Evaluation of a ketogenic diet for improvement of neurological recovery in individuals with acute spinal cord injury: a pilot, randomized safety and feasibility trial

Ceren Yarar-Fisher, Adarsh Kulkarni, Jia Li, Paige Farley, Cassandra Renfro, Hammad Aslam, Patrick Bosarge, Landon Wilson, Stephen Barnes

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Study design: Longitudinal, randomized study. Objectives: (1) Test the safety and feasibility of a ketogenic diet (KD) intervention in the acute stages of spinal cord injury (SCI), (2) assess the effects of a KD on neurological recovery, and (3) identify potential serum biomarkers associated with KD-induced changes in neurological recovery. Setting: Acute care and rehabilitation facility. Methods: The KD is a high-fat, low-carbohydrate diet that includes ≈70–80% total energy as fat. Seven participants with acute complete and incomplete SCI (AIS A–D) were randomly assigned to KD (n = 4) or standard diet (SD, n = 3). Neurological examinations, resting energy expenditure analysis, and collection of blood for evaluation of circulating ketone levels were performed within 72 h of injury and before discharge. Untargeted metabolomics analysis was performed on serum samples to identify potential serum biomarkers that may explain differential responses between groups. Results: Our pilot findings primarily demonstrated that KD is safe and feasible to be administered in acute SCI. Furthermore, upper extremity motor scores were higher (p < 0.05) in the KD vs. SD group and an anti-inflammatory lysophospholipid, lysoPC 16:0, was present at higher levels, and an inflammatory blood protein, fibrinogen, was present at lower levels in the KD serum samples vs. SD serum samples. Conclusion: Taken together, these preliminary results suggest that a KD may have anti-inflammatory effects that may promote neuroprotection, resulting in improved neurological recovery in SCI. Future studies with larger sample size are warranted for demonstrating efficacy of KD for improving neurological recovery.

Original languageEnglish (US)
Article number88
JournalSpinal cord series and cases
Volume4
Issue number1
DOIs
StatePublished - Dec 2018
Externally publishedYes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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