NTR 340

Can you treat nuerodengerative disease/disorders with

nutritional intervention?

Eric Paglione

A Ketogenic diet can be used to treat patients with neurodegenerative diseases

such as multiple sclerosis, Parkinsons, and Alzheimers disease through the
neuroprotective properties of how fats are metabolized and used as fuel for the
brain on the Ketogenic diet.

Neurodegenerative diseases such as Parkinsons disease, Multiple Sclerosis (MS), and

Alzheimers disease (AD) affect millions of people every year. Each one of these diseases are
very different but share one common theme and that is western modern medicine has yet to find
any cure, prevention or way to slow the progression of these brain diseases13,14,15.
In the last ten years, nutritional therapy such as the Ketogenic diet (KD) has showed
possible positive implications in treatment of these three diseases through metabolic pathways.
In the age of skyrocketing health care costs this is exciting because nutritional change such as a
diet in a patient is a very low risk, high reward, and cost effective way of treating a disease. The
Ketogenic Diet was originally invented by Dr. Wilder who worked at the Mayo clinic in the mid
1920s. It was developed and used to treat patients with Epilepsy. Its a high fat and high protein
diet with low carbohydrates. To simplify the physiology behind the diet, it is when the fat in the
food is broken down through the liver, the body produces ketones which are used as fuel for the
brain. The idea behind this is that with more ketones, the brain will function better, especially
when under stress from diseases like Parkinsons, MS, and or Alzheimers 3,4.
The first question is what are Parkinsons, multiple sclerosis, Alzheimers disease and
how do they impact brain function and the nervous system? Parkinsons disease is a
neurodegenerative disease of the brain where neurons start to die off. The disease mostly kills off
neurons on the substantia nigra part of the brain. The disease progresses and gets worse over
time. There is no known cure or cause. Prescription and medical intervention can help alleviate
the severity of the symptoms, which include involuntary muscular tremors and/or the slowing of
speech and movement. Multiple Sclerosis is an auto immune disease where body attacks and
damages its own nerve covering affecting the signals from the brain to the body13. There is no
definitive reason why people develop it and there is no known cure14. The last disease looked at

in this literature review is Alzheimers disease. Approximately 6 million Americans have the
disease. The numbers could rise to about 20 million in the next 30 years. Its also the 6th leading
cause of death in America. Its a neurodegenerative disease where plaques of protein form that
kill off neurons and cause tangles of dead neurons. As the disease progresses cognitive and
memory function start to decline15. There is no known cause, only theories, and no known cures.
All three diseases mentioned briefly above all have two main similarities. 1. The disease
kills off neurons in the brain 2. There are no known causes or medical cures at this time. This is
why the Ketogenic diet is so promising because of its ability to protect neurons through fat
metabolization and the byproduct of that metabolization which are ketone bodies. This leads us
into the main thesis statement which is: A Ketogenic diet can be used to treat patients with
neurodegenerative diseases such as multiple sclerosis, Parkinsons, and Alzheimers disease
through the neuroprotective properties of how fats are metabolized and used as fuel for the brain
on the Ketogenic diet.
The research for the therapeutic use of the ketogenic diet to treat patients with
Parkinsons does exist but there is not as much direct research done when comparing it to the
other two diseases discussed. The fact is overall research for how a Ketogenic diet can help
protect the brain of someone with a neurological disorder is pretty strong when it comes to
Parkinsons disease the overall research is lacking so its pretty week in contrast to other diseases
mentioned in the introduction. One research study shows improved mitochondrial function and
the keytone bodies being produced by the diet helping the cells get around the mitochondrial
dysfunction in patients with Parkinsons. The issue is the study was very small so its impossible
to discount some kind of placebo effect on the patients improved Parkinson disease scores on
the standard rating scale. The second study is an invitro study that looks at the possible anti-

inflammatory protective properties of the ketogenic diet in patients with a neurodegenerative

disease. The issue with this research is it was in vitro and not specific to Parkinsons disease. It
was designed to show the possible neuroprotective and increased mitochondrial function
properties on Alzheimers patients neurons. Since the diet was effective with AD neurons it was
brought up by the researcher that it could possibly be used in treatment of Parkinsons disease
patients as well 3.
The lack of overall research for the specific use of the KD for Parkinson disease leads us
to more abundant research pool for the KD in the treatment of Alzheimers disease. With
implications that this research shows possible beneficial effects for all neurodegenerative
diseases including Parkinsons. Next we will take a look at the use of a Ketogenic diet for the
treatment and to slow the progression of Alzheimers disease through the metabolic function of
the diet providing the brain with an alternative fuel. The onset and progression of Alzheimers
disease is believed to be at least partially caused by the abnormally low metabolic rate of
glucose. Since glucose is a main source of fuel for the brain this can leave the brain with not
enough fuel to maintain proper function and can add to the progression of AD. A second source
of fuel are ketone bodies which can be produced in higher numbers on a high fat Ketogenic diet
giving the brain an alternative fuel source to possibly reduce the stress and progression of AD.
Other research shows that there is a cognitive benefit from a Ketogenic diet on mild cognitive
impairment. MCI is usually the precursor for full blown Alzheimers disease. This Ketogenic diet
has shown be effective on cognitive function in MCI patients even when there is very low
glucose uptake happening. This is important because the research shows the lack of glucose
uptake is a big part in loss of cognitive function as brains age and people develop AD. It also
shows that this glucose fuel deficit can partially be corrected with an alternative brain fuel like

ketones produced form a Ketogenic diet and improve cognitive function. There is further
research that deals with specifically the protein plaques and tangles in an Alzheimers patients
brain that are believed to be the main cause of cognitive impairment in a patient with the disease.
The formation of protein plaques in an AD patients brain is theorized to come from abnormal
mitochondrial production and also abnormal function in the neuron circuits themselves. One
benefit of the KD is improved functioning of mitochondria in the nerve cells. This is shown to
help protect the neurons from the toxic build up of the protein in the plaques in an Alzheimer
patients brain. The protection of the neurons from the protein in the plaque build ups can
improve overall brain function. It also can lessen the impact of tangles because the patient will
have less neuron die off and less tangles form. This overall neuron protection, increased
mitochondrial function, and reduction in inflammation is beneficial in any neurodegenerative
disorder including Parkinson disease and beneficial for protecting the brain cells from the overall
aging process3,4,6,11,12.
These various neuroprotective qualities mentioned in studies for Parkinsons and
Alzheimers leads us to more positive information of the use of the KD in another
neurodegenerative disease and that disease is Multiple Sclerosis. The neuroprotective properties
of the Ketogenic diet can also be used to help MS patients improve their memory, cognitive, and
motor function. Neurodegenration is a main component of the progression of Multiple Sclerosis.
The Ketogenic diet has been shown to have to be able to protect the central nervous system from
degeneration of the neurons. The KD is shown to reduce oxidative stress, increase ATP levels,
and increase mitochondria production. This along with the neuroprotective properties of the diet
are essential components of improving cognitive, memory ,motor function in a patient with MS.
These are all essential components of treating other brain diseases such as Parkinsons disease.

Here are some of the results from the research conducted looking at the specific actions of the
Ketogenic diet in a study of Mice with mimicked MS disease. In studys using mice to mimic
MS in humans they use and infect the rats with Experimental Autoimmune Encephalomyelitis or
EAS. This mimics how MS affects the brain and nervous system. In EAS rats the KD reduced
brain legions. The diet also showed to reduce oxidative stress and have neuroprotective property
by reducing inflammation. This lead to improved motor function and improved memory function
in the EAS mice. The KD diet showed cognitive improvement in EAS mice but showed not to
protect the mice from developing EAS. This study shows us the protective quality of the KD in
possibly slowing and reliving the symptoms with MS but still leaves us still with no answer on
how to prevent MS1,2.
The treatment of all three of the neurological disorders is a complex one. The research
shows that a high fat ketogenic diet metabolizes fatty acids into ketone bodies which in turn used
as fuel for the brain has many neuroprotective benefits. From an alternative fuel source in
glucose depleted brain to mitochondrial production in a stressed diseased brain. The diet also
increases ATP production while decreasing inflammation and oxidative stress. These are all very
important in improving cognitive function in an aging diseased brain. Since all three of these
diseases have no cure the research is very positive to be able to treat these diseases with
something like dietary intervention3,6.
When looking at all three diseases and their specific ways they negatively impact the
brain, the neuroprotective quality of the Ketogenic diet decreasing inflammation seems to be the
best solution from the diet and shows the most effective promising positive effects as shown in
the Multiple Sclerosis research. This reduction of inflammation and protective quality of the diet
on the neurons was a main theme through all of the research. Not to discount the other benefits

of the diet on the neurons this seemed to be the most important because all three diseases cause
inflammation and kill neurons causing some kind of neurological or motor function
impairment1,2,3,4,5.
The research, although positive, does come with some flaws. There are some noticeable
gaps in the research that include a lack of overall quantity of research looking at the Ketogenic
diet for treatment of diseases besides epilepsy. The good news is those gaps are starting to be
filled because there are many studies being conducted because of the research mentioned in this
paper and we should be getting new study results in the next 1-3 years. The implications that a
ketogenic diet can have a neuroprotective quality on the neurons in a diseased and aging brain
are very important. Its important for our overall understanding of these diseases and how to best
treat them by pinpointing how the ketones are helping improve and protect cognitive function.
There are so many unknowns with the three diseases discussed in the paper that research on
dietary intervention that points us in the right direction and possibly gives us answers to more
effective is very positive in moving forward.

Citations
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http://www.pdf.org/about_pd
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