A Modified MCT-Based Ketogenic Diet Increases Plasma β-Hydroxybutyrate but Has Less Effect on Fatigue and Quality of Life in People with Multiple Sclerosis Compared to a Modified Paleolithic Diet: A Waitlist-Controlled, Randomized Pilot Study.

IF 3.4 4区 医学 Q2 NUTRITION & DIETETICS
Jennifer E Lee, Tyler J Titcomb, Babita Bisht, Linda M Rubenstein, Rebecca Louison, Terry L Wahls
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引用次数: 33

Abstract

Objective: To investigate the feasibility of a modified MCT-based ketogenic diet and its impact on plasma β-hydroxybutyrate and MS outcomes compared to a modified Paleolithic diet and usual diet in people with Multiple Sclerosis (MS).

Methods: Fifteen individuals with MS were randomized to 3 groups: 1) modified Paleolithic diet (Paleo; n = 6); 2) medium-chain triglyceride (MCT)-based ketogenic diet that included coconut as a fat source (Keto; n = 5); or 3) usual diet (Control; n = 4). Participants had blood drawn every 4 weeks to monitor nutritional ketosis. Participants completed 4-day weighed food records, measures of disability, fatigue, quality of life (QoL), cognitive function, and physical function at baseline and 12-weeks.

Results: Macronutrient intake significantly shifted toward a ratio indicative of a ketogenic diet in the Keto group at 12 weeks. Similarly, plasma β-hydroxybutyrate indicated nutritional ketosis in the Keto group, whereas neither macronutrient intake nor plasma β-hydroxybutyrate indicated nutritional ketosis in the Paleo and Control groups. The Paleo group had significant within group reductions in fatigue scores and maintained cognitive function scores compared to the Control group. The Keto group had significant reductions in fasting glucose and insulin compared to baseline values; however, no clinical outcomes significantly changed.

Conclusions: Participants consuming the MCT-based ketogenic diet achieved nutritional ketosis; however, it was not associated with significant clinical improvement in this study whereas the modified Paleolithic diet was associated with significant clinical improvements. Larger randomized controlled trials are needed to determine the safety and efficacy of the modified Paleolithic and MCT-based ketogenic diets on MS.

改良的mct生酮饮食增加了多发性硬化症患者血浆β-羟基丁酸,但与改良的旧石器时代饮食相比,对疲劳和生活质量的影响较小:一项候补对照随机试点研究。
目的:探讨改良mct生酮饮食的可行性及其对多发性硬化症(MS)患者血浆β-羟基丁酸酯和MS预后的影响,并与改良旧石器饮食和常规饮食进行比较。方法:15例多发性硬化症患者随机分为3组:1)改良旧石器饮食(Paleo;n = 6);2)以中链甘油三酯(MCT)为基础的生酮饮食,包括椰子作为脂肪来源(Keto;n = 5);或3)日常饮食(控制;n = 4)。参与者每4周抽血监测营养性酮症。参与者在基线和12周时完成了4天的称重食物记录、残疾、疲劳、生活质量(QoL)、认知功能和身体功能的测量。结果:在12周时,生酮组的大量营养素摄入量显著转向指示生酮饮食的比例。同样,酮组血浆β-羟基丁酸盐表明营养性酮症,而古饮食组和对照组的大量营养素摄入量和血浆β-羟基丁酸盐均未表明营养性酮症。与对照组相比,旧石器组在疲劳评分和维持认知功能评分方面有显著的组内降低。与基线值相比,酮组空腹血糖和胰岛素显著降低;然而,临床结果没有明显改变。结论:以mct为基础的生酮饮食的参与者实现了营养性酮症;然而,在这项研究中,它与显著的临床改善无关,而改良的旧石器时代饮食与显著的临床改善有关。需要更大规模的随机对照试验来确定改良旧石器时代和mct为基础的生酮饮食对多发性硬化症的安全性和有效性。
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来源期刊
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审稿时长
>12 weeks
期刊介绍: The Journal of the American College of Nutrition accepts the following types of submissions: Original and innovative research in nutrition science with useful application for researchers, physicians, nutritionists, and other healthcare professionals with emphasis on discoveries which help to individualize or "personalize" nutrition science; Critical reviews on pertinent nutrition topics that highlight key teaching points and relevance to nutrition; Letters to the editors and commentaries on important issues in the field of nutrition; Abstract clusters on nutritional topics with editorial comments; Book reviews; Abstracts from the annual meeting of the American College of Nutrition in the October issue.
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