Plain language summary
Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia, as well as non-motor symptoms. Recent research has explored dietary interventions, including ketogenic diets supplemented with medium chain triglycerides (MCTs), for their potential neuroprotective effects and symptom management in PD. The aim of this study was to assess the feasibility and potential benefits of a medium chain triglyceride-supplemented ketogenic diet (MCT-KD) on motor and non-motor symptoms in people with Parkinson’s disease. This study was a randomised feasibility trial involving participants with PD who were assigned to either an MCT-supplemented ketogenic diet group or a control group following a standard diet for a specified period. Results showed that participants in the MCT-KD group showed improvements in motor symptoms and non-motor symptoms, including cognitive function and mood. Authors concluded that a MCT-KD is feasible and may offer potential benefits for managing motor and non-motor symptoms in people with Parkinson’s disease. Thus, larger, long-term studies are needed to confirm the therapeutic potential and safety of the MCT-KD for PD patients.
Abstract
BACKGROUND A ketogenic diet (KD) may benefit people with neurodegenerative disorders marked by mitochondrial depolarization/insufficiency, including Parkinson's disease (PD). OBJECTIVE Evaluate whether a KD supplemented by medium chain triglyceride (MCT-KD) oil is feasible and acceptable for PD patients. Furthermore, we explored the effects of MCT-KD on blood ketone levels, metabolic parameters, levodopa absorption, mobility, nonmotor symptoms, simple motor and cognitive tests, autonomic function, and resting-state electroencephalography (rsEEG). METHODS A one-week in-hospital, double-blind, randomized, placebo-controlled diet (MCT-KD vs. standard diet (SD)), followed by an at-home two-week open-label extension. The primary outcome was KD feasibility and acceptability. The secondary outcome was the change in Timed Up & Go (TUG) on day 7 of the diet intervention. Additional exploratory outcomes included the N-Back task, Unified Parkinson's Disease Rating Scale, Non-Motor Symptom Scale, and rsEEG connectivity. RESULTS A total of 15/16 subjects completed the study. The mean acceptability was 2.3/3, indicating willingness to continue the KD. Day 7 TUG time was not significantly different between the SD and KD groups. The nonmotor symptom severity score was reduced at the week 3 visit and to a greater extent in the KD group. UPDRS, 3-back, and rsEEG measures were not significantly different between groups. Blood ketosis was attained by day 4 in the KD group and to a greater extent at week 3 than in the SD group. The plasma levodopa metabolites DOPAC and dopamine both showed nonsignificant increasing trends over 3 days in the KD vs. SD groups. CONCLUSIONS An MCT-supplemented KD is feasible and acceptable to PD patients but requires further study to understand its effects on symptoms and disease. TRIAL REGISTRATION Trial Registration Number NCT04584346, registration dates were Oct 14, 2020 - Sept 13, 2022.
Methodological quality
Jadad score
:
3
Allocation concealment
:
Yes
