Objective: We aimed to analyse the efficacy of Ketogenic Diet (KD) in metabolic and motor characteristics of patients with Parkinson’s Disease (PD).

Background: Many studies have shown the positive effects of KD on a variety of neurological and neuromuscular disorders1. The Dewsbury et al. systematic review supports the use of KD in positive effects on brain function and general health2. In this context, there is growing interest in the approach of diet manipulation for PD patients3.

Method: We systematically reviewed PUBMED, EMBASE and Cochrane Library databases for randomized controlled trials (RCTs) with PD patients who underwent regular diet (RD) or KD. Outcomes of interest were weight loss, UPDRS-3 punctuation and blood glucose levels. Statistical analysis was performed in Review Manager 5.4.1.4, and heterogeneity was assessed with I². We analysed the risk of bias of the studies using the RoB 2 and the Robins I tools.

Results: We included 3 studies3,5,6 (68 patients, 39 in the KD group). 2 included studies were RCTs and 1 was a prospective cohort. Follow up was from 8 to 12 weeks. 

In pooled analysis, KD was associated with greater weight loss [MD -1.46; 95%CI (-2.06)-(-0.85); p<0,01; I2= 95%] when compared to RD. Furthermore, motor examination [MD -1.72; 95%CI (-6.85)-(3.41); p=0.51; I2=45%] and blood glucose [MD -7.27; 95%CI (-15.34)-(0.81); p=0.08; I2=0%] had a tendency to be lower with KD, but the results were non-significant. Overall, the studies showed low risk of bias, with some concerns in a few areas.

Conclusion: In conclusion, our analysis suggests that KD has better outcomes than RD when related to weight loss. However, it was not possible to determine if it would be favorable for motor improvements related to PD or for better control of glucose blood levels. Therefore, there is still a need for future studies that could ascertain if these improvements translate into better quality of life for PD patients.

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References: 1. KOYUNCU, Handan et al. Effect of ketogenic diet versus regular diet on voice quality of patients with Parkinson’s disease. Acta neurologica Belgica. [S. I.], v. 121, n. 6, p. 1729-1732, 2021
2. Dewsbury LS , LimCK, SteinerGZ. The efficacy of ketogenic therapies in the clinical management of people with neurodegenerative disease: a systematic review. Adv. Nutr., 12(4), 1571–1593 (2021).
3. PHILLIPS, Matthew er al. Low-fat versus ketogenic diet in Parkinson’s disease: A pilot randomized controlled trial. Movement disorders: official journal of the Movement Disorder Society. [S. I.], v. 33, n. 8, p. 1306-1314, 2018.
4. Review Manager (RevMan). Versão 5.4. Copenhague: The Nordic Cochrane Centre, The Cochrane Collaboration; 2020.
5. KRIKORIAN, Robert et al. Nutritional ketosis for mild cognitive impairment in Parkinson’s disease: A controlled pilot trial. Clinical parkinsonism & related disorders. [S. I.], v. 1, p. 41-47, 2019.
6. TIDMAN, Melanie et al. Effects of an low carbohydrate/healthy fat/ketogenic diet on biomarkers of health and symptoms, anxiety and depression in Parkinson’s disease: a pilot study. Neurodegenerative disease management. [S. I.], v. 2, n. 12, p. 57-66, 2022

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-of-adhering-to-a-ketogenic-diet-in-parkinsons-disease-a-systematic-review-and-meta-analysis/