SEARCHSYSTEMATIC_REVIEWneurology, psychiatry

systematic_review·neurology, psychiatry, nutrition, preclinical research, systematic review·PMC10220548

The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice

Nutrients · 6 authors, 3 centres

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This scoping review summarizes preclinical and clinical evidence on the ketogenic diet's potential neuroprotective effects for neurodegenerative and psychiatric disorders.

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The methods involved a comprehensive search of multiple databases and a structured data extraction process. The central result is that basic research reveals numerous neuroprotective mechanisms, such as inhibiting neuroinflammation, decreasing amyloid plaque deposition, and protecting dopaminergic neurons. However, clinical evidence is described as scarce, with most studies being small, uncontrolled, and focused on short-term effects, often with high dropout rates and heterogeneity. The review concludes that large, long-term, randomized controlled trials are needed to determine if KD can effectively manage or treat these disorders.

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systematic_review

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neurology

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ORIGINAL PAPER

PMC10220548

The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice

Nutrients

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ABSTRACT

Background: The ketogenic diet (KD) has become widespread for the therapy of epileptic pathology in childhood and adulthood. In the last few decades, the current re-emergence of its popularity has focused on the treatment of obesity and diabetes mellitus. KD also exerts anti-inflammatory and neuroprotective properties, which could be utilized for the therapy of neurodegenerative and psychiatric disorders. Purpose: This is a thorough, scoping review that aims to summarize and scrutinize the currently available basic research performed in in vitro and in vivo settings, as well as the clinical evidence of the potential beneficial effects of KD against neurodegenerative and psychiatric diseases. This review was conducted to systematically map the research performed in this area as well as identify gaps in knowledge. Methods: We thoroughly explored the most accurate scientific web databases, e.g., PubMed, Scopus, Web of Science, and Google Scholar, to obtain the most recent in vitro and in vivo data from animal studies as well as clinical human surveys from the last twenty years, applying effective and characteristic keywords. Results: Basic research has revealed multiple molecular mechanisms through which KD can exert neuroprotective effects, such as neuroinflammation inhibition, decreased reactive oxygen species (ROS) production, decreased amyloid plaque deposition and microglial activation, protection in dopaminergic neurons, tau hyper-phosphorylation suppression, stimulating mitochondrial biogenesis, enhancing gut microbial diversity, restoration of histone acetylation, and neuron repair promotion. On the other hand, clinical evidence remains scarce. Most existing clinical studies are modest, frequently uncontrolled, and merely assess the short-term impacts of KD. Moreover, several clinical studies had large dropout rates and a considerable lack of compliance assessment, as well as an increased level of heterogeneity in the study design and methodology. Conclusions: KD can exert substantial neuroprotective effects via multiple molecular mechanisms in various neurodegenerative and psychiatric pathological states. Large, long-term, randomized, double-blind, controlled clinical trials with a prospective design are strongly recommended to delineate whether KD may attenuate or even treat neurodegenerative and psychiatric disease development, progression, and symptomatology.

CITATION EXPORT

Maria Mentzelou, Antonios Dakanalis, Georgios K. Vasios et al.. The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice. Nutrients. (2023). https://doi.org/10.3390/nu15102270

AUTHORS

6 · 3 CENTRES

Maria Mentzelou, Antonios Dakanalis, Georgios K. Vasios, Maria Gialeli, Sousana K. Papadopoulou, Constantinos Giaginis

1Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; [email protected] (M.M.); [email protected] (G.K.V.); [email protected] (M.G.)
2School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
3Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; [email protected]

EDITOR / REVIEWER

Panteleimon Giannakopoulos