechanisms that assess and adapt to their energy status and demand. The proteins mTOR and AMPK play prominent roles in maintaining homeostasis and are implicated in pathological states such as cancer, obesity, neurodegeneration, and aging. These proteins may play a role in the benefit of fasting-related diets for conditions like MS.

Frequently Asked Questions

Q. What are the differences between intermittent fasting, alternate day fasting and the fasting mimicking diet?

As a means to weight loss, intermittent fasting (daily 12 to 20 hour fasts) or alternate day fasting (one or more 24 hour fasts in a week) can be incorporated into daily routines and have been shown to be effective in losing weight. The FMD diet was originally developed to improve health without the risks of a prolonged fast of 72 hours or more. The FMD would appear to rejuvenate multiple systems within the body and as recently reported, may impact systems involved in cancer, autoimmunity issues, and inflammation.

Q. Would the fasting mimicking diet be beneficial if it was done continuously without resuming normal feeding?

The researchers believe that the fasting mimicking diet works because it is conducted in cycles. This is because during the fast, the disease-causing immune cells are essentially stopped and killed off. When normal feeding is resumed, normal immune cells and the myelin-producing oligodendrocytes are regenerated. Together, this process of cycling is how some of the mice in the study became disease-free. It is important to note that a larger study in humans is required to further establish how diet and autoimmunity interact, particularly in a disease setting.

Q. Does diet influence longevity?

Studies have shown that fasting and low carbohydrate diets such as the ketogenic diet directly promote autophagy. This is the process by which the cell destroys waste products and dysfunctional cellular components. Often described as the garbage bin of the cell, this process recycles waste that may otherwise damage the cell. Several studies have shown that enhancement of autophagy can increase the lifespan of many different organisms. Longevity-promoting regimes that are associated with autophagy include fasting and calorie restriction, which have been shown to inhibit the mTOR pathway. As previously described, the mTOR signalling pathway is implicated in several age-related disorders.

What should I know?

Researchers investigated a diet that mimics fasting, and found that it reduced symptoms in mice that had an experimental disease model similar to MS. The fasting mimicking diet caused a complete recovery in some of the mice and further analysis revealed fewer invading immune cells. In addition, FMD reduced levels of markers for inflammation, and there were observations of myelin regeneration at lesion sites.

In the second part of the study, FMD was tested on human participants with relapsing-remitting MS, and the researchers noted some improvements in quality of life and disability scores for participants who were on FMD or KD.

Keto Diet for MS: a Firsthand Account

I love bread like Kanye loves Kanye. So why would I even think about going on the ketogenic diet? In this article, I provide a firsthand account of my first week on the keto diet, including how it affected my MS symptoms.

What is the Keto Diet?

The ketogenic diet is a low-carb, moderate-protein, and high-fat diet. Experts claim that the keto diet offers many health benefits. It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into an alterned metabolic state (ketosis). When this happens, your body becomes incredibly efficient at burning fat for energy. There are many scientific studies that support the use of the diet to reduce lose weight and improve health. Despite the success stories the diet is still controversial. A diet very high in saturated fat is associated with an increased risk of heart disease. And putting your body into a ketogenic state is not something that should be taken lightly.

But there are numerous health benefits associated with being on the keto diet! Studies show that a high-fat/low carb diet can lead to:

  • Dramatic reduction in blood triglycerides, which are fat molecules that increase your risk of heart disease
  • Increased levels of ‘good’ HDL cholesterol levels, which can lower your risk of heart disease
  • Reduced blood sugar and insulin levels – particularly helpful for people with diabetes and insulin resistance
  • lower blood pressure
  • treatment for neurological disorders

I don’t want to die of heart disease! I have a neurological disorder! Maybe this diet is for me!

The Keto Diet for Brain Health

Your brain primarily relies on glucose for the bulk of its energy demands. In a typical American diet high in carbohydrates, there is plenty of glucose available for brain fuel.

But when the brain does not have enough glucose for energy, e.g., during times of fasting or low carb intake,it needs a backup fuel source. In response, the liver breaks down fatty acids and amino acids to produce ketone bodies. Typically, the liver produces ketones in small amounts whenever you go several hours without eating, for example, after a long sleep. However, during fasting or when carb intake is resicted, typically below 50 grams per day, the liver increases its production of ketones from fatty acids even further. This metabolic state, which is known as ketosis, is considered holy grail of the ketogenic diet.

When carbs are eliminated or minimized, ketones can provide up to 70% of the brain’s energy needs.

The ketogenic diet is an established treatment option for children with drug-resistant epilepsy. The chemicals produced during states of ketosis have a marked affect on chemical signaling in the brain, resulting in a reduction in seizures. We really don’t understand the mechanism behind the diet’s anti-seizure effects, but because it has been so successful, scientists have started studying the effects of the keto diet on other neurological issues. These studies centered around the effects of the keto diet on migraine headaches, Alzheimer’s disease, Parkinson’s disease, sleep disorders, brain cancer, autism, and ALS. And recently, the University of Virginia launched a two-year study on the effects of the keto diet on MS.

I have MS, and my neurogist is at UVA!

And so I enrolled in the study.

Keto Diet for MS: The Study

Turns out that I am the perfect candidate for this study, since I have MS, am in the correct age range, and I am willing to torture myself for little to no compensation. Kidding on the last part.

I made the appointment to meet with the Clinical Study team at UVA.

Bring a bathing suit. We’re going to put you in the Bod Pod.

Ok.

Enrollment in the study started just like any other enrollment in a clincial study. Lots of paperwork, questionaires, and cognitive tests just for funsies! Kidding again. These are all designed to measure my baseline levels so that my sleep, mood, and cognitive function can be monitored throughout the course of the study. Great. Then I got to speak with the principal investigator for the study and a registered dietician. Access to a dietician is one of the biggest perks of the study in my opinion, since it gives everyone some assurance that I am safely and effectively entering and sustaining ketosis.

After the baseline tests and the meetings, it was time to get my bathing suit on and hop in the Bod Pod.

The Bod Pod is a machine that gives an accurate measurement of your body fat percentage using air displacement. It looks like a giant Tylenol capsule. Basically, you sit in the Tyelnol for about 3 minutes while it does its thing, occassionally breathing into a giant tube. Then the computer spits out a report that lets you know how out of shape you really are.

Special thanks to the UVA Exercise Physiology Core Laboratory team for this image and not laughing at me while I was in this Bod Pod.

I am out of shape. But they’ve seen worse. Much worse. And while I admit that I need to lose a few pounds, I was not completely prepared for the numbers that I received, stating that I am at risk for obesity-related issues.

Maybe the keto diet will fix that. After all, people go on it to lose weight.

The First Days of the Keto Diet

At press time, I have been on the keto diet for about 10 days. I am eating all the bacon and sausage and almonds and spinach and whipping cream and avocados and eggs that I can get my hands on. I make sure to add leafy green vegetables that are low in carbs to my most of my meals. And I perform the Ketostix test (i.e., I pee on a stick) daily to measure for ketone bodies. According to the tests, I entered ketosis after the first day, and have detected ketones every day since I started the diet.

So Far, So Good, I Guess

I know I am only 10 days in, but I don’t notice any significant changes yet. There have been days that I have been more lethargic than usual – not MS fatigue, but just a general feeling like not doing much of anything. This feeling is typically paired with a bit of achiness in my upper body and mental spaciness. Then, there are days that I feel terrific – mentally sharper, more energetic. But I am not really sure if that is the diet, or if I am just having a good day. I have not lost any weight. Not one. Single. Pound.

And believe it or not, I don’t miss or crave bread, cookies, or cakes. What I do miss is convenience. For instance, I can’t just go in the pantry and get a granola bar when I am hungry. I can’t snack on Boom Chicka Pop or pretzels at night while I am watching TV. I have to plan meals, and because I am not subjecting my entire family to this torture – I mean diet – I end cooking more than one meal at dinner time. It’s annoying.

Stay tuned to see if things change!

Ketogenic Paleo Diet Reversed Multiple Sclerosis: Keto Starves Cancer

By CNY Fertility Updated on January 14, 2020

Dr. Terry Wahls, a professor at the University of Iowa Medical School, successfully reversed her progressive multiple sclerosis with a low carb, high-fat ketogenic Paleo diet.
Wahls, a physician who was diagnosed with MS in 2000, developed her own personalized keto-Paleo diet called the Wahls Protocol, and has successfully managed her multiple sclerosis with her plan.
“I used what I had learned from the medical literature, functional medicine, and my knowledge of the Hunter-Gatherer diet to create my food plan,” Dr. Wahls wrote in her bestselling book, The Wahls Protocol.
Dr. Wahls said her multiple sclerosis improved dramatically —without drugs — after she switched to a ketogenic Paleo diet.
Dr. Terry Wahls is no longer confined to a wheelchair, thanks to a high-fat, low-carb ketogenic Paleo diet. (Photo: Terry Wahls)
“The results stunned my physician, my family, and me,” said Wahls. “Within a year, I was able to walk through the hospital without a cane and even complete an 18-mile bicycle tour.”
Physician Terry Wahls reversed her multiple sclerosis after adopting a low-carb, high-fat ketogenic Paleo diet. (Photos: Dr. Terry Wahls)
TV star Jack Osbourne recently revealed he is treating his multiple sclerosis with a ketogenic-style Paleo diet. Osbourne also credited the diet for his jaw-dropping 70-pound weight loss.
Similarly, singer Chad Vaccarino of the duo A Great Big World is treating his MS with a low-carb, high-fat keto Paleo diet inspired by Dr. Wahls, Celebrity Health Fitness reported.
“My symptoms went away completely,” Vaccarino told ABC. “I’m sharing my story in the hopes that it might inspire you the way Dr. Wahls’ story inspired me.”
Scientists: Ketogenic Diet Starves Cancer
The ketogenic diet has also been touted for stopping epilepsy-induced seizures, reversing diabetes and preventing Alzheimer’s disease. More recently, the keto diet has gained attention for its capacity to “starve” cancer.
Cancer researcher Dr. Dominic D’Agostino of the University of South Florida Medical School said we are only as healthy as our mitochondria, which are the power sources of all our cells, so if we keep our mitochondria healthy, we can stall the onset of age-related chronic diseases such as cancer.
D’Agostino’s research during the past five years indicates a ketogenic diet successfully manages advanced cancer.
This is because nearly all the healthy cells in our body have the metabolic flexibility to use fat, glucose and ketones to survive, but cancer cells lack this metabolic flexibility and require large amounts of glucose and cannot survive on ketones. By limiting carbohydrates you can reduce glucose (and insulin) and restrict the primary fuel for cancer cell growth.
Mice with metastatic cancer lived 103% longer with a combination of the ketogenic diet (KD), ketone supplements (KE) and hyperbaric oxygen therapy (HBOT), compared to mice fed a standard diet (SD), according to Dominic D’Agostino’s research.
D’Agostino’s mentor, Dr. Thomas Seyfried, the author of Cancer as a Metabolic Disease, said the ketogenic diet beats chemotherapy for most cancers. This is because cancer is a metabolic — not a genetic — disease, according to Seyfried’s decades of research at Boston College.
Research shows the ketogenic diet effectively treats advanced cancer in mice. These same anti-cancer properties have also been observed in human cancer patients and reported in published studies.
There are numerous anecdotal studies of individuals treating their advanced cancer with the ketogenic diet.
Elaine Cantin discussed how she used the ketogenic diet to manage her son’s type I diabetes and her own aggressive breast cancer in her book, The Cantin Ketogenic Diet.
Professor Thomas Seyfried’s decades of research shows cancer is a metabolic disease.
“The cancer research community needs to change its view of cancer as a metabolic — not a genetic — disease in order to make meaningful progress,” said Travis Christofferson, author of Tripping Over the Truth: The Metabolic Theory of Cancer.
Today there are about a dozen studies that are investigating the use of the keto diet to manage all kinds of cancer. Those results will determine whether the medical community will adopt metabolic therapy to treat cancer in the future.
“The ketogenic diet is a single metabolic approach to a multitude of different diseases,” said Dr. Seyfried. “The standard of care has been an abysmal failure for cancer. The ketogenic diet may one day replace the standard of care for most cancers.”

MS and ketogenic diet

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