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Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration Volume 24, 2023 - Issue 1-2
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ALS Untangled

ALSUntangled #63: ketogenic diets

Richard Bedlack1 Neurology Department, Duke University, Durham, NC, United StatesCorrespondence[email protected]
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Paul E. Barkhaus2 Neurology Department, Froedtert & the Medical College of Wisconsin, Kenosha, WI, United StatesView further author information
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Benjamin Barnes3 Neurology Department, Augusta University Medical College of Georgia, Augusta, GA, United StatesView further author information
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Morgan Beauchamp4 North Carolina State University, Raleigh, NC, United StatesView further author information
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Tulio Bertorini5 Neurology Department, The University of Tennessee Health Science Center VolShop Memphis, Memphis, TN, United StatesView further author information
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Mark B. Bromberg6 Neurology Department, University of Utah Health Hospitals and Clinics, Salt Lake City, UT, United StatesView further author information
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Gregory T. Carter7 St Lukes Rehabilitation Hospital, Physical Medicine and Rehabilitation, Chesterfield, MO, United StatesView further author information
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Vinay Chaudry8 Neurology Department, University of North Carolina School of Medicine Neuroscience Center, Chapel Hill, NC, United StatesView further author information
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Merit Cudkowicz9 Neurology Department, Mass General Brigham Inc., Boston, MA, United StatesView further author information
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Ce Jackson10 Neurology Department, The University of Texas Health Science Center at San Antonio – Greehey Academic and Research Campus, San Antonio, TX, United StatesView further author information
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Gleb Levitsky11 Real Health Clinic, Russian FederationView further author information
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Isaac Lund12 Green Hope High School, Cary, NC, United StatesView further author information
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Christopher McDermott13 The University of Sheffield Institute for Translational Neuroscience, Sheffield, United KingdomORCID Iconhttps://orcid.org/0000-0002-1269-9053View further author information
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Steven Novella14 Neurology Department, Yale University, New Haven, CT, United StatesView further author information
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Natasha Olby15 Neurology Department, North Carolina State University, Raleigh, NC, United StatesView further author information
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Lyle Ostrow16 Neurology Department, Johns Hopkins University, Baltimore, MD, United StatesView further author information
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Gary L. Pattee17 Neurology Department, University of Nebraska Medical Center College of Medicine, Omaha, NE, United StatesView further author information
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Terry Heiman-Patterson18 Neurology Department, Temple University, Philadelphia, PA, United StatesView further author information
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Dylan Ratner19 Longmeadow High School, Longmeadow, MA, United StatesView further author information
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Kristiana Salmon20 Neurology Department, McGill Centre for Research in Neuroscience, Montreal, CanadaView further author information
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Susan Steves21 Nutrition Department, Duke University, Durham, NC, United StatesView further author information
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Mark Terrelonge22 Neurology Department, University of California San Francisco, San Francisco, CA, United States View further author information
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Paul Wicks23 Independent, Lichfield, GBORCID Iconhttps://orcid.org/0000-0002-2293-9284View further author information
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Anne-Marie Wills9 Neurology Department, Mass General Brigham Inc., Boston, MA, United StatesView further author information
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Pages 159-163 | Received 02 Sep 2021, Accepted 28 Sep 2021, Published online: 14 Oct 2021
 
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Abstract

ALSUntangled reviews alternative and off label treatments with a goal of helping patients make more informed decisions about them. Here we review ketogenic diets. We shows that these have plausible mechanisms, including augmenting cellular energy balance and reducing excitotoxicity, neuroinflammation and oxidative stress. We review a mouse model study, anecdotal reports and trials in ALS and other diseases. We conclude that there is yet not enough data to recommend ketogenic diets for patients with ALS, especially in light of the many side effects these can have.

Declaration of interest

ALSUntangled is sponsored by the ALS Association. Richard Bedlack has research support from ALSA, Orion, MediciNova, and the Healey Center, and consulting support from AB Science, Alexion, ALSA, Amylyx, Biogen, Brainstorm Cell, Corcept, GenieUs, Guidepoint, ITF Pharma, Mallinkrodt, New Biotic, Orphazyme, and Woolsey Pharma.

Additional information

Funding

This work was supported by Amyotrophic Lateral Sclerosis Association.

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