Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer's disease. Issue 1 (4th December 2017)

• Record Type: Journal Article
• Authors: Taylor, Matthew K.; Sullivan, Debra K.; Mahnken, Jonathan D.; Burns, Jeffrey M.; Swerdlow, Russell H.
• Is Part Of: Alzheimer's & dementia. Volume 4:Issue 1(2018)
• Page Start: 28
• Page End: 36
• Publication Date: 2017-12-04
• Subjects: Alzheimer's disease -- Cognition -- Ketogenic diet -- Low‐carbohydrate diet -- Medium‐chain triglyceride; Dementia -- Periodicals; Dementia -- Treatment -- Periodicals; Alzheimer's disease -- Treatment -- Periodicals; Alzheimer's disease -- Periodicals; 616.831
• DOI: 10.1016/j.trci.2017.11.002
• Languages: English
• ISSNs: 2352-8737

Abstract

Abstract: Introduction: We assessed the feasibility and cognitive effects of a ketogenic diet (KD) in participants with Alzheimer's disease. Methods: The Ketogenic Diet Retention and Feasibility Trial featured a 3‐month, medium‐chain triglyceride–supplemented KD followed by a 1‐month washout in clinical dementia rating (CDR) 0.5, 1, and 2 participants. We obtained urine acetoacetate, serum β‐hydroxybutyrate, food record, and safety data. We administered the Alzheimer's Disease Assessment Scale‐cognitive subscale and Mini–Mental State Examination before the KD, and following the intervention and washout. Results: We enrolled seven CDR 0.5, four CDR 1, and four CDR 2 participants. One CDR 0.5 and all CDR 2 participants withdrew citing caregiver burden. The 10 completers achieved ketosis. Most adverse events were medium‐chain triglyceride–related. Among the completers, the mean of the Alzheimer's Disease Assessment Scale‐cognitive subscale score improved by 4.1 points during the diet ( P = .02) and reverted to baseline after the washout. Discussion: This pilot trial justifies KD studies in mild Alzheimer's disease. Highlights: The medium‐chain triglyceride–supplemented KD was feasible in very mild (clinical dementia rating [CDR] 0.5) and mild (CDR 1) Alzheimer's disease participants, as 10 of 11 participants adhered to the dietary protocol. The medium chain triglyceride‐supplemented KD was not feasible in moderate (CDR 2) Alzheimer's disease participants as all four of these participants withdrew from the study. Dietary compliant participants had a 4.1‐point mean improvement on Alzheimer's Disease Assessment Scale‐cognitive subscale scores from baseline to the end of the diet. Alzheimer's Disease Assessment Scale‐cognitive subscale improvements diminished after a 1‐month diet washout period.