Efficacy of the Ketogenic Diet with and Without Medium-chain Triglyceride (MCT) Supplementation in Parkinson's Disease: A Systematic Review and Single-arm Meta-analysis
Elizabeth de Farias1, Altair Neto1, Helvécio Filho2, Murilo Geremias3, Leonardo Cardoso4, Karlos dos Santos1, Aishwarya Koppanatham5
1Federal University of Roraima, 2University of Fortaleza, 3University of Joinville Region (UNIVILLE), 4Federal University of Minas Gerais, 5Andhra Medical College
Objective:
Analyze the efficacy of the ketogenic diet with and without medium-chain triglyceride (MCT) supplementation in patients with Parkinson's disease.
Background:

The primary treatment for Parkinson's disease motor symptoms is levodopa, although it does not effectively address non-motor symptoms. A ketogenic diet may benefit patients by enhancing neuronal energy metabolism and addressing respiratory chain defects. While food can positively impact health and alleviate neuromuscular disease symptoms, there is a lack of studies on the ketogenic diet's effect in Parkinson's disease patients.


Design/Methods:

PubMed, EMBASE, Cochrane Central and Web of Science were used as search tools. The outcomes of interest selected were change in UPDRS I, II, III and IV, gastrointestinal side effects (nausea, vomiting, diarrhea, poor feeding),body weight loss (Kg) and adherence rate. Statistical analysis was performed using RevMan 5.1.7. 


Results:

402 articles were screened and 7 RCTs and (107 patients) were included. Ketogenic diet was associated with reduced UPDRS I (MD=-2.03; 95%CI [−3.84; −0.21]; p<0.01), UPDRS II (MD=−3.10; 95% CI [ −4.37; −1.82]; p=0.74;), UPDRS III (MD=−4.35; 95% CI [−6.74; −1.97]; p<0.01) and UPDRS IV (MD=−1.29; 95% CI [−2.16; −0.41]; p=0.22). Moreover, KD was associated with elevated gastrointestinal side effects (Events=9.69; 95% CI [2.64; 16.73]; p=0.19), body weight loss (MD=5.96; 95% CI [ 4.20; 7.72]; p=0.05), and adherence rate (Events=89.02; 95% CI [75.96; 100.00]; p=0.09).  


Conclusions:
The ketogenic diet was associated with a significant reduction in UPDRS scores, suggesting improvement in patients' motor symptoms, despite the observed gastrointestinal side effects and weight loss. Adherence to treatment, although not statistically significant, indicates a possible acceptability of the diet.
10.1212/WNL.0000000000209094
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