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The ketogenic (keto) diet works by triggering ketosis, a metabolic state in which your body uses fat for fuel instead of carbohydrates.
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Studies have suggested a keto diet can be helpful for people who have epilepsy, cancer, Alzheimer’s disease and, most recently, multiple sclerosis (MS).
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If you have MS and want to consider a keto diet, talk to your doctor about whether it’s right for you.
Chances are good that you know someone who has adopted the ketogenic, or keto, diet. You may even have tried it yourself, hoping to lose a few — or a lot of — pounds. But did you know that some people are using the keto diet for purposes other than to lose weight? Studies have shown that this type of diet may benefit people with epilepsy, cancer, Alzheimer’s disease and diabetes. Researchers are also discovering that following a keto diet could reduce symptoms for people with multiple sclerosis (MS).
What is the keto diet?
Let’s start with the basics about this type of diet and the science behind it. Ketosis is a metabolic state in which your body uses fat for fuel instead of carbohydrates. You can force your body into ketosis by limiting the number of carbohydrates you consume. Generally, people who are on a keto diet limit their carbs to 20 to 50 grams per day. Instead of carbs, they satisfy their hunger with fats from meat, eggs, nuts and healthy oils.
There are several different versions of the keto diet. A few of the most popular ones include:
- The standard ketogenic diet, in which your diet consists of 70-75% fat, 20% protein and 5-10% carbs.
- The cyclical ketogenic diet, in which you could have several ketogenic days, followed by a couple of high-carb days.
- The targeted ketogenic diet, which permits you to spend sugars or carbs any day in which you work out.
- The high-protein ketogenic diet, which still has only about 5% carbs, but slightly more of your diet — about 35% — consists of protein, and slightly less includes fat.
“Our body’s main source of fuel is carbohydrates, and when carbohydrates are extremely limited, our amazing body will use fat as a source of fuel,” said Chris Collins, RD, LD, CSOWM, CDCES, a dietitian at the Providence Center for Weight Management and Bariatric Surgery.
“That conversion of fat to fuel produces ketones — chemicals made in the liver that provide energy to our brain, organs and muscles.”
Keto and MS
MS is a neurological disease that attacks nerves and causes inflammation in the brain. It also causes the immune system to damage myelin, which is a fatty substance that protects the nerve fibers. Over time, MS may slow down nerve impulses and destroy the nerves themselves.
Some studies have shown that ketones can help restore damaged nerves and reduce inflammation, and the keto diet helps increase the production of ketones by changing the body’s energy source.
One recent study included 65 volunteers with MS who adopted a ketogenic diet. More than 80% of the volunteers stuck with the diet for a full six months, and at the end of that time, they reported significant improvements in fatigue, depression and quality of life. They were also better able to endure a six-minute walk than they were before they started the keto diet.
“Personally, I’m excited that dietary interventions are being researched for therapeutic use,” said Collins. “I believe there is no single eating pattern that is right for a person, but there is an eating pattern that may be the right fit for right now. As a dietitian, it’s my job to help patients discover that eating pattern and apply it to their daily lives in a way that is sustainable and fulfilling. If research shows that the ketogenic diet is beneficial during an MS flare or relapse, that’s one more tool in my toolkit.”
Downsides to keto for people with MS
While preliminary studies have suggested a ketogenic diet could help with some MS symptoms, it may not be right for everyone. It may cause:
- Weak bones – People who have MS are at a higher risk for developing osteoporosis and breaking bones, and keto diets don’t have as much calcium as other diets.
- Fatigue – Higher ketone levels can cause fatigue, and people with MS already suffer from an increased level of tiredness.
- Constipation – Some people with MS suffer from constipation and need increased levels of fiber in their diet, and a keto diet is low in fiber.
If you have MS and want to consider adopting a keto diet, talk to your doctor. Researchers are still studying the long-term effects of the keto diet on people with MS, and you will need to pursue any major changes with caution. You will also need to work with a dietitian to determine what type of meal plan is right for you.
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Related resources
Understanding multiple sclerosis
Telehealth improves access for multiple sclerosis patients
Learn about multiple sclerosis symptoms and treatments
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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