Newly diagnosed people with MS in particular want to know.
The answer has been elusive without biomarkers, other than MRI, to evaluate treatment efficacy and disease course. Serum neurofilament light chain protein(sNfL) is a new sensitive and accurate biomarker of damage to neurons and axons and correlates with disease activity and severity in MS.
In a new study, a group of 60 people with MS were randomized to one of 3 diets. The ketogenic diet was <50 grams of carbohydrate and >160 grams of fat a day. The caloric restriction diet was a single 7-day “fast” of ❤50 calories a day. Both were compared to the control group on a “common” diet. sNfL was measured at baseline and after 3 and 6 months.
The ketogenic diet group showed an increase (worsening) at 3 months but a reduction (improvement) of sNfL, compared to the common diet group. The “fasting” group showed no difference from the control group at either time point. The ketogenic diet needs time to activate homeostatic processes.
Limitations of the study are the small number of patients (60) and the short duration (6 months). If the results prove reproducible in larger and longer studies, the ketogenic diet, which has no unwanted side effects, may prove to be a valuable treatment tool for MS.
Adapted from the article by Bock et al in Neurology: Neuroimmunology and Neuroinflammation, January 2022.
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