Abstract
Background: It was previously established that Multiple sclerosis (MS) generates
energy alterations at the mitochondrial level related to the loss of muscle mass. Ketone bodies,
mainly beta-hydroxybutyrate (BHB), re-establish this energy alteration causing satiety, changes in
body composition and a decrease in hormone-dependant hunger, such as ghrelin. The aim of this
study was to establish possible improvements in body composition and the level of oxidation in
patients with MS, by means of the satiating effect of a ketogenic diet.
Methods: A pilot study was
carried out with 27 MS patients who were given a Mediterranean isocaloric and ketogenic diet for
4 months. Anthropometric measurements, as well as satiety and hunger perception (VAS scale),
were taken. In addition, BHB and paraoxonase 1 (PON1), as an oxidation marker, were measured by
spectrophotometric automated assays, and ghrelin was determined by an enzyme immunoassay in the
serum. All measurements were taken before and after the intervention.
Results: A significant increase
in satiety perception at lunch and dinner and of BHB in the blood was obtained. Hunger perception
decreased significantly at lunch and dinner with similar levels of ghrelin. In addition, an important
increase in lean mass and PON1 was observed. To our knowledge, this is the first study addressing
improvements in body composition, oxidation state and metabolism in MS patients, based on the
satiating effect of a Mediterranean isocaloric diet.
Conclusion: A ketogenic diet increases lean mass
and decreases inflammation and oxidation possibly as a consequence of an increase in satiety and
decrease in hunger in MS patients.
Keywords: satiety; ketogenic diet; multiple sclerosis; β-hydroxybutyrate; ghrelin; paraoxonase 1