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Review
. 2022 Jun 8;14(12):2384.
doi: 10.3390/nu14122384.

Ketogenic and Modified Mediterranean Diet as a Tool to Counteract Neuroinflammation in Multiple Sclerosis: Nutritional Suggestions

Danila Di Majo  1   2 , Francesco Cacciabaudo  2 , Giulia Accardi  2   3 , Giuditta Gambino  1 , Giuseppe Giglia  1   4 , Giuseppe Ferraro  1   2 , Giuseppina Candore  3 , Pierangelo Sardo  1   2
Affiliations
Review

Ketogenic and Modified Mediterranean Diet as a Tool to Counteract Neuroinflammation in Multiple Sclerosis: Nutritional Suggestions

Danila Di Majo et al. Nutrients. .

Abstract

Ketogenic Diet is a nutritional pattern often used as dietotherapy in inflammatory diseases, including neurological disorders. Applied on epileptic children since 1920, in recent years it has been taken into account again as a tool to both reduce inflammatory burdens and ameliorate the nutritional status of patients affected by different pathologies. Multiple sclerosis (MS) is considered an immune-mediated neuro-inflammatory disease and diet is a possible factor in its pathogenesis. The aim of this work is to investigate the main potential targets of MS-related impairments, in particular the cognitive deficits, focusing on the alteration of biomarkers such as the Brain Derived-Neurotrophic Factor and the Tryptophan/Kynurenine ratio that could play a role on neuroprotection and thus on MS progression. Furthermore, we here propose nutritional suggestions which are useful in the development of a ketogenic diet protocol that takes advantage of the anti-inflammatory properties of low-carbohydrate foods from the Mediterranean diet to be applied to subjects with MS. In conclusion, this approach will allow one to develop the ketogenic diet combined with a modified Mediterranean diet as a possible tool to improve neuroinflammation in multiple sclerosis.

Keywords: Mediterranean; Tryptophan/Kynurenine ratio; brain derived neurotrophic factor; diet; ketogenic; multiple sclerosis; neuroinflammation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trend of daily carbohydrate intake in the protocol to be developed to achieve proper levels of ketosis.
Figure 2
Figure 2
Qualitative and quantitative daily distribution of macronutrients into the future protocol proposed to be applied to patients with MS.
See this image and copyright information in PMC

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