Nearly six months of a ketogenic diet, low in carbohydrates and high in fat, relieved motor symptoms and anxiety and depression while improving cognition in a woman with mild Parkinson’s disease, found a study of case.
These findings suggest that a ketogenic diet may provide an additional, non-pharmacological way to address motor and non-motor symptoms of Parkinson’s and support its subsequent evaluation in properly controlled trials, the study author noted.
People with Parkinson’s disease may experience a variety of motor difficulties and non-motor symptoms, such as cognitive impairment, depression, anxiety, and sleep disorders.
Current pharmacological treatments often have little or no effect on these non-motor symptoms, and dietary approaches are gaining interest as possible complementary strategies for managing Parkinson’s.
The ketogenic diet, or keto, is a type of low-carbohydrate / healthy fat (LCHF) diet with a limited protein intake. A small previous trial showed that taking a keto diet for 2.5 months was associated with a greater reduction in patients’ non-motor symptoms relative to those assigned to a low-fat diet.
Although the underlying mechanisms of these benefits are not yet clear, the induced change in the body’s energy source from standard glucose, or sugar, to fatty ketones can “sustain the brain’s energy demands and reduce [brain] inflammation, especially in the elderly with PE [Parkinson’s disease]”Wrote the author.
Ketones are fat-derived molecules produced by the liver to serve as an energy source when glucose (sugar) is unavailable.
A researcher at AT Still University of Health Sciences in Arizona described the case of a 68-year-old woman with mild Parkinson’s, whose motor and non-motor symptoms were relieved with the keto diet.
The woman, who was still able to move around and perform daily activities without help, had slow leg movements, moderate tremors in her hands, and painful sensations in her feet. He also reported mild to moderate feelings of depression and anxiety, occasional sleep disturbances, high blood pressure, and problems with blood glucose control.
He was taking standard Parkinson’s medication.
The woman was obese and exercised two to three times a week with a personal trainer. He followed a standard, low-fat diet, but admitted that he tended to consume mostly processed foods and sugar.
A traditional ketogenic diet was started, consisting of 70-75% fat, 20-25% protein and 5-10% carbohydrates, for 24 weeks (almost six months) with the help of a list of recommended foods, a cookbook with recipes and meal plans, and a food tracking tool called the MyFitnessPal app.
A Keto-Mojo device was also provided for daily home measurements of fasting glucose and ketone levels to help assess diet compliance.
Assessments were also performed covering health biomarkers, disease severity, and levels of anxiety and depression before the diet (baseline measures), halfway through the diet (12 weeks), and at the end of the diet. intervention (24 weeks).
Health biomarkers include weight, body mass index (a ratio of weight to height), waist circumference, and blood levels of HbA1C (a glucose control marker), fasting insulin, triglycerides , HDL or “good cholesterol” and C-reagent. protein, a biomarker of inflammation.
In particular, according to her high levels of HbA1C, low HDL, a waist circumference of more than 35 inches and a high blood pressure at baseline, the woman qualified for metabolic syndrome, a set of conditions that together increase the risk of heart disease, stroke. and type 2 diabetes.
Compliance with the diet was confirmed from the start of the diet until week 24, with a mean blood ketone reading of 0.5 nanomoles, indicating sustained nutritional ketosis, the state in which the body can use stored fat to get energy more efficiently.
Gradual improvements were observed in all biomarkers of health at 12 and 24 weeks of the diet, including an increase in HDL levels and a decrease in HbA1C, C-reactive protein, triglycerides, and insulin levels in fasting. Weight loss, waist circumference, and heart risk factors were also observed.
At the end of the 24-week ketogenic diet, the woman “no longer met the criteria for a diagnosis of metabolic syndrome,” the researcher wrote.
In particular, “PD can be associated with an increase in CRP [C-reactive protein] “Although women’s PCR levels” did not rise significantly at first, the 24-week results did indicate a reduction in this marker of inflammation, “the author added.
The overall score on the unified Parkinson’s disease rating scale, a measure of the severity of the disease, was higher at the end of the diet, indicating a worsening of the disease. However, tremors had been reduced by 12 weeks and painful sensations in the lower extremities were reported to be moderately lower at 12 weeks, with no further improvement at 24 weeks.
Improvements in concentration and a reduction in symptoms of depression, tremors in the hands, and painful sensations in the lower extremities were reported at week 12. Most of these benefits remained unchanged at week 24.
Granted, the symptoms of depression, when specifically assessed with the Center for Epidemiological Studies’ Revised Depression Scale, were modestly reduced at the end of the diet. The Parkinson’s Anxiety Score score, a measure of anxiety symptoms, was also lower at 12 and 24 weeks.
The clinical relevance of these improvements is not yet clear, the report notes.
The results suggest that the ketogenic diet may be “safe and effective in improving biomarkers of health, symptoms of depression, anxiety, and symptoms of PM in patients with [mild] PD, “the researcher wrote.
“People with PD can be empowered through a more personalized nutritional approach to symptom management by offering adjuvant treatment approaches along with drug therapy to reduce symptoms and improve function,” the report notes.
Future controlled clinical trials are needed to further evaluate the effectiveness of the LCHF / keto diet “to improve cognitive function and to control or reduce the symptoms of depression, anxiety and motor and non-motor symptoms of MP”. concluded the researcher.
Tidman M (March 31, 2022) Effects of a Ketogenic Diet on Symptoms, Biomarkers, Depression, and Anxiety in Parkinson’s Disease: A Case Study. Cureus 14(3): e23684. doi:10.7759/cureus.23684