Experts don’t yet know specifically what about the keto diet leads to the changes they observe in study subjects with MS, but they have a few theories.
Following the Diet May Reduce Inflammation
MS is an inflammatory disease that damages the central nervous system. According to Dr. Brenton, research supports the theory that keto diets decrease inflammation, increase the process by which cells produce new mitochondria called mitochondrial biogenesis, and reduce levels of oxidative stress. He suggests that these may improve MS symptoms.
“Additionally, fat is a more efficient energy source than carbohydrate for the brain,” he advises. “This may be particularly important in a brain that is battling inflammation, as is the case in MS.”
People With MS May Respond Better to Ketones Than to Glucose
Inflammation isn’t the only cause of MS symptoms. As Mary Rensel, MD, a staff neurologist and the 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, a progressive loss of nerve cell function that contributes to 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, the primary fuel the body takes from carbohydrates, in people with MS. These people may respond better to energy markers called ketone bodies, which develop as a result of ketosis.
“Ketone bodies get through the blood-brain barrier,” Rensel says. “This means they can reach the brain, and the brain can use them as an energy source,” Rensel says.
Weight Loss May Improve Quality of Life in People With MS
“It seems that people who have obesity and a poor diet may be at an increased risk of getting MS,” Rensel suggests. “And when you have MS, obesity and poor diet can lead to more progressive disability, so [being overweight] may indeed increase the risk of getting it or [negatively influence] the course of it.”
Brenton agrees that a healthy body weight, whether managed through the keto diet or another method, is beneficial. “I do believe that weight management can positively impact many comorbid MS symptoms, including pain, fatigue, and mood disorders,” he says.
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