• A ketogenic diet may reduce inflammation in the brains of people living with multiple sclerosis (MS), a new study says.
• Previous studies of the ketogenic diet’s effect on MS have been mixed, and some health experts caution that the diet may not be optimal in the long term for people with MS.
• Larger and longer-duration studies are needed to evaluate whether a keto diet could significantly change relapse rates or the severity of MS symptoms.

A ketogenic diet — which is low in carbohydrates and rich in fats — may reduce inflammation in the brain among people with multiple sclerosis, a new study indicates. Specifically, the diet may help reduce levels of serum neurofilament light chain (sNfL), a marker of neuron damage and inflammation.

“Overall, our study suggests that an AKD [adapted ketogenic diet] offers an avenue to impact sNfL levels, which seems to be a promising biomarker in neuroinflammatory diseases, supporting the use of dietary interventions as a supplement treatment tool for MS,” the study authors wrote. “These findings are of urgent medical interest because such dietetic strategies exhibit few unwanted side effects.”

Diet and MS

Over the years, researchers have investigated various types of diets and their impact on MS.

Some previous research has suggested that people living with MS may benefit from adopting a ketogenic diet. A study from 2019 found that people with relapsing MS tolerated the diet well, experienced improvements in fatigue and depression, and lost weight. A 2020 study concluded that a ketogenic diet and a fasting diet “may modulate immunity, reduce disease severity and promote remyelination in the mouse model of MS,” but it noted more research was needed.

Another study from 2019 found that with ketogenic diets, “no difference in mental and physical health [quality of life] was noted in patients with multiple sclerosis.”

Some health experts have questioned the long-term safety of a ketogenic diet, cautioning it can lead to nutritional deficiencies. “The verdict is still out on the long-term safety of low-carb diets,” according to the Multiple Sclerosis Society. “They tend to be high in total fat, especially saturated animal fat, which has been linked to heart disease, cancer, and perhaps even MS. The low-carb craze also restricts fruits, vegetables and whole grains. This can result in deficiencies of valuable vitamins, minerals, phytonutrients, antioxidants, and fiber. All of these are important to long-term good health.”

A 2021 study identified two diets high in fruits, vegetables, and unsaturated fat that could help manage symptoms of multiple sclerosis: the Swank diet and Wahls Protocol.

Learn more about healthy eating and MS.

Ketogenic Diet Linked to Lower Inflammation

In this latest study, German researchers enrolled a total of 60 people who were assigned to receive one of three diets for six months: the AKD, a calorie-restricted diet, or — for the control group — a standard German diet. Each participant remained on their regularly prescribed disease-modifying therapy for their MS for the duration of the study.

The participants on the adapted ketogenic diet consumed fewer than 50 carbohydrates per day, with 100 or fewer grams of protein and more than 160 grams of fat.

Researchers then evaluated how each diet impacted participants’ sNFL levels, measuring them at the start and end of the trial. Participants who were enrolled in the ketogenic diet group were monitored for successful sustained ketosis through regular urine testing. Ketosis is a metabolic process through which the body burns fat instead of carbohydrates to fuel the body.

In the end, researchers found that participants on the AKD demonstrated a significant decrease in their sNfL levels. They saw no significant changes in the control or the calorie-restricted groups.

Choose Your Diet With Care

People living with MS should speak with their doctor before making drastic changes to their diet, including adopted a ketogenic diet. “People with MS need to plan for the long haul. Maintaining a healthy weight is important, and while carbohydrates may contribute to weight gain, it’s calories that pack on the pounds,” the Multiple Scleorosis Society notes.