March 5, 2025 • 41 mins
Join us on the Live Parkinson's: Live and Exceptional Life podcast as we explore the fascinating connection between the ketogenic diet and Parkinson's Disease (PD). In this episode, we delve into the potential of using a high-fat, low-carb approach to manage PD symptoms and improve quality of life. Learn:
- What is the Ketogenic Diet? Understand the macronutrient ratios and the metabolic shift to ketosis.
- Neuroprotective Benefits: Discover how ketones may protect brain cells and slow PD progression.
- Symptom Management: Explore how keto can potentially improve motor and non-motor symptoms like tremor, rigidity, and cognitive function.
- Gut-Brain Connection: Learn how the ketogenic diet may positively influence gut health and impact PD.
- Research & Evidence: We review current studies and discuss the science behind keto and Parkinson's.
- Potential Side Effects: We discuss what to be aware of when considering this diet.
This episode provides valuable insights for anyone seeking complementary therapies for Parkinson's Disease.
Ready to learn more?
- Visit liveparkinsons.com to subscribe to our free monthly newsletter for the latest PD research, tips, and stories.
- Support the podcast and website by donating at ko-fi.com/liveparkinsons.
Recommended Books (Amazon Affiliate Links)
The Easy 5-Ingredient Ketogenic Diet Cookbook: Low-Carb, High-Fat Recipes for Busy People on the Keto Diet - Jen Fisch
The Complete Ketogenic Diet for Beginners: Your Essential Guide to Living the Keto Lifestyle - Amy Ramos
#ParkinsonsDisease #KetogenicDiet #KetoForParkinsons #ParkinsonsAwareness #Neurodegeneration #GutBrainAxis #ComplementaryTherapy #LiveParkinsons #HealthPodcast #Podcast #Parkinsons
Disclaimer: This podcast is for educational purposes only is not intended to treat or diagnose Parkinson's Disease. Please ensure that you are following the treatment plan developed by your doctor. Please ensure before starting anything new you get approval from your doctor. The information being provided is based on my own personal experiences and does not guarantee that it will benefit everyone.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Hello and welcome to Live Parkinson's Live an
Exceptional Life.
I'm your host, chrisKustenbotter, and I've been
living an exceptional life withParkinson's for the past 15
years.
The mission of this podcast isto help as many people as
possible living with Parkinson'sto have a great quality of life
is to help as many people aspossible living with Parkinson's
to have a great quality of life.
Today's topic is Parkinson'sand keto exploring the ketogenic
diet for PD symptom management.
(00:31):
Now, what if the key tomanaging Parkinson's disease
symptoms wasn't just found in apill bottle, but also on your
plate?
It sounds radical, I know, butthe connection between diet and
neurological health is becomingincreasingly clear.
In this episode, we'reexploring the ketogenic diet, a
high-fat, low-carb approach, andasking tough questions Can it
(00:52):
really make a difference forpeople living with Parkinson's?
We'll examine the science, thepotential benefits and the
important considerations foranyone with Parkinson's
exploring this dietary approach.
All right, let me explain why.
I wanted to share this topicwith you as additional potential
diet plan to review with yourdoctor.
I've done podcasts on theMediterranean diet, the MIND
(01:14):
diet and their potentialbenefits for Parkinson's, and
I'd read a lot of research onthe ketogenic diet for
Parkinson's.
Last Sunday, I was at thefitness center and I was doing
some swimming, my wife and I andwhen I was done I was getting
changed in the locker room and Ihad a discussion with a
respected physician in thecommunity I'll call him Dr P and
(01:36):
Dr P participates in triathlonsand we talked a little bit
about running and I said now,because of Parkinson's, I don't
run.
But I told him that I docycling and swimming and he said
that was great because I'mdoing a lot of repetitive
activities, which is reallygoing to help with Parkinson's.
And then he also mentioned thathis dad had Parkinson's and his
(02:00):
dad was also a physician and sohe did a lot of research to
help his dad.
And he said that I shouldreally check into the ketogenic
diet.
He said it is shown to helpwith inflammation, which is
believed to contribute toneurodegeneration diseases like
Parkinson's.
I told him that I would do theresearch and, if the research
was promising, ask my movementdisorder specialist if it might
(02:21):
be a good option for me.
Now I know the weight loss partof the keto diet would sure
help.
So I've been doing research onthe ketogenic diet and I wanted
to share some of my findingswith all of you.
Now I do want to make thisdisclaimer up front, and we'll
bring it up again a few timesduring the podcast.
The information that I'm goingto be providing is for
informational purposes only.
(02:41):
I'm not a certified medicalprofessional or a registered
dietitian.
I do have a bachelor's degreein biology, so it's crucial that
you review any diet andnutrition changes with your
healthcare professional toensure that it's appropriate for
your specific needs.
Okay, now that I've shared thatwith you, let's take an aerial
view of what we'll be coveringin this podcast.
(03:02):
Now, since the topic is theketogenic diet, let's start out
and discuss what the ketogenicdiet is, what the macronutrients
and the ratios are, themetabolic shift from the diet
that is different from some ofthe other types of diets, and
the foods that are allowed andfoods to avoid, with examples,
of course.
(03:22):
And then in segment two, we'llexplore the ketogenic diet and
Parkinson's by looking at someof the potential benefits.
We'll look at neuroprotection,symptom management, the
gut-brain connection andinflammation.
Then, in segment three, becauseI also want to provide fair
balance with the informationthat I'm talking about, so if I
(03:42):
talk about the potentialbenefits, I also want to talk
about the potential side effects, and so we'll be looking at
some of the potential sideeffects of the ketogenic diet
and considerations for peoplewith PD.
Then, in segment four, I'llcover the current research and
evidence available for theketogenic diet and Parkinson's,
and then we'll pack all thatinformation in a box and, after
(04:05):
tying it together, send you backout into the world.
Okay, so, now that everyone'son board, let's leave the
terminal and take off on ourjourney to learn more about the
ketogenic diet.
Now, most of you have probablyheard about the ketogenic diet
and may even know people who usethe ketogenic diet as part of
their lifestyle.
I know people who often use itfor weight loss.
But really, what is theketogenic diet exactly and what
(04:26):
does the word ketogenic actuallymean?
Let's start by definingketogenic.
The term refers to this diet'sability to induce ketosis, which
we'll talk about in a fewminutes in more detail, but it's
a metabolic state where yourbody uses ketones for energy
instead of glucose.
Now, the ketogenic diet isoften referred to as keto, and
(04:48):
it's a dietary approach that'svery low in carbohydrate intake,
moderate protein consumptionand high intake of fats.
All right, so let's give you abreakdown of the ketogenic diet,
starting with the macronutrientratios Macronutrients.
The macronutrient ratios.
Macronutrients macro meaningbig are the big nutrients
Proteins, fats and carbohydrates.
(05:14):
Those are the ones that you seeprominently listed on the food
labels for all the foods you buy.
Now, besides serving size onthe labels, they often tell you
how many grams of eachmacronutrient are in the food
and the percentage of each.
Now the ketogenic dietemphasizes a specific
distribution of macronutrients,which is the following high fat,
and that's typically 70 to 80%of the daily calories.
Moderate protein, roughly 10 to20% of the total daily calories
(05:40):
.
And then very low carbohydrates, usually 5% to 10% of daily
calories and often limited to 20to 50 grams of carbohydrates
per day.
Now, sometimes it can getconfusing regarding water
proteins and water carbohydratesand the way I like to explain
it and it's true most of thetime that proteins walk on the
(06:02):
ground like your cows so forbeef, pigs for pork, chicken and
turkeys for poultry and swimaround.
That would be your fish, whilecarbohydrates typically grow in
the ground and they would beyour fruits and vegetables,
grains, etc.
Now there are some variations,like edamame, which grows in a
(06:24):
pod, but it has a good amount ofprotein.
So it's just an analogy as aquick guide to distinguish
between carbohydrates andprotein.
All right, now here are some ofthe food choices on the diet,
and let's start with foods thatthe ketogenic diet emphasizes,
starting with the fats, becauseyou may have been thinking,
chris, how can a dietemphasizing 70 to 80% of
(06:45):
calories from fat be good foryou?
Well, the ketogenic dietemphasizes eating healthy fats,
like avocados, olive oil,coconut oil, nuts and seeds,
like your chai seeds and yourflax seeds.
Meats.
Here's your proteins, like beef, poultry, fish, especially
(07:06):
fatty fish, like salmon, macroand tuna that are high in
omega-3 fatty acids.
And then, finally, lowcarbohydrate vegetables, and
they would include your leafygreens, like spinach and kale
spring mix, and then yourcruciferous vegetables, like
broccoli, cauliflower andBrussels sprouts.
So those are the differenttypes of foods that you want to
(07:28):
include as part of the ketogenicdiet.
Now let's look at some foods toavoid, and they would be any
type of sugary food, and thatwould include soda, juices,
candies, pastries, desserts andpies.
Also, this is now this one's akiller for me, because I love
these bread, pasta and rice.
(07:50):
Starchy vegetables likepotatoes and corn again both
personal favorites of mine andmost fruits, except small
portions of berries.
Okay, so that's a basicoverview of the ketogenic diet
and the foods that areacceptable to eat and the ones
to avoid.
Now let's look at how theketogenic diet is different from
(08:10):
some of the other diets thatare available out there.
Now, the big difference is theketogenic diet causes a
metabolic shift called ketosis,in which the body is producing
ketones for food.
Okay, chris, what exactly doesthat mean?
You need to explain yourself.
Do you remember the old TV showDifferent Strokes, where Gary
(08:32):
Coleman's character would alwayssay to his brother what you
talking about, willis?
Well, that's what we're goingto try to answer right now.
Okay, so let's break it down andlook at glucose blood sugar
versus ketones.
Okay, normally our body'sprimary energy source.
And let's say we eat a piece ofpizza or we eat a donut or we
(08:52):
eat some fruit those our bodytakes in and we break it down
into glucose, which comes fromcarbohydrates.
When you eat, like I said,bread, pizza, pasta, sweets, the
starches and sugars are brokendown into glucose and your body
uses that glucose for fuel.
Any excess glucose is stored asglycogen in the liver and
(09:12):
muscle cells or it's convertedto triglycerides and stored in
fat cells.
So that's why people tend togain weight if they're eating a
lot of carbs and don't get a lotof exercise.
Now, when carbohydrate intakeis drastically reduced, your
body's glucose stores becomedepleted.
So to provide energy to yourbody, the liver starts to break
(09:35):
down fats into molecules calledketones.
Now ketones are produced in theliver from fatty acids, and
ketones can be used as analternative fuel source for your
body by your brain, your heartand your muscles.
So the metabolic shift fromburning glucose for energy to
ketones is called ketosis.
(09:55):
Hopefully that wasn't toocomplicated.
So, really, what's thedifference between ketones and
glucose?
First of all, the source wherethey come from ketones and
glucose.
First of all, the source wherethey come from Glucose or sugar
comes primarily fromcarbohydrates, while ketones
come from fats.
So, in terms of how theyfunction, both of them provide
(10:16):
energy for the body, but thebody uses them differently.
Metabolically, glucose is thepreferred energy source when
it's readily available, becauseit's easy to use and uptake by
the cells.
Ketones are an alternate sourceof energy when glucose is
scarce, and one of the reasonsis how they are produced.
So, again, glucose is readilyavailable from the digestion of
(10:40):
your foods, especiallycarbohydrates or carbs, while
ketones are produced by theliver through the breakdown of
fats.
So, in essence, the ketogenicdiet forces the body to switch
from its fuel source, fromcarbohydrates, to fats,
resulting in the production ofketones and the metabolic state
of ketosis.
(11:01):
Now there are a few differenttypes of variations on the
ketogenic diet.
Now there are a few differenttypes of variations on the
ketogenic diet, which I'll justbriefly cover.
The first is the classicketogenic diet, and this is the
original ketogenic diet and it'sused primarily in clinical
settings, especially forepilepsy.
Now it has a very strict ratioof fat combined with proteins
(11:25):
and carbohydrates, often a 4 to1 ratio, so four grams of fat
for every one of protein andcarbs.
This makes the diet veryrestrictive.
Then you have a ketogenic dietwhich is called the MCT or
medium chain triglycerideketogenic diet, and this diet
utilizes MCT oil, which is atype of fat that is easily
converted into ketones by theliver.
(11:45):
Now, because the medium chaintriglycerides are so readily
used, this allows for slightlymore protein and carbohydrates
than the classic and it can be alittle bit easier for people to
tolerate.
And then, finally, is themodified Atkins or MAD, and this
diet's less restrictive thanthe classic and generally
(12:07):
involves a 1 to 1 or 2 to 1ratio of fat to combine protein
and carbohydrates, so it's oftenmore a manageable approach to
ketosis.
Now, the key distinctionbetween three of these diets
revolve around the specificratio of the macronutrients, the
types of fats emphasized andthe overall restrictiveness.
(12:29):
All right, that was a lot ofinformation.
So let's round out our overviewof the ketogenic diet by
looking at some of the foodsthat are allowed and foods to
avoid.
And let's start with foodsallowed and we'll lead it off
with healthy fats, since thathas the highest percentage of
macronutrients.
And again, we said that itshould be about 70 to 80% of
(12:51):
your daily calories and shouldinclude oils like olive oil,
coconut oil, avocado oil and MCToil, which is the medium chain
triglycerides, which is themedium chain triglycerides.
Avocados, nuts and seeds.
Almonds, walnuts, macadamianuts, chai seeds and flax seeds
(13:11):
are all good examples.
Butter and ghee, grass-fedbutter I didn't know that butter
could eat grass, but okay andghee, which is clarified butter,
and fatty cuts of meat likeribeye, steak, salmon and bacon.
All right.
Next up is moderate protein,which is 10 to 20% of the
(13:31):
calories, and this includes meat, beef, chicken, lamb, pork,
fish and seafood, and theseafood would include salmon,
tuna, cod and shrimp.
Then you have eggs as anotherprotein source and low carb
(13:52):
dairy, and again, that's inmoderation, and that would
include hard cheeses, heavycream, plain Greek yogurt, and
remember to check the label forcarbs.
Finally, very low carbvegetables, and that's 5 to 10%
of calories, focusing on thenon-starchy ones Now.
These include leafy greens likespinach, kale, lettuce and
arugula.
Cruciferous veggies likebroccoli, cauliflower, brussels
(14:15):
sprouts and cabbage, and otherveggies include zucchini,
asparagus, bell peppers,cucumbers and then berries in
very small quantitiesraspberries, blueberries,
strawberries.
All right, now let's look at thefoods to avoid Heading.
The list is sugary foods,that's your soda juice,
sweetened beverages, honey,maple syrup, and then you have
(14:40):
grains, and that would be yourbread, pasta, rice, cereal.
Ouch, that hurts, because Ireally love all of those Oats,
quinoa and barley.
Starchy vegetables likepotatoes, sweet potatoes, corn
and peas Again, that's killingme, they're some of my favorites
Squash, some varieties likebutternut squash, and then next
(15:03):
is most fruits, like bananas,apples, oranges, grapes and
dried fruit, then legumes, whichare your beans, lentils and
chickpeas, and then moving on tothe low-fat or diet products,
because they often have hiddencarbs.
Low-fat or diet products,because they often have hidden
carbs.
Low-fat yogurt, diet sodas,many processed diet snacks.
(15:24):
And then we have unhealthytrans fats, which are your
processed and fried foods,margarine, and then a sneaky one
is the high-carb condimentsketchup and sugary salad
dressings, barbecue sauce andthen, finally, alcohol.
Now, many alcoholic drinks arehigh in carbs, including beer,
(15:50):
sweet wines and the sugarycocktails that a lot of times
people get when they go out tothe restaurants.
And there you have it.
That's an overview of theketogenic diet Now.
Hopefully you found thathelpful.
Now, just as a friendlyreminder, before switching to a
new diet plan, make sure youconsult your healthcare
professional to ensure it'sright for you and your specific
(16:11):
needs.
All right, now it's time toswitch gears and look at the
ketogenic diet and Parkinson'sand some of the potential and
that's the key word, potentialbenefits.
Emerging research suggests thatthe ketogenic diet may offer in
terms of benefits for peoplewith PD, including improved
motor symptoms.
In the clinical study, impact ofa Keto Diet on Symptoms of
(16:33):
Parkinson's Disease, biomarkers,depression, anxiety and Quality
of Life a Longitudinal Studypublished in the
Neurodegenerative DiseaseManagement Journal on June 13th
of 2024.
(16:54):
Positively influence gait andmobility, self-care,
socialization, depression andanxiety-improved biomarkers of
general health.
Another benefit isneuroprotective effects, reduced
inflammation and enhancedmitochondrial function.
Now, mitochondria are theorganelles in the cell that
(17:19):
produce energy and are calledthe powerhouses of the cell.
All right, let's look at eachbenefit in a little more detail,
starting with neuroprotection.
Now, what exactly does that mean, chris?
Well, neuroprotection refers tothe ability of a substance or
intervention, like a diet, toprotect neurons or brain cells
from damage or degeneration.
(17:40):
So, in Parkinson's,neuroprotection is crucial for
slowing disease progression.
Okay, there are actually acouple things going on in terms
of neuroprotection.
There are some mechanisms thatprovide improved neuroprotection
, and the first one is oxidativestress reduction, and I've
talked a little bit about thisbefore on some of my other
(18:01):
podcasts, but anything with theword stress and reduction has to
be good, right.
So why is it important toreduce oxidative stress and what
exactly is oxidative stress?
I mean, maybe it's nice to knowwhat that is first, before we
know why we need to reduce it.
Well, oxidative stress happenswhen you have an imbalance
(18:24):
between the production of freeradicals, which are the unstable
molecules in your body, andyour body's ability to
counteract their harmful effectswith antioxidants.
Now, free radicals can damageyour cells, proteins and DNA,
which can lead to diseases likeneurodegenerative diseases.
So, in essence, oxidativestress occurs when your body
(18:47):
struggles to keep the freeradicals in check.
Okay, now that's important toreduce oxidative stress.
So how can the keto diet helpwith that?
So how can the keto diet helpwith that?
Well, ketones, particularlycalled beta-hydroxybutyrate,
have been shown to haveantioxidant properties which can
potentially reduce oxidativestress.
(19:09):
Now another mechanism ofneuroprotective effects is
improved mitochondrial function.
Okay, what are mitochondria andwhy is it so important that
their function is improved?
Okay, if you open the vault tothe deep recesses of your brain
and picture yourself sitting inhigh school biology class and
(19:31):
your teacher's discussing thecomponents of the cell, and next
thing you know, they throw outthe big word mitochondria and
ask does anyone know what themitochondria are and what they
do?
Your hand immediately shoots inthe air and is waving pick me,
pick me.
The teacher calls on you andwithout hesitation, you say
(19:52):
mitochondria are called thepowerhouse of the cell and that
they provide energy, that thecells need to function and that
they provide energy that thecells need to function.
The teacher says you arecorrect and, yes, you look like
a genius that you know you are.
So why is it important?
Cells generate enough energy,which can lead to health
(20:13):
problems.
Now here's where the ketogenicdiet comes into play.
Ketones can provide analternative and more efficient
energy source for mitochondria,potentially improving their
function.
In the clinical study, ketoneselicit distinct alterations in
adipose mitochondrialbioenergetics published in the
International Journal ofMolecular Sciences in August of
(20:35):
2020.
Now the authors noted that theobservation of significantly
increased mitochondrialrespiration in response to
ketone exposure may play somepart in increased whole body
energy expenditure.
That has been seen in humans inketosis.
Studies have suggested that theketogenic diet can stimulate
(20:57):
mitochondrial biogenesis,increasing the number of
mitochondria in the cells.
So, just like Tim Taylor on theshow Home Improvement, which
was one of my favorites, hewould always say more power.
And I go oh, oh, oh.
Another mechanism in helpingwith neuroprotection is
anti-inflammatory effects,because chronic inflammation
(21:19):
contributes to neurodegeneration.
In Parkinson's disease, theketogenic diet has been shown to
have anti-inflammatory effects,potentially again, that's the
key word reducingneuroinflammation.
Research in the area ofneuroprotection is ongoing, but
some studies have shownpromising results.
(21:39):
Research has explored theeffects of the keto diet on
mitochondrial function andoxidative stress in animal
models and PD.
Now more studies are needed inhuman trials to further show
that there's a benefit.
All right, now let's look atsome of the potential benefits
of the ketogenic diet forParkinson's and cover that its
effect on motor and non-motorsymptoms.
(22:01):
Now in a clinical study low-fatversus ketogenic diet in
Parkinson's disease a pilotrandomized controlled trial and
it was published in the MovementDisorder Journal in August of
2018.
This study started with 47randomized patients, 44 who
actually participated in thestudy and 38 actually completed
(22:22):
the study for an 86% completionrate, which is really good.
The study compared theplausibility, safety and
efficacy of a low-fat,high-carbohydrate diet versus a
ketogenic diet in a hospitalclinic of PD patients.
The study was evaluatingchanges both within and between
(22:42):
the groups.
So if you were on a low-fat,high-carbohydrate diet, you were
compared to others within thatgroup and then also between your
group and the ketogenic group.
The study used the MDS-UPDRSscale for evaluating changes
both within the groups.
(23:02):
Now I know you're probablythinking wait just a minute,
chris.
What did you say?
Mds-updrs, what I thought?
The same thing the MDS-UPDRS orMovement Disorder Society
Unified Parkinson's DiseaseRating Scale, and it's a
comprehensive tool that's usedto evaluate the various aspects
(23:23):
of Parkinson's.
So it looks at both motor andnon-motor experiences of daily
living and it's divided intofour parts.
So part one is going to look atyour non-motor experiences of
daily living.
Part two is going to look atyour motor experiences of daily
living.
Part two is going to look atyour motor experience as a daily
living.
Part three it's a motorexamination and then part four
(23:47):
is motor complications.
So in this study they were usingthis scale to look at the low
fat versus the ketogenic diet,both between and within the
groups in parts one to four,over eight weeks.
Now the results showed thatpatients on the ketogenic diet
group maintained physiologicalketosis, so those that were on a
(24:11):
ketogenic diet stayed inketosis during the course of the
study.
It also showed that both groupssignificantly decreased their
MDS-UPDRS scores, but theketogenic group decreased more
in part one, which were thenon-motor symptoms, showing a
41% improvement in baseline andpart one scores compared to the
(24:33):
low-fat group, which shared an11% improvement.
Now the study observed that thelargest difference between
groups decreases in urinaryproblems, pain and other
sensations, fatigue, dailysleepiness and cognitive
impairment.
Now there were no between-groupdifferences in the magnitude of
decrease for parts two to four.
(24:55):
So the study authors concludedthat it's plausible and safe for
PD patients to maintain alow-fat or ketogenic diet for
eight weeks.
Both diet groups significantlyimproved in motor symptom and
non-motor symptoms.
However, the ketogenic dietshowed greater improvements in
non-motor symptoms.
So this is one study thatlooked at the effect of the
(25:18):
ketogenic diet on motor andnon-motor symptoms and showed
positive results in the studygroup.
Now let's take a look at thepotential benefits of the
ketogenic diet on motor symptoms.
Now the ketogenic diet may isthe key word again improve motor
function, including reductionsin tremor rigidity, bradykinesia
(25:40):
or slowness of movement.
In the clinical studyNutritional Ketosis in
Parkinson's Disease a review ofremaining questions and insights
that was published inNeurotherapeutics in July of
2021, the authors note that theconcept of ketosis can be
therapeutic for PD motorsymptoms, bradykinesia and
(26:01):
rigidity, and it's consistentwith the results of the Van
Atali et al study.
Outside the study, improvementsin motor function are thought
to be related to improvements inmitochondrial function and the
neuroprotective effect ofketones.
And then in another study howCan a Ketogenic Diet Improve
(26:24):
Motor Symptom Function,published in Frontiers of
Molecular Science in January of2018, the authors note that in
the study abstract that themotor function has also been
shown to be improved by aketogenic diet or medium-chain
triglycerides diets in rodentmodels of Parkinson's and
Alzheimer's, as well as ALS andspinal cord injury.
(26:47):
While there are a number ofstudies looking at the effects
of the ketogenic diet on motorsymptoms.
There's inconsistency in thedata, and that relates to the
sample size and how many weredone with animal models versus
human models.
So more testing is needed indouble-blind, placebo-controlled
studies to see if specificbenefits of motor symptoms are
(27:11):
observed in humans that areusing the ketogenic diet.
Non-motor symptoms inParkinson's it involves a range
of non-motor symptoms whichthose of us with Parkinson's
know can include cognitivedecline, mood disturbances like
anxiety and depression, sleepdisorders, fatigue and the
ketogenic diet may positivelyinfluence these symptoms.
(27:33):
Now I covered the study earlierthat showed that the low-fat,
high-carbohydrate in theketogenic diet in people with
Parkinson's showed the 41%improvement in the keto group in
eight weeks for non-motorsymptoms.
And then another area thatthey're looking at is the
gut-brain connection, and that'sone of the key areas of
(27:53):
research which we'll cover next,with the keto diet potentially
improving gut microbiome health,which, in turn, can impact your
mood and your cognition.
In a study the Effects of theKetogenic Diet on Symptom
Biomarkers, depression andAnxiety, and Parkinson's Disease
(28:13):
a case study that was publishedin Curious in March of 2022 by
Melanie Tidman, the author notedthat, based on our findings,
the ketogenic diet is safe andeffective for improving
biomarkers of health, symptomsof depression and anxiety and PD
symptoms in patients in stage 1PD.
(28:34):
The study also notes in thesummary points that a 24-week
ketogenic diet intervention inadults with PD positively
influenced gait, immobility,self-care, socialization,
depression and anxiety andimproved biomarkers of general
health.
Now I did want to point outsome things to consider Now.
(28:54):
First, it's essential toemphasize the point that the
keto diet is not a cure for PDand individual responses to the
diet can vary significantly.
So it's important to work withyour healthcare professional,
especially to ensure that thereare no medication interactions.
And then, finally, morelarge-scale human trials are
really needed to fullyunderstand the long-term effects
(29:16):
of the keto diet on people withParkinson's.
So, in a nutshell, you'llnotice I use the keywords may or
potentially, because more datais needed to show specific
benefits to motor and non-motorsymptoms.
All right, let's briefly look atthe two other potential
benefits of the keto diet forpeople with Parkinson's, and
let's start with the gut-brainconnection, the gut microbiome.
(29:40):
And what is that you may beasking?
The gut microbiome is really alittle bustling community of
tiny living organisms, which aremostly bacteria that live in
your intestines.
They help digest food, theyproduce vitamins, they help
protect against harmful bacteria, they prevent the harmful
bacteria from causing infection,they help to boost your immune
(30:03):
system by training the immunesystem to recognize and fight
harmful invaders.
And then they influence yourmood and health.
Now, you didn't realize you hadall those little critters
living in your GI tract, helpingyou to keep your health, did
you?
So it's important to eat ahealthy, balanced diet with lots
of fiber to keep those goodbacteria flourishing All right.
Now, where were we?
(30:24):
Ah, yes, the gut microbiome andits role in Parkinson's.
Now, it's a rapidly evolvingarea of research and it's
revealing some strongconnections between gut health
and neurological function.
So how does your gut and yourbrain communicate with each
other?
No, they don't call each otheror text on the cell phones.
(30:45):
They communicate through what'scalled the gut-brain axis,
which is a complex networkinvolving neural networks,
nerves, hormonal andimmunological pathways.
And disruption to this complexnetwork's communication can
contribute to the developmentand progression of disorders
like Parkinson's.
And one of the key areas ofresearch is with alpha-synuclein
(31:07):
.
And one of the features ofParkinson's is the accumulation
of misfolded alpha-synucleinprotein in the brain.
Now, the misfolded and damagedalpha-synuclein protein in the
brain Now the misfolded anddamaged alpha-synuclein is
detrimental to the neurons inthe brain, killing off the
neurons.
Emerging evidence suggests thatalpha-synuclein aggregation, or
(31:29):
clumping, may actually begin inthe gut and then spread to the
brain via the vagus nerve.
Therefore, believe it or not,your gut health may play a role
in the initial stages of PD.
Now, in addition toalpha-synuclein clumping,
inflammation is another key areaof study, and the gut
microbiome plays a crucial rolein regulating inflammatory
(31:50):
inflammation.
Imbalances in the gutmicrobiome, which is also known
as dysbiosis, can lead toincreased inflammation, which
can contribute toneuroinflammation in PD.
Now the chronic inflammation isthought to worsen
neurodegeneration.
And then, finally, the gutmicrobiome is involved in
(32:12):
neurotransmitter production.
So the gut microbiome canproduce and metabolize
neurotransmitters, includingdopamine, which is deficient in
people with PD, and alterationsin the gut microbiome may affect
neurotransmitter levels andeven contribute to PD symptoms.
(32:33):
Okay, so let's look at how theketo diet may positively affect
gut health.
First is changes in themicrobiome composition.
The ketogenic diet alters thecomposition of the gut
microbiome, potentiallyincreasing the abundance of
beneficial bacteria and reducingthe abundance of harmful
bacteria.
In an article from theUniversity of California, san
(32:56):
Francisco, titled Ketogenic DietAlters Gut Microbiome in Humans
and Mice, by Nicholas Weiler,and the author notes that
additional research in miceshowed that so-called ketone
bodies a molecule byproduct thatgives the ketogenic diet its
name directly impacts the gutmicrobiome in ways that may
(33:18):
ultimately suppress inflammation, suggesting evidence for
potential benefits of ketonebodies as a therapy for
autoimmune disorders affectingthe gut.
And then the next is increasedshort chain fatty acids.
Some studies suggest that theketogenic diet may increase the
production of short-chain fattyacids, which are produced by
(33:40):
beneficial bacteria in the gut,and short-term fatty acids have
an anti-inflammatory andneuroprotective effect.
And then, finally, improved gutbarrier function.
A leaky gut or increasedintestinal permeabilityability,
where things move across themembrane, can allow harmful
(34:00):
substances to enter thebloodstream and contribute to
inflammation.
The keto diet may and againthat's the keyword help to
improve gut barrier function,reducing gut leakage.
So what's the potential?
And again, that's the keywordpotential again, impact on PD
progression.
By positively influencing guthealth, the keto diet may help
(34:21):
slow the progression of PD byreducing neuroinflammation,
potentially limiting the spreadof alpha-synuclein, which was
the clump proteins, andimproving neurotransmitter
balance.
Now it's still important for meto note that research on keto
diet and the gut microbiome isstill in its very early stages.
More research is needed tofully understand the long-term
(34:43):
effects of the ketogenic diet ongut health and PD progression.
All right, let's briefly look atour last potential benefit of
the ketogenic diet withParkinson's, and that's
inflammation, which plays asignificant role in the
progression of Parkinson'sdisease.
And let's look at inflammationand PD and some of the factors
involved.
First is neuroinflammation.
(35:05):
Parkinson's is characterized byneuroinflammation or
inflammation within the brain.
Some contributing factors toneuroinflammation include
accumulation of thealpha-synuclein protein, which
we talked about, and thattriggers an immune response.
Gut dysbiosis or the imbalanceof gut bacteria can contribute
to systemic inflammation, whichcan then affect the brain.
(35:27):
Oxidative stress, which wetalked about earlier, can also
contribute to an inflammatoryresponse.
So the consequences ofinflammation are that chronic or
ongoing inflammation cancontribute to neuron damage and
helps accelerateneurodegeneration.
Now the keto diet's potentialanti-inflammatory effects
(35:49):
include improvements in guthealth, positively influencing
the gut microbiome.
The keto diet can reduce gutinflammation, which could have a
downstream effect on braininflammation.
Ketone bodies, particularlybeta-hydroxybutyrate don't you
love the way that just flows offthe tongue and they've been
shown to have anti-inflammatoryproperties.
(36:10):
And then, finally, reducedoxidative stress.
Since keto diet can reduceoxidative stress, this in turn
reduces the inflammatoryresponse that oxidative stress
causes.
Now the exact mechanisms arestill being investigated, but
it's likely to involve multiplepathways that may contribute to
its potential neuroprotectiveeffects in PD.
(36:32):
So, in essence, the ketogenicdiet again key word is may
contribute to its potentialneuroprotective effects in
Parkinson's.
Well, there you have it thepotential benefits of keto on
Parkinson's.
Now, for fair balance, let'slook at some of the potential
side effects and considerationsfor people with PD.
Now some common side effects ofthe keto diet include the keto
(36:56):
flu, which is really acollection of symptoms that some
people not everybody experiencewhen they start a ketogenic
diet, and symptoms can includeheadache, fatigue, irritability,
nausea, dizziness similar tothe flu, hence the name the keto
flu.
These symptoms can last a fewdays as your body adjusts to
(37:16):
burning fat as a fuel ratherthan carbs.
Now some ways to prevent orlessen the Ketoflu include
staying hydrated, so make sureyou drink plenty of water to
prevent dehydration, increaseelectrolytes, ensure you're
getting enough sodium andpotassium and magnesium, and you
can add some pink Himalayansalt to your meals or drinks and
(37:39):
that's going to give you someof the electrolytes.
There's also Gatorade and someothers out there.
Get the zero, of course,gatorade zero, because you don't
want the ones with sugar, andthen gradual carb reduction.
Instead of cutting caloriesdrastically all at once, try
reducing them gradually over acouple of days to help your body
adjust to going into ketosis.
Eat enough fat.
Eat enough healthy fats toprovide your body with energy
(38:01):
and get plenty of rest.
Other common side effectsinclude constipation.
Nutritional deficiencies Ifyou're not eating enough foods
containing good vitamins andminerals and antioxidants.
And make sure you're eatingcolorful, low-carbohydrate
vegetables to help reduce thatproblem, and then the fiber will
(38:22):
also help you with constipation.
Some additional considerationsfor Parkinson's include
medication interaction, so it'simportant to consult with your
doctor to ensure that the ketodiet is appropriate for your
specific needs and doesn'tinterfere with your medications.
And then nutritional adequacyCareful meal planning is
important to ensure propernutrient intake.
(38:42):
So lots of colorful, low-carbveggies, healthy fats like
avocados and olive oil.
Again, make sure you stayhydrated to prevent dehydration,
because keto helps you losewater and sodium.
All right now we've journeyedthrough the intricate world of
the ketogenic diet and itspotential impact on Parkinson's.
(39:03):
From understanding themetabolic shift to explaining
the promising research onneuroprotection, gut health and
inflammation, it's clear thatthis dietary approach holds
significant interest for thoseseeking complementary therapies.
However, let's be clear theketogenic diet is not a magic
bullet and any dietary changes,especially for individuals with
(39:26):
Parkinson's, must be made underthe guidance of a qualified
healthcare professional.
Every person's journey withParkinson's is unique and what
works for one may not work foranother.
The research is ongoing and,while potential benefits are
exciting, it's essential toapproach this topic with a
balanced perspective.
We're here to explore thescience, share information and
(39:46):
empower you to make informeddecisions about your health.
If you're intrigued by what youheard today and want to dig
deeper, I encourage you to visitlibparkinsonscom.
There, you can subscribe to thefree monthly newsletter, which
is packed with the latestresearch, practical tips and
inspiring stories.
You'll also find a wealth offree materials and articles to
(40:07):
further your understanding ofParkinson's, as well as other
complementary therapies.
Now, two books I recommend onthe keto diet are the Easy Five
Ingredient Keto Cookbook by JenFish I really love the keto root
beer float and the orange creamfloat and the second book is
the Complete Ketogenic Diet forBeginners by Amy Ramos.
(40:30):
Now, if you're interested, I'llleave a link in the podcast
description for both those books, and if you found value in this
podcast and want to support ourmission to provide accessible
and reliable information, pleaseconsider visiting my Ko-fi page
at ko-ficom.
Slash Liz Parkinson's.
Your support helps us continueto bring you reliable content
(40:50):
and maintain our podcast andwebsite.
So thank you for joining me onthis exploration on the
ketogenic diet and Parkinson'sdisease.
Remember, knowledge is powerand together we can navigate the
challenges of Parkinson'stogether with hope and
resilience.
Now, until next time, stayhealthy, stay strong and, as
always, live your best life withParkinson's you.
Hello and welcome to Live Parkinson's Live an
Exceptional Life.
I'm your host, chrisKustenbotter, and I've been
living an exceptional life withParkinson's for the past 15
years.
The mission of this podcast isto help as many people as
possible living with Parkinson'sto have a great quality of life
is to help as many people aspossible living with Parkinson's
to have a great quality of life.
Today's topic is Parkinson'sand keto exploring the ketogenic
diet for PD symptom management.
(00:31):
Now, what if the key tomanaging Parkinson's disease
symptoms wasn't just found in apill bottle, but also on your
plate?
It sounds radical, I know, butthe connection between diet and
neurological health is becomingincreasingly clear.
In this episode, we'reexploring the ketogenic diet, a
high-fat, low-carb approach, andasking tough questions Can it
(00:52):
really make a difference forpeople living with Parkinson's?
We'll examine the science, thepotential benefits and the
important considerations foranyone with Parkinson's
exploring this dietary approach.
All right, let me explain why.
I wanted to share this topicwith you as additional potential
diet plan to review with yourdoctor.
I've done podcasts on theMediterranean diet, the MIND
(01:14):
diet and their potentialbenefits for Parkinson's, and
I'd read a lot of research onthe ketogenic diet for
Parkinson's.
Last Sunday, I was at thefitness center and I was doing
some swimming, my wife and I andwhen I was done I was getting
changed in the locker room and Ihad a discussion with a
respected physician in thecommunity I'll call him Dr P and
(01:36):
Dr P participates in triathlonsand we talked a little bit
about running and I said now,because of Parkinson's, I don't
run.
But I told him that I docycling and swimming and he said
that was great because I'mdoing a lot of repetitive
activities, which is reallygoing to help with Parkinson's.
And then he also mentioned thathis dad had Parkinson's and his
(02:00):
dad was also a physician and sohe did a lot of research to
help his dad.
And he said that I shouldreally check into the ketogenic
diet.
He said it is shown to helpwith inflammation, which is
believed to contribute toneurodegeneration diseases like
Parkinson's.
I told him that I would do theresearch and, if the research
was promising, ask my movementdisorder specialist if it might
(02:21):
be a good option for me.
Now I know the weight loss partof the keto diet would sure
help.
So I've been doing research onthe ketogenic diet and I wanted
to share some of my findingswith all of you.
Now I do want to make thisdisclaimer up front, and we'll
bring it up again a few timesduring the podcast.
The information that I'm goingto be providing is for
informational purposes only.
(02:41):
I'm not a certified medicalprofessional or a registered
dietitian.
I do have a bachelor's degreein biology, so it's crucial that
you review any diet andnutrition changes with your
healthcare professional toensure that it's appropriate for
your specific needs.
Okay, now that I've shared thatwith you, let's take an aerial
view of what we'll be coveringin this podcast.
(03:02):
Now, since the topic is theketogenic diet, let's start out
and discuss what the ketogenicdiet is, what the macronutrients
and the ratios are, themetabolic shift from the diet
that is different from some ofthe other types of diets, and
the foods that are allowed andfoods to avoid, with examples,
of course.
(03:22):
And then in segment two, we'llexplore the ketogenic diet and
Parkinson's by looking at someof the potential benefits.
We'll look at neuroprotection,symptom management, the
gut-brain connection andinflammation.
Then, in segment three, becauseI also want to provide fair
balance with the informationthat I'm talking about, so if I
(03:42):
talk about the potentialbenefits, I also want to talk
about the potential side effects, and so we'll be looking at
some of the potential sideeffects of the ketogenic diet
and considerations for peoplewith PD.
Then, in segment four, I'llcover the current research and
evidence available for theketogenic diet and Parkinson's,
and then we'll pack all thatinformation in a box and, after
(04:05):
tying it together, send you backout into the world.
Okay, so, now that everyone'son board, let's leave the
terminal and take off on ourjourney to learn more about the
ketogenic diet.
Now, most of you have probablyheard about the ketogenic diet
and may even know people who usethe ketogenic diet as part of
their lifestyle.
I know people who often use itfor weight loss.
But really, what is theketogenic diet exactly and what
(04:26):
does the word ketogenic actuallymean?
Let's start by definingketogenic.
The term refers to this diet'sability to induce ketosis, which
we'll talk about in a fewminutes in more detail, but it's
a metabolic state where yourbody uses ketones for energy
instead of glucose.
Now, the ketogenic diet isoften referred to as keto, and
(04:48):
it's a dietary approach that'svery low in carbohydrate intake,
moderate protein consumptionand high intake of fats.
All right, so let's give you abreakdown of the ketogenic diet,
starting with the macronutrientratios Macronutrients.
The macronutrient ratios.
Macronutrients macro meaningbig are the big nutrients
Proteins, fats and carbohydrates.
(05:14):
Those are the ones that you seeprominently listed on the food
labels for all the foods you buy.
Now, besides serving size onthe labels, they often tell you
how many grams of eachmacronutrient are in the food
and the percentage of each.
Now the ketogenic dietemphasizes a specific
distribution of macronutrients,which is the following high fat,
and that's typically 70 to 80%of the daily calories.
Moderate protein, roughly 10 to20% of the total daily calories
(05:40):
.
And then very low carbohydrates, usually 5% to 10% of daily
calories and often limited to 20to 50 grams of carbohydrates
per day.
Now, sometimes it can getconfusing regarding water
proteins and water carbohydratesand the way I like to explain
it and it's true most of thetime that proteins walk on the
(06:02):
ground like your cows so forbeef, pigs for pork, chicken and
turkeys for poultry and swimaround.
That would be your fish, whilecarbohydrates typically grow in
the ground and they would beyour fruits and vegetables,
grains, etc.
Now there are some variations,like edamame, which grows in a
(06:24):
pod, but it has a good amount ofprotein.
So it's just an analogy as aquick guide to distinguish
between carbohydrates andprotein.
All right, now here are some ofthe food choices on the diet,
and let's start with foods thatthe ketogenic diet emphasizes,
starting with the fats, becauseyou may have been thinking,
chris, how can a dietemphasizing 70 to 80% of
(06:45):
calories from fat be good foryou?
Well, the ketogenic dietemphasizes eating healthy fats,
like avocados, olive oil,coconut oil, nuts and seeds,
like your chai seeds and yourflax seeds.
Meats.
Here's your proteins, like beef, poultry, fish, especially
(07:06):
fatty fish, like salmon, macroand tuna that are high in
omega-3 fatty acids.
And then, finally, lowcarbohydrate vegetables, and
they would include your leafygreens, like spinach and kale
spring mix, and then yourcruciferous vegetables, like
broccoli, cauliflower andBrussels sprouts.
So those are the differenttypes of foods that you want to
(07:28):
include as part of the ketogenicdiet.
Now let's look at some foods toavoid, and they would be any
type of sugary food, and thatwould include soda, juices,
candies, pastries, desserts andpies.
Also, this is now this one's akiller for me, because I love
these bread, pasta and rice.
(07:50):
Starchy vegetables likepotatoes and corn again both
personal favorites of mine andmost fruits, except small
portions of berries.
Okay, so that's a basicoverview of the ketogenic diet
and the foods that areacceptable to eat and the ones
to avoid.
Now let's look at how theketogenic diet is different from
(08:10):
some of the other diets thatare available out there.
Now, the big difference is theketogenic diet causes a
metabolic shift called ketosis,in which the body is producing
ketones for food.
Okay, chris, what exactly doesthat mean?
You need to explain yourself.
Do you remember the old TV showDifferent Strokes, where Gary
(08:32):
Coleman's character would alwayssay to his brother what you
talking about, willis?
Well, that's what we're goingto try to answer right now.
Okay, so let's break it down andlook at glucose blood sugar
versus ketones.
Okay, normally our body'sprimary energy source.
And let's say we eat a piece ofpizza or we eat a donut or we
(08:52):
eat some fruit those our bodytakes in and we break it down
into glucose, which comes fromcarbohydrates.
When you eat, like I said,bread, pizza, pasta, sweets, the
starches and sugars are brokendown into glucose and your body
uses that glucose for fuel.
Any excess glucose is stored asglycogen in the liver and
(09:12):
muscle cells or it's convertedto triglycerides and stored in
fat cells.
So that's why people tend togain weight if they're eating a
lot of carbs and don't get a lotof exercise.
Now, when carbohydrate intakeis drastically reduced, your
body's glucose stores becomedepleted.
So to provide energy to yourbody, the liver starts to break
(09:35):
down fats into molecules calledketones.
Now ketones are produced in theliver from fatty acids, and
ketones can be used as analternative fuel source for your
body by your brain, your heartand your muscles.
So the metabolic shift fromburning glucose for energy to
ketones is called ketosis.
(09:55):
Hopefully that wasn't toocomplicated.
So, really, what's thedifference between ketones and
glucose?
First of all, the source wherethey come from ketones and
glucose.
First of all, the source wherethey come from Glucose or sugar
comes primarily fromcarbohydrates, while ketones
come from fats.
So, in terms of how theyfunction, both of them provide
(10:16):
energy for the body, but thebody uses them differently.
Metabolically, glucose is thepreferred energy source when
it's readily available, becauseit's easy to use and uptake by
the cells.
Ketones are an alternate sourceof energy when glucose is
scarce, and one of the reasonsis how they are produced.
So, again, glucose is readilyavailable from the digestion of
(10:40):
your foods, especiallycarbohydrates or carbs, while
ketones are produced by theliver through the breakdown of
fats.
So, in essence, the ketogenicdiet forces the body to switch
from its fuel source, fromcarbohydrates, to fats,
resulting in the production ofketones and the metabolic state
of ketosis.
(11:01):
Now there are a few differenttypes of variations on the
ketogenic diet.
Now there are a few differenttypes of variations on the
ketogenic diet, which I'll justbriefly cover.
The first is the classicketogenic diet, and this is the
original ketogenic diet and it'sused primarily in clinical
settings, especially forepilepsy.
Now it has a very strict ratioof fat combined with proteins
(11:25):
and carbohydrates, often a 4 to1 ratio, so four grams of fat
for every one of protein andcarbs.
This makes the diet veryrestrictive.
Then you have a ketogenic dietwhich is called the MCT or
medium chain triglycerideketogenic diet, and this diet
utilizes MCT oil, which is atype of fat that is easily
converted into ketones by theliver.
(11:45):
Now, because the medium chaintriglycerides are so readily
used, this allows for slightlymore protein and carbohydrates
than the classic and it can be alittle bit easier for people to
tolerate.
And then, finally, is themodified Atkins or MAD, and this
diet's less restrictive thanthe classic and generally
(12:07):
involves a 1 to 1 or 2 to 1ratio of fat to combine protein
and carbohydrates, so it's oftenmore a manageable approach to
ketosis.
Now, the key distinctionbetween three of these diets
revolve around the specificratio of the macronutrients, the
types of fats emphasized andthe overall restrictiveness.
(12:29):
All right, that was a lot ofinformation.
So let's round out our overviewof the ketogenic diet by
looking at some of the foodsthat are allowed and foods to
avoid.
And let's start with foodsallowed and we'll lead it off
with healthy fats, since thathas the highest percentage of
macronutrients.
And again, we said that itshould be about 70 to 80% of
(12:51):
your daily calories and shouldinclude oils like olive oil,
coconut oil, avocado oil and MCToil, which is the medium chain
triglycerides, which is themedium chain triglycerides.
Avocados, nuts and seeds.
Almonds, walnuts, macadamianuts, chai seeds and flax seeds
(13:11):
are all good examples.
Butter and ghee, grass-fedbutter I didn't know that butter
could eat grass, but okay andghee, which is clarified butter,
and fatty cuts of meat likeribeye, steak, salmon and bacon.
All right.
Next up is moderate protein,which is 10 to 20% of the
(13:31):
calories, and this includes meat, beef, chicken, lamb, pork,
fish and seafood, and theseafood would include salmon,
tuna, cod and shrimp.
Then you have eggs as anotherprotein source and low carb
(13:52):
dairy, and again, that's inmoderation, and that would
include hard cheeses, heavycream, plain Greek yogurt, and
remember to check the label forcarbs.
Finally, very low carbvegetables, and that's 5 to 10%
of calories, focusing on thenon-starchy ones Now.
These include leafy greens likespinach, kale, lettuce and
arugula.
Cruciferous veggies likebroccoli, cauliflower, brussels
(14:15):
sprouts and cabbage, and otherveggies include zucchini,
asparagus, bell peppers,cucumbers and then berries in
very small quantitiesraspberries, blueberries,
strawberries.
All right, now let's look at thefoods to avoid Heading.
The list is sugary foods,that's your soda juice,
sweetened beverages, honey,maple syrup, and then you have
(14:40):
grains, and that would be yourbread, pasta, rice, cereal.
Ouch, that hurts, because Ireally love all of those Oats,
quinoa and barley.
Starchy vegetables likepotatoes, sweet potatoes, corn
and peas Again, that's killingme, they're some of my favorites
Squash, some varieties likebutternut squash, and then next
(15:03):
is most fruits, like bananas,apples, oranges, grapes and
dried fruit, then legumes, whichare your beans, lentils and
chickpeas, and then moving on tothe low-fat or diet products,
because they often have hiddencarbs.
Low-fat or diet products,because they often have hidden
carbs.
Low-fat yogurt, diet sodas,many processed diet snacks.
(15:24):
And then we have unhealthytrans fats, which are your
processed and fried foods,margarine, and then a sneaky one
is the high-carb condimentsketchup and sugary salad
dressings, barbecue sauce andthen, finally, alcohol.
Now, many alcoholic drinks arehigh in carbs, including beer,
(15:50):
sweet wines and the sugarycocktails that a lot of times
people get when they go out tothe restaurants.
And there you have it.
That's an overview of theketogenic diet Now.
Hopefully you found thathelpful.
Now, just as a friendlyreminder, before switching to a
new diet plan, make sure youconsult your healthcare
professional to ensure it'sright for you and your specific
(16:11):
needs.
All right, now it's time toswitch gears and look at the
ketogenic diet and Parkinson'sand some of the potential and
that's the key word, potentialbenefits.
Emerging research suggests thatthe ketogenic diet may offer in
terms of benefits for peoplewith PD, including improved
motor symptoms.
In the clinical study, impact ofa Keto Diet on Symptoms of
(16:33):
Parkinson's Disease, biomarkers,depression, anxiety and Quality
of Life a Longitudinal Studypublished in the
Neurodegenerative DiseaseManagement Journal on June 13th
of 2024.
(16:54):
Positively influence gait andmobility, self-care,
socialization, depression andanxiety-improved biomarkers of
general health.
Another benefit isneuroprotective effects, reduced
inflammation and enhancedmitochondrial function.
Now, mitochondria are theorganelles in the cell that
(17:19):
produce energy and are calledthe powerhouses of the cell.
All right, let's look at eachbenefit in a little more detail,
starting with neuroprotection.
Now, what exactly does that mean, chris?
Well, neuroprotection refers tothe ability of a substance or
intervention, like a diet, toprotect neurons or brain cells
from damage or degeneration.
(17:40):
So, in Parkinson's,neuroprotection is crucial for
slowing disease progression.
Okay, there are actually acouple things going on in terms
of neuroprotection.
There are some mechanisms thatprovide improved neuroprotection
, and the first one is oxidativestress reduction, and I've
talked a little bit about thisbefore on some of my other
(18:01):
podcasts, but anything with theword stress and reduction has to
be good, right.
So why is it important toreduce oxidative stress and what
exactly is oxidative stress?
I mean, maybe it's nice to knowwhat that is first, before we
know why we need to reduce it.
Well, oxidative stress happenswhen you have an imbalance
(18:24):
between the production of freeradicals, which are the unstable
molecules in your body, andyour body's ability to
counteract their harmful effectswith antioxidants.
Now, free radicals can damageyour cells, proteins and DNA,
which can lead to diseases likeneurodegenerative diseases.
So, in essence, oxidativestress occurs when your body
(18:47):
struggles to keep the freeradicals in check.
Okay, now that's important toreduce oxidative stress.
So how can the keto diet helpwith that?
So how can the keto diet helpwith that?
Well, ketones, particularlycalled beta-hydroxybutyrate,
have been shown to haveantioxidant properties which can
potentially reduce oxidativestress.
(19:09):
Now another mechanism ofneuroprotective effects is
improved mitochondrial function.
Okay, what are mitochondria andwhy is it so important that
their function is improved?
Okay, if you open the vault tothe deep recesses of your brain
and picture yourself sitting inhigh school biology class and
(19:31):
your teacher's discussing thecomponents of the cell, and next
thing you know, they throw outthe big word mitochondria and
ask does anyone know what themitochondria are and what they
do?
Your hand immediately shoots inthe air and is waving pick me,
pick me.
The teacher calls on you andwithout hesitation, you say
(19:52):
mitochondria are called thepowerhouse of the cell and that
they provide energy, that thecells need to function and that
they provide energy that thecells need to function.
The teacher says you arecorrect and, yes, you look like
a genius that you know you are.
So why is it important?
Cells generate enough energy,which can lead to health
(20:13):
problems.
Now here's where the ketogenicdiet comes into play.
Ketones can provide analternative and more efficient
energy source for mitochondria,potentially improving their
function.
In the clinical study, ketoneselicit distinct alterations in
adipose mitochondrialbioenergetics published in the
International Journal ofMolecular Sciences in August of
(20:35):
2020.
Now the authors noted that theobservation of significantly
increased mitochondrialrespiration in response to
ketone exposure may play somepart in increased whole body
energy expenditure.
That has been seen in humans inketosis.
Studies have suggested that theketogenic diet can stimulate
(20:57):
mitochondrial biogenesis,increasing the number of
mitochondria in the cells.
So, just like Tim Taylor on theshow Home Improvement, which
was one of my favorites, hewould always say more power.
And I go oh, oh, oh.
Another mechanism in helpingwith neuroprotection is
anti-inflammatory effects,because chronic inflammation
(21:19):
contributes to neurodegeneration.
In Parkinson's disease, theketogenic diet has been shown to
have anti-inflammatory effects,potentially again, that's the
key word reducingneuroinflammation.
Research in the area ofneuroprotection is ongoing, but
some studies have shownpromising results.
(21:39):
Research has explored theeffects of the keto diet on
mitochondrial function andoxidative stress in animal
models and PD.
Now more studies are needed inhuman trials to further show
that there's a benefit.
All right, now let's look atsome of the potential benefits
of the ketogenic diet forParkinson's and cover that its
effect on motor and non-motorsymptoms.
(22:01):
Now in a clinical study low-fatversus ketogenic diet in
Parkinson's disease a pilotrandomized controlled trial and
it was published in the MovementDisorder Journal in August of
2018.
This study started with 47randomized patients, 44 who
actually participated in thestudy and 38 actually completed
(22:22):
the study for an 86% completionrate, which is really good.
The study compared theplausibility, safety and
efficacy of a low-fat,high-carbohydrate diet versus a
ketogenic diet in a hospitalclinic of PD patients.
The study was evaluatingchanges both within and between
(22:42):
the groups.
So if you were on a low-fat,high-carbohydrate diet, you were
compared to others within thatgroup and then also between your
group and the ketogenic group.
The study used the MDS-UPDRSscale for evaluating changes
both within the groups.
(23:02):
Now I know you're probablythinking wait just a minute,
chris.
What did you say?
Mds-updrs, what I thought?
The same thing the MDS-UPDRS orMovement Disorder Society
Unified Parkinson's DiseaseRating Scale, and it's a
comprehensive tool that's usedto evaluate the various aspects
(23:23):
of Parkinson's.
So it looks at both motor andnon-motor experiences of daily
living and it's divided intofour parts.
So part one is going to look atyour non-motor experiences of
daily living.
Part two is going to look atyour motor experiences of daily
living.
Part two is going to look atyour motor experience as a daily
living.
Part three it's a motorexamination and then part four
(23:47):
is motor complications.
So in this study they were usingthis scale to look at the low
fat versus the ketogenic diet,both between and within the
groups in parts one to four,over eight weeks.
Now the results showed thatpatients on the ketogenic diet
group maintained physiologicalketosis, so those that were on a
(24:11):
ketogenic diet stayed inketosis during the course of the
study.
It also showed that both groupssignificantly decreased their
MDS-UPDRS scores, but theketogenic group decreased more
in part one, which were thenon-motor symptoms, showing a
41% improvement in baseline andpart one scores compared to the
(24:33):
low-fat group, which shared an11% improvement.
Now the study observed that thelargest difference between
groups decreases in urinaryproblems, pain and other
sensations, fatigue, dailysleepiness and cognitive
impairment.
Now there were no between-groupdifferences in the magnitude of
decrease for parts two to four.
(24:55):
So the study authors concludedthat it's plausible and safe for
PD patients to maintain alow-fat or ketogenic diet for
eight weeks.
Both diet groups significantlyimproved in motor symptom and
non-motor symptoms.
However, the ketogenic dietshowed greater improvements in
non-motor symptoms.
So this is one study thatlooked at the effect of the
(25:18):
ketogenic diet on motor andnon-motor symptoms and showed
positive results in the studygroup.
Now let's take a look at thepotential benefits of the
ketogenic diet on motor symptoms.
Now the ketogenic diet may isthe key word again improve motor
function, including reductionsin tremor rigidity, bradykinesia
(25:40):
or slowness of movement.
In the clinical studyNutritional Ketosis in
Parkinson's Disease a review ofremaining questions and insights
that was published inNeurotherapeutics in July of
2021, the authors note that theconcept of ketosis can be
therapeutic for PD motorsymptoms, bradykinesia and
(26:01):
rigidity, and it's consistentwith the results of the Van
Atali et al study.
Outside the study, improvementsin motor function are thought
to be related to improvements inmitochondrial function and the
neuroprotective effect ofketones.
And then in another study howCan a Ketogenic Diet Improve
(26:24):
Motor Symptom Function,published in Frontiers of
Molecular Science in January of2018, the authors note that in
the study abstract that themotor function has also been
shown to be improved by aketogenic diet or medium-chain
triglycerides diets in rodentmodels of Parkinson's and
Alzheimer's, as well as ALS andspinal cord injury.
(26:47):
While there are a number ofstudies looking at the effects
of the ketogenic diet on motorsymptoms.
There's inconsistency in thedata, and that relates to the
sample size and how many weredone with animal models versus
human models.
So more testing is needed indouble-blind, placebo-controlled
studies to see if specificbenefits of motor symptoms are
(27:11):
observed in humans that areusing the ketogenic diet.
Non-motor symptoms inParkinson's it involves a range
of non-motor symptoms whichthose of us with Parkinson's
know can include cognitivedecline, mood disturbances like
anxiety and depression, sleepdisorders, fatigue and the
ketogenic diet may positivelyinfluence these symptoms.
(27:33):
Now I covered the study earlierthat showed that the low-fat,
high-carbohydrate in theketogenic diet in people with
Parkinson's showed the 41%improvement in the keto group in
eight weeks for non-motorsymptoms.
And then another area thatthey're looking at is the
gut-brain connection, and that'sone of the key areas of
(27:53):
research which we'll cover next,with the keto diet potentially
improving gut microbiome health,which, in turn, can impact your
mood and your cognition.
In a study the Effects of theKetogenic Diet on Symptom
Biomarkers, depression andAnxiety, and Parkinson's Disease
(28:13):
a case study that was publishedin Curious in March of 2022 by
Melanie Tidman, the author notedthat, based on our findings,
the ketogenic diet is safe andeffective for improving
biomarkers of health, symptomsof depression and anxiety and PD
symptoms in patients in stage 1PD.
(28:34):
The study also notes in thesummary points that a 24-week
ketogenic diet intervention inadults with PD positively
influenced gait, immobility,self-care, socialization,
depression and anxiety andimproved biomarkers of general
health.
Now I did want to point outsome things to consider Now.
(28:54):
First, it's essential toemphasize the point that the
keto diet is not a cure for PDand individual responses to the
diet can vary significantly.
So it's important to work withyour healthcare professional,
especially to ensure that thereare no medication interactions.
And then, finally, morelarge-scale human trials are
really needed to fullyunderstand the long-term effects
(29:16):
of the keto diet on people withParkinson's.
So, in a nutshell, you'llnotice I use the keywords may or
potentially, because more datais needed to show specific
benefits to motor and non-motorsymptoms.
All right, let's briefly look atthe two other potential
benefits of the keto diet forpeople with Parkinson's, and
let's start with the gut-brainconnection, the gut microbiome.
(29:40):
And what is that you may beasking?
The gut microbiome is really alittle bustling community of
tiny living organisms, which aremostly bacteria that live in
your intestines.
They help digest food, theyproduce vitamins, they help
protect against harmful bacteria, they prevent the harmful
bacteria from causing infection,they help to boost your immune
(30:03):
system by training the immunesystem to recognize and fight
harmful invaders.
And then they influence yourmood and health.
Now, you didn't realize you hadall those little critters
living in your GI tract, helpingyou to keep your health, did
you?
So it's important to eat ahealthy, balanced diet with lots
of fiber to keep those goodbacteria flourishing All right.
Now, where were we?
(30:24):
Ah, yes, the gut microbiome andits role in Parkinson's.
Now, it's a rapidly evolvingarea of research and it's
revealing some strongconnections between gut health
and neurological function.
So how does your gut and yourbrain communicate with each
other?
No, they don't call each otheror text on the cell phones.
(30:45):
They communicate through what'scalled the gut-brain axis,
which is a complex networkinvolving neural networks,
nerves, hormonal andimmunological pathways.
And disruption to this complexnetwork's communication can
contribute to the developmentand progression of disorders
like Parkinson's.
And one of the key areas ofresearch is with alpha-synuclein
(31:07):
.
And one of the features ofParkinson's is the accumulation
of misfolded alpha-synucleinprotein in the brain.
Now, the misfolded and damagedalpha-synuclein protein in the
brain Now the misfolded anddamaged alpha-synuclein is
detrimental to the neurons inthe brain, killing off the
neurons.
Emerging evidence suggests thatalpha-synuclein aggregation, or
(31:29):
clumping, may actually begin inthe gut and then spread to the
brain via the vagus nerve.
Therefore, believe it or not,your gut health may play a role
in the initial stages of PD.
Now, in addition toalpha-synuclein clumping,
inflammation is another key areaof study, and the gut
microbiome plays a crucial rolein regulating inflammatory
(31:50):
inflammation.
Imbalances in the gutmicrobiome, which is also known
as dysbiosis, can lead toincreased inflammation, which
can contribute toneuroinflammation in PD.
Now the chronic inflammation isthought to worsen
neurodegeneration.
And then, finally, the gutmicrobiome is involved in
(32:12):
neurotransmitter production.
So the gut microbiome canproduce and metabolize
neurotransmitters, includingdopamine, which is deficient in
people with PD, and alterationsin the gut microbiome may affect
neurotransmitter levels andeven contribute to PD symptoms.
(32:33):
Okay, so let's look at how theketo diet may positively affect
gut health.
First is changes in themicrobiome composition.
The ketogenic diet alters thecomposition of the gut
microbiome, potentiallyincreasing the abundance of
beneficial bacteria and reducingthe abundance of harmful
bacteria.
In an article from theUniversity of California, san
(32:56):
Francisco, titled Ketogenic DietAlters Gut Microbiome in Humans
and Mice, by Nicholas Weiler,and the author notes that
additional research in miceshowed that so-called ketone
bodies a molecule byproduct thatgives the ketogenic diet its
name directly impacts the gutmicrobiome in ways that may
(33:18):
ultimately suppress inflammation, suggesting evidence for
potential benefits of ketonebodies as a therapy for
autoimmune disorders affectingthe gut.
And then the next is increasedshort chain fatty acids.
Some studies suggest that theketogenic diet may increase the
production of short-chain fattyacids, which are produced by
(33:40):
beneficial bacteria in the gut,and short-term fatty acids have
an anti-inflammatory andneuroprotective effect.
And then, finally, improved gutbarrier function.
A leaky gut or increasedintestinal permeabilityability,
where things move across themembrane, can allow harmful
(34:00):
substances to enter thebloodstream and contribute to
inflammation.
The keto diet may and againthat's the keyword help to
improve gut barrier function,reducing gut leakage.
So what's the potential?
And again, that's the keywordpotential again, impact on PD
progression.
By positively influencing guthealth, the keto diet may help
(34:21):
slow the progression of PD byreducing neuroinflammation,
potentially limiting the spreadof alpha-synuclein, which was
the clump proteins, andimproving neurotransmitter
balance.
Now it's still important for meto note that research on keto
diet and the gut microbiome isstill in its very early stages.
More research is needed tofully understand the long-term
(34:43):
effects of the ketogenic diet ongut health and PD progression.
All right, let's briefly look atour last potential benefit of
the ketogenic diet withParkinson's, and that's
inflammation, which plays asignificant role in the
progression of Parkinson'sdisease.
And let's look at inflammationand PD and some of the factors
involved.
First is neuroinflammation.
(35:05):
Parkinson's is characterized byneuroinflammation or
inflammation within the brain.
Some contributing factors toneuroinflammation include
accumulation of thealpha-synuclein protein, which
we talked about, and thattriggers an immune response.
Gut dysbiosis or the imbalanceof gut bacteria can contribute
to systemic inflammation, whichcan then affect the brain.
(35:27):
Oxidative stress, which wetalked about earlier, can also
contribute to an inflammatoryresponse.
So the consequences ofinflammation are that chronic or
ongoing inflammation cancontribute to neuron damage and
helps accelerateneurodegeneration.
Now the keto diet's potentialanti-inflammatory effects
(35:49):
include improvements in guthealth, positively influencing
the gut microbiome.
The keto diet can reduce gutinflammation, which could have a
downstream effect on braininflammation.
Ketone bodies, particularlybeta-hydroxybutyrate don't you
love the way that just flows offthe tongue and they've been
shown to have anti-inflammatoryproperties.
(36:10):
And then, finally, reducedoxidative stress.
Since keto diet can reduceoxidative stress, this in turn
reduces the inflammatoryresponse that oxidative stress
causes.
Now the exact mechanisms arestill being investigated, but
it's likely to involve multiplepathways that may contribute to
its potential neuroprotectiveeffects in PD.
(36:32):
So, in essence, the ketogenicdiet again key word is may
contribute to its potentialneuroprotective effects in
Parkinson's.
Well, there you have it thepotential benefits of keto on
Parkinson's.
Now, for fair balance, let'slook at some of the potential
side effects and considerationsfor people with PD.
Now some common side effects ofthe keto diet include the keto
(36:56):
flu, which is really acollection of symptoms that some
people not everybody experiencewhen they start a ketogenic
diet, and symptoms can includeheadache, fatigue, irritability,
nausea, dizziness similar tothe flu, hence the name the keto
flu.
These symptoms can last a fewdays as your body adjusts to
(37:16):
burning fat as a fuel ratherthan carbs.
Now some ways to prevent orlessen the Ketoflu include
staying hydrated, so make sureyou drink plenty of water to
prevent dehydration, increaseelectrolytes, ensure you're
getting enough sodium andpotassium and magnesium, and you
can add some pink Himalayansalt to your meals or drinks and
(37:39):
that's going to give you someof the electrolytes.
There's also Gatorade and someothers out there.
Get the zero, of course,gatorade zero, because you don't
want the ones with sugar, andthen gradual carb reduction.
Instead of cutting caloriesdrastically all at once, try
reducing them gradually over acouple of days to help your body
adjust to going into ketosis.
Eat enough fat.
Eat enough healthy fats toprovide your body with energy
(38:01):
and get plenty of rest.
Other common side effectsinclude constipation.
Nutritional deficiencies Ifyou're not eating enough foods
containing good vitamins andminerals and antioxidants.
And make sure you're eatingcolorful, low-carbohydrate
vegetables to help reduce thatproblem, and then the fiber will
(38:22):
also help you with constipation.
Some additional considerationsfor Parkinson's include
medication interaction, so it'simportant to consult with your
doctor to ensure that the ketodiet is appropriate for your
specific needs and doesn'tinterfere with your medications.
And then nutritional adequacyCareful meal planning is
important to ensure propernutrient intake.
(38:42):
So lots of colorful, low-carbveggies, healthy fats like
avocados and olive oil.
Again, make sure you stayhydrated to prevent dehydration,
because keto helps you losewater and sodium.
All right now we've journeyedthrough the intricate world of
the ketogenic diet and itspotential impact on Parkinson's.
(39:03):
From understanding themetabolic shift to explaining
the promising research onneuroprotection, gut health and
inflammation, it's clear thatthis dietary approach holds
significant interest for thoseseeking complementary therapies.
However, let's be clear theketogenic diet is not a magic
bullet and any dietary changes,especially for individuals with
(39:26):
Parkinson's, must be made underthe guidance of a qualified
healthcare professional.
Every person's journey withParkinson's is unique and what
works for one may not work foranother.
The research is ongoing and,while potential benefits are
exciting, it's essential toapproach this topic with a
balanced perspective.
We're here to explore thescience, share information and
(39:46):
empower you to make informeddecisions about your health.
If you're intrigued by what youheard today and want to dig
deeper, I encourage you to visitlibparkinsonscom.
There, you can subscribe to thefree monthly newsletter, which
is packed with the latestresearch, practical tips and
inspiring stories.
You'll also find a wealth offree materials and articles to
(40:07):
further your understanding ofParkinson's, as well as other
complementary therapies.
Now, two books I recommend onthe keto diet are the Easy Five
Ingredient Keto Cookbook by JenFish I really love the keto root
beer float and the orange creamfloat and the second book is
the Complete Ketogenic Diet forBeginners by Amy Ramos.
(40:30):
Now, if you're interested, I'llleave a link in the podcast
description for both those books, and if you found value in this
podcast and want to support ourmission to provide accessible
and reliable information, pleaseconsider visiting my Ko-fi page
at ko-ficom.
Slash Liz Parkinson's.
Your support helps us continueto bring you reliable content
(40:50):
and maintain our podcast andwebsite.
So thank you for joining me onthis exploration on the
ketogenic diet and Parkinson'sdisease.
Remember, knowledge is powerand together we can navigate the
challenges of Parkinson'stogether with hope and
resilience.
Now, until next time, stayhealthy, stay strong and, as
always, live your best life withParkinson's you.
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