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

Jennifer E. Lee; Tyler J. Titcomb; Babita Bisht; Linda M. Rubenstein; Rebecca Louison; Terry L. Wahls

doi:10.1080/07315724.2020.1734988

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Journal article

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

Jennifer E. Lee, Tyler J. Titcomb, Babita Bisht, Linda M. Rubenstein, Rebecca Louison and Terry L. Wahls

Journal of the American College of Nutrition, Vol.40(1), pp.13-25

01/02/2021

DOI: 10.1080/07315724.2020.1734988

PMID: 32213121

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https://www.ncbi.nlm.nih.gov/pmc/articles/11833548View

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Abstract

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). 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. 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. 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.

ketogenic diet

modified Paleolithic diet

Multiple sclerosis

quality of life

β-hydroxybutyrate

Details

Title: Subtitle: 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
Creators: Jennifer E. Lee - University of Iowa
Tyler J. Titcomb - Roy J. and Lucille A. Carver College of Medicine
Babita Bisht - University of Iowa
Linda M. Rubenstein - University of Iowa
Rebecca Louison - Mount Mercy University
Terry L. Wahls - Iowa City VA Health Care System
Resource Type: Journal article
Publication Details: Journal of the American College of Nutrition, Vol.40(1), pp.13-25
DOI: 10.1080/07315724.2020.1734988
PMID: 32213121
NLM abbreviation: J Am Coll Nutr
ISSN: 0731-5724
eISSN: 1541-1087
Publisher: Taylor & Francis
Grant note: name: Direct-MS; DOI: 10.13039/100008893, name: University of Iowa, award: U54TR001356
Language: English
Date published: 01/02/2021
Academic Unit: Neurology; Epidemiology; Nursing; General Internal Medicine; Internal Medicine
Record Identifier: 9984302199402771

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