Parkinson's & Keto: Exploring the Ketogenic Diet for PD Symptom Management

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.

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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

Chapters

• 0:00 Introduction to Parkinson's and Keto
• 25:00 Defining the Ketogenic Diet
• 1:00:00 Potential Benefits for Parkinson's Patients
• 1:50:00 Discussing Side Effects and Considerations
• 2:15:00 Current Research Insights
• 3:00:00 Conclusion and Final Thoughts

Transcript

Speaker 1: 0:10

Hello and welcome to Live Parkinson's Live an Exceptional Life. I'm your host, chris Kustenbotter, and I've been living an exceptional life with Parkinson's for the past 15 years. The mission of this podcast is to help as many people as possible living with Parkinson's to have a great quality of life is to help as many people as possible living with Parkinson's to have a great quality of life. Today's topic is Parkinson's and keto exploring the ketogenic diet for PD symptom management. Now, what if the key to managing Parkinson's disease symptoms wasn't just found in a pill bottle, but also on your plate? It sounds radical, I know, but the connection between diet and neurological health is becoming increasingly clear. In this episode, we're exploring the ketogenic diet, a high-fat, low-carb approach, and asking tough questions Can it really make a difference for people living with Parkinson's? We'll examine the science, the potential benefits and the important considerations for anyone with Parkinson's exploring this dietary approach. All right, let me explain why. I wanted to share this topic with you as additional potential diet plan to review with your doctor. I've done podcasts on the Mediterranean diet, the MIND diet and their potential benefits for Parkinson's, and I'd read a lot of research on the ketogenic diet for Parkinson's. Last Sunday, I was at the fitness center and I was doing some swimming, my wife and I and when I was done I was getting changed in the locker room and I had a discussion with a respected physician in the community I'll call him Dr P and Dr P participates in triathlons and 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 do cycling and swimming and he said that was great because I'm doing a lot of repetitive activities, which is really going to help with Parkinson's. And then he also mentioned that his dad had Parkinson's and his dad was also a physician and so he did a lot of research to help his dad. And he said that I should really check into the ketogenic diet. He said it is shown to help with inflammation, which is believed to contribute to neurodegeneration diseases like Parkinson's. I told him that I would do the research and, if the research was promising, ask my movement disorder specialist if it might be a good option for me. Now I know the weight loss part of the keto diet would sure help. So I've been doing research on the ketogenic diet and I wanted to share some of my findings with all of you.

Speaker 1: 2:32

Now I do want to make this disclaimer up front, and we'll bring it up again a few times during the podcast. The information that I'm going to be providing is for informational purposes only. I'm not a certified medical professional or a registered dietitian. I do have a bachelor's degree in biology, so it's crucial that you review any diet and nutrition changes with your healthcare professional to ensure that it's appropriate for your specific needs. Okay, now that I've shared that with you, let's take an aerial view of what we'll be covering in this podcast. Now, since the topic is the ketogenic diet, let's start out and discuss what the ketogenic diet is, what the macronutrients and the ratios are, the metabolic shift from the diet that is different from some of the other types of diets, and the foods that are allowed and foods to avoid, with examples, of course. And then in segment two, we'll explore the ketogenic diet and Parkinson's by looking at some of the potential benefits. We'll look at neuroprotection, symptom management, the gut-brain connection and inflammation. Then, in segment three, because I also want to provide fair balance with the information that I'm talking about, so if I talk about the potential benefits, I also want to talk about the potential side effects, and so we'll be looking at some of the potential side effects of the ketogenic diet and considerations for people with PD. Then, in segment four, I'll cover the current research and evidence available for the ketogenic diet and Parkinson's, and then we'll pack all that information in a box and, after tying it together, send you back out into the world. Okay, so, now that everyone's on board, let's leave the terminal and take off on our journey to learn more about the ketogenic diet.

Speaker 1: 4:15

Now, most of you have probably heard about the ketogenic diet and may even know people who use the ketogenic diet as part of their lifestyle. I know people who often use it for weight loss. But really, what is the ketogenic diet exactly and what does the word ketogenic actually mean? Let's start by defining ketogenic. The term refers to this diet's ability to induce ketosis, which we'll talk about in a few minutes in more detail, but it's a metabolic state where your body uses ketones for energy instead of glucose. Now, the ketogenic diet is often referred to as keto, and it's a dietary approach that's very low in carbohydrate intake, moderate protein consumption and high intake of fats.

Speaker 1: 4:56

All right, so let's give you a breakdown of the ketogenic diet, starting with the macronutrient ratios Macronutrients. The macronutrient ratios. Macronutrients macro meaning big are the big nutrients Proteins, fats and carbohydrates. Those are the ones that you see prominently listed on the food labels for all the foods you buy. Now, besides serving size on the labels, they often tell you how many grams of each macronutrient are in the food and the percentage of each.

Speaker 1: 5:24

Now the ketogenic diet emphasizes 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 to 20% of the total daily calories. And then very low carbohydrates, usually 5% to 10% of daily calories and often limited to 20 to 50 grams of carbohydrates per day. Now, sometimes it can get confusing regarding water proteins and water carbohydrates and the way I like to explain it and it's true most of the time that proteins walk on the ground like your cows so for beef, pigs for pork, chicken and turkeys for poultry and swim around. That would be your fish, while carbohydrates typically grow in the ground and they would be your fruits and vegetables, grains, etc. Now there are some variations, like edamame, which grows in a pod, but it has a good amount of protein. So it's just an analogy as a quick guide to distinguish between carbohydrates and protein.

Speaker 1: 6:32

All right, now here are some of the food choices on the diet, and let's start with foods that the ketogenic diet emphasizes, starting with the fats, because you may have been thinking, chris, how can a diet emphasizing 70 to 80% of calories from fat be good for you? Well, the ketogenic diet emphasizes eating healthy fats, like avocados, olive oil, coconut oil, nuts and seeds, like your chai seeds and your flax seeds. Meats. Here's your proteins, like beef, poultry, fish, especially fatty fish, like salmon, macro and tuna that are high in omega-3 fatty acids. And then, finally, low carbohydrate vegetables, and they would include your leafy greens, like spinach and kale spring mix, and then your cruciferous vegetables, like broccoli, cauliflower and Brussels sprouts. So those are the different types of foods that you want to include as part of the ketogenic diet. Now let's look at some foods to avoid, and they would be any type of sugary food, and that would include soda, juices, candies, pastries, desserts and pies. Also, this is now this one's a killer for me, because I love these bread, pasta and rice. Starchy vegetables like potatoes and corn again both personal favorites of mine and most fruits, except small portions of berries. Okay, so that's a basic overview of the ketogenic diet and the foods that are acceptable to eat and the ones to avoid.

Speaker 1: 8:08

Now let's look at how the ketogenic diet is different from some of the other diets that are available out there. Now, the big difference is the ketogenic diet causes a metabolic shift called ketosis, in which the body is producing ketones for food. Okay, chris, what exactly does that mean? You need to explain yourself. Do you remember the old TV show Different Strokes, where Gary Coleman's character would always say to his brother what you talking about, willis? Well, that's what we're going to try to answer right now.

Speaker 1: 8:38

Okay, so let's break it down and look at glucose blood sugar versus ketones. Okay, normally our body's primary energy source. And let's say we eat a piece of pizza or we eat a donut or we eat some fruit those our body takes in and we break it down into glucose, which comes from carbohydrates. When you eat, like I said, bread, pizza, pasta, sweets, the starches and sugars are broken down into glucose and your body uses that glucose for fuel. Any excess glucose is stored as glycogen in the liver and muscle cells or it's converted to triglycerides and stored in fat cells. So that's why people tend to gain weight if they're eating a lot of carbs and don't get a lot of exercise. Now, when carbohydrate intake is drastically reduced, your body's glucose stores become depleted. So to provide energy to your body, the liver starts to break down fats into molecules called ketones. Now ketones are produced in the liver from fatty acids, and ketones can be used as an alternative fuel source for your body by your brain, your heart and your muscles. So the metabolic shift from burning glucose for energy to ketones is called ketosis.

Speaker 1: 9:55

Hopefully that wasn't too complicated. So, really, what's the difference between ketones and glucose? First of all, the source where they come from ketones and glucose. First of all, the source where they come from Glucose or sugar comes primarily from carbohydrates, while ketones come from fats. So, in terms of how they function, both of them provide energy for the body, but the body uses them differently. Metabolically, glucose is the preferred energy source when it's readily available, because it's easy to use and uptake by the cells. Ketones are an alternate source of energy when glucose is scarce, and one of the reasons is how they are produced. So, again, glucose is readily available from the digestion of your foods, especially carbohydrates or carbs, while ketones are produced by the liver through the breakdown of fats. So, in essence, the ketogenic diet forces the body to switch from its fuel source, from carbohydrates, to fats, resulting in the production of ketones and the metabolic state of ketosis.

Speaker 1: 11:01

Now there are a few different types of variations on the ketogenic diet. Now there are a few different types of variations on the ketogenic diet, which I'll just briefly cover. The first is the classic ketogenic diet, and this is the original ketogenic diet and it's used primarily in clinical settings, especially for epilepsy. Now it has a very strict ratio of fat combined with proteins and carbohydrates, often a 4 to 1 ratio, so four grams of fat for every one of protein and carbs. This makes the diet very restrictive. Then you have a ketogenic diet which is called the MCT or medium chain triglyceride ketogenic diet, and this diet utilizes MCT oil, which is a type of fat that is easily converted into ketones by the liver. Now, because the medium chain triglycerides are so readily used, this allows for slightly more protein and carbohydrates than the classic and it can be a little bit easier for people to tolerate. And then, finally, is the modified Atkins or MAD, and this diet's less restrictive than the classic and generally involves a 1 to 1 or 2 to 1 ratio of fat to combine protein and carbohydrates, so it's often more a manageable approach to ketosis. Now, the key distinction between three of these diets revolve around the specific ratio of the macronutrients, the types of fats emphasized and the overall restrictiveness.

Speaker 1: 12:29

All right, that was a lot of information. So let's round out our overview of the ketogenic diet by looking at some of the foods that are allowed and foods to avoid. And let's start with foods allowed and we'll lead it off with healthy fats, since that has the highest percentage of macronutrients. And again, we said that it should be about 70 to 80% of your daily calories and should include oils like olive oil, coconut oil, avocado oil and MCT oil, which is the medium chain triglycerides, which is the medium chain triglycerides. Avocados, nuts and seeds. Almonds, walnuts, macadamia nuts, chai seeds and flax seeds are all good examples. Butter and ghee, grass-fed butter I didn't know that butter could eat grass, but okay and ghee, which is clarified butter, and fatty cuts of meat like ribeye, steak, salmon and bacon. All right.

Speaker 1: 13:29

Next up is moderate protein, which is 10 to 20% of the calories, and this includes meat, beef, chicken, lamb, pork, fish and seafood, and the seafood would include salmon, tuna, cod and shrimp. Then you have eggs as another protein source and low carb dairy, and again, that's in moderation, and that would include hard cheeses, heavy cream, plain Greek yogurt, and remember to check the label for carbs. Finally, very low carb vegetables, and that's 5 to 10% of calories, focusing on the non-starchy ones Now. These include leafy greens like spinach, kale, lettuce and arugula. Cruciferous veggies like broccoli, cauliflower, brussels sprouts and cabbage, and other veggies include zucchini, asparagus, bell peppers, cucumbers and then berries in very small quantities raspberries, blueberries, strawberries.

Speaker 1: 14:29

All right, now let's look at the foods to avoid Heading. The list is sugary foods, that's your soda juice, sweetened beverages, honey, maple syrup, and then you have grains, and that would be your bread, pasta, rice, cereal. Ouch, that hurts, because I really love all of those Oats, quinoa and barley. Starchy vegetables like potatoes, sweet potatoes, corn and peas Again, that's killing me, they're some of my favorites Squash, some varieties like butternut squash, and then next is most fruits, like bananas, apples, oranges, grapes and dried fruit, then legumes, which are your beans, lentils and chickpeas, and then moving on to the low-fat or diet products, because they often have hidden carbs.

Speaker 1: 15:20

Low-fat or diet products, because they often have hidden carbs. Low-fat yogurt, diet sodas, many processed diet snacks. And then we have unhealthy trans fats, which are your processed and fried foods, margarine, and then a sneaky one is the high-carb condiments ketchup and sugary salad dressings, barbecue sauce and then, finally, alcohol. Now, many alcoholic drinks are high in carbs, including beer, sweet wines and the sugary cocktails that a lot of times people get when they go out to the restaurants. And there you have it.

Speaker 1: 15:58

That's an overview of the ketogenic diet Now. Hopefully you found that helpful. Now, just as a friendly reminder, before switching to a new diet plan, make sure you consult your healthcare professional to ensure it's right for you and your specific needs. All right, now it's time to switch gears and look at the ketogenic diet and Parkinson's and some of the potential and that's the key word, potential benefits. Emerging research suggests that the ketogenic diet may offer in terms of benefits for people with PD, including improved motor symptoms.

Speaker 1: 16:29

In the clinical study, impact of a Keto Diet on Symptoms of Parkinson's Disease, biomarkers, depression, anxiety and Quality of Life a Longitudinal Study published in the Neurodegenerative Disease Management Journal on June 13th of 2024. Positively influence gait and mobility, self-care, socialization, depression and anxiety-improved biomarkers of general health. Another benefit is neuroprotective effects, reduced inflammation and enhanced mitochondrial function. Now, mitochondria are the organelles in the cell that produce energy and are called the powerhouses of the cell. All right, let's look at each benefit in a little more detail, starting with neuroprotection.

Speaker 1: 17:28

Now, what exactly does that mean, chris? Well, neuroprotection refers to the ability of a substance or intervention, like a diet, to protect neurons or brain cells from damage or degeneration. So, in Parkinson's, neuroprotection is crucial for slowing disease progression. Okay, there are actually a couple things going on in terms of neuroprotection.

Speaker 1: 17:53

There are some mechanisms that provide improved neuroprotection, and the first one is oxidative stress reduction, and I've talked a little bit about this before on some of my other podcasts, but anything with the word stress and reduction has to be good, right. So why is it important to reduce oxidative stress and what exactly is oxidative stress? I mean, maybe it's nice to know what that is first, before we know why we need to reduce it. Well, oxidative stress happens when you have an imbalance between the production of free radicals, which are the unstable molecules in your body, and your body's ability to counteract their harmful effects with antioxidants. Now, free radicals can damage your cells, proteins and DNA, which can lead to diseases like neurodegenerative diseases. So, in essence, oxidative stress occurs when your body struggles to keep the free radicals in check. Okay, now that's important to reduce oxidative stress. So how can the keto diet help with that? So how can the keto diet help with that? Well, ketones, particularly called beta-hydroxybutyrate, have been shown to have antioxidant properties which can potentially reduce oxidative stress.

Speaker 1: 19:09

Now another mechanism of neuroprotective effects is improved mitochondrial function. Okay, what are mitochondria and why is it so important that their function is improved? Okay, if you open the vault to the deep recesses of your brain and picture yourself sitting in high school biology class and your teacher's discussing the components of the cell, and next thing you know, they throw out the big word mitochondria and ask does anyone know what the mitochondria are and what they do? Your hand immediately shoots in the air and is waving pick me, pick me. The teacher calls on you and without hesitation, you say mitochondria are called the powerhouse of the cell and that they provide energy, that the cells need to function and that they provide energy that the cells need to function. The teacher says you are correct 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 problems.

Speaker 1: 20:14

Now here's where the ketogenic diet comes into play. Ketones can provide an alternative and more efficient energy source for mitochondria, potentially improving their function. In the clinical study, ketones elicit distinct alterations in adipose mitochondrial bioenergetics published in the International Journal of Molecular Sciences in August of 2020. Now the authors noted that the observation of significantly increased mitochondrial respiration in response to ketone exposure may play some part in increased whole body energy expenditure. That has been seen in humans in ketosis. Studies have suggested that the ketogenic diet can stimulate mitochondrial biogenesis, increasing the number of mitochondria in the cells. So, just like Tim Taylor on the show Home Improvement, which was one of my favorites, he would always say more power. And I go oh, oh, oh.

Speaker 1: 21:12

Another mechanism in helping with neuroprotection is anti-inflammatory effects, because chronic inflammation contributes to neurodegeneration. In Parkinson's disease, the ketogenic diet has been shown to have anti-inflammatory effects, potentially again, that's the key word reducing neuroinflammation. Research in the area of neuroprotection is ongoing, but some studies have shown promising results. Research has explored the effects of the keto diet on mitochondrial function and oxidative stress in animal models and PD. Now more studies are needed in human trials to further show that there's a benefit. All right, now let's look at some of the potential benefits of the ketogenic diet for Parkinson's and cover that its effect on motor and non-motor symptoms.

Speaker 1: 22:01

Now in a clinical study low-fat versus ketogenic diet in Parkinson's disease a pilot randomized controlled trial and it was published in the Movement Disorder Journal in August of 2018. This study started with 47 randomized patients, 44 who actually participated in the study and 38 actually completed the study for an 86% completion rate, which is really good. The study compared the plausibility, safety and efficacy of a low-fat, high-carbohydrate diet versus a ketogenic diet in a hospital clinic of PD patients. The study was evaluating changes both within and between the groups. So if you were on a low-fat, high-carbohydrate diet, you were compared to others within that group and then also between your group and the ketogenic group. The study used the MDS-UPDRS scale for evaluating changes both within the groups.

Speaker 1: 23:02

Now I know you're probably thinking wait just a minute, chris. What did you say? Mds-updrs, what I thought? The same thing the MDS-UPDRS or Movement Disorder Society Unified Parkinson's Disease Rating Scale, and it's a comprehensive tool that's used to evaluate the various aspects of Parkinson's. So it looks at both motor and non-motor experiences of daily living and it's divided into four parts. So part one is going to look at your non-motor experiences of daily living. Part two is going to look at your motor experiences of daily living. Part two is going to look at your motor experience as a daily living. Part three it's a motor examination and then part four is motor complications.

Speaker 1: 23:50

So in this study they were using this 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 that patients on the ketogenic diet group maintained physiological ketosis, so those that were on a ketogenic diet stayed in ketosis during the course of the study. It also showed that both groups significantly decreased their MDS-UPDRS scores, but the ketogenic group decreased more in part one, which were the non-motor symptoms, showing a 41% improvement in baseline and part one scores compared to the low-fat group, which shared an 11% improvement. Now the study observed that the largest difference between groups decreases in urinary problems, pain and other sensations, fatigue, daily sleepiness and cognitive impairment. Now there were no between-group differences in the magnitude of decrease for parts two to four. So the study authors concluded that it's plausible and safe for PD patients to maintain a low-fat or ketogenic diet for eight weeks. Both diet groups significantly improved in motor symptom and non-motor symptoms. However, the ketogenic diet showed greater improvements in non-motor symptoms. So this is one study that looked at the effect of the ketogenic diet on motor and non-motor symptoms and showed positive results in the study group.

Speaker 1: 25:24

Now let's take a look at the potential benefits of the ketogenic diet on motor symptoms. Now the ketogenic diet may is the key word again improve motor function, including reductions in tremor rigidity, bradykinesia or slowness of movement. In the clinical study Nutritional Ketosis in Parkinson's Disease a review of remaining questions and insights that was published in Neurotherapeutics in July of 2021, the authors note that the concept of ketosis can be therapeutic for PD motor symptoms, bradykinesia and rigidity, and it's consistent with the results of the Van Atali et al study. Outside the study, improvements in motor function are thought to be related to improvements in mitochondrial function and the neuroprotective effect of ketones. And then in another study how Can a Ketogenic Diet Improve Motor Symptom Function, published in Frontiers of Molecular Science in January of 2018, the authors note that in the study abstract that the motor function has also been shown to be improved by a ketogenic diet or medium-chain triglycerides diets in rodent models of Parkinson's and Alzheimer's, as well as ALS and spinal cord injury.

Speaker 1: 26:47

While there are a number of studies looking at the effects of the ketogenic diet on motor symptoms. There's inconsistency in the data, and that relates to the sample size and how many were done with animal models versus human models. So more testing is needed in double-blind, placebo-controlled studies to see if specific benefits of motor symptoms are observed in humans that are using the ketogenic diet. Non-motor symptoms in Parkinson's it involves a range of non-motor symptoms which those of us with Parkinson's know can include cognitive decline, mood disturbances like anxiety and depression, sleep disorders, fatigue and the ketogenic diet may positively influence these symptoms. Now I covered the study earlier that showed that the low-fat, high-carbohydrate in the ketogenic diet in people with Parkinson's showed the 41% improvement in the keto group in eight weeks for non-motor symptoms. And then another area that they're looking at is the gut-brain connection, and that's one of the key areas of 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.

Speaker 1: 28:06

In a study the Effects of the Ketogenic Diet on Symptom Biomarkers, depression and Anxiety, and Parkinson's Disease a case study that was published in Curious in March of 2022 by Melanie Tidman, the author noted that, based on our findings, the ketogenic diet is safe and effective for improving biomarkers of health, symptoms of depression and anxiety and PD symptoms in patients in stage 1 PD. The study also notes in the summary points that a 24-week ketogenic diet intervention in adults with PD positively influenced gait, immobility, self-care, socialization, depression and anxiety and improved biomarkers of general health. Now I did want to point out some things to consider Now. First, it's essential to emphasize the point that the keto diet is not a cure for PD and individual responses to the diet can vary significantly. So it's important to work with your healthcare professional, especially to ensure that there are no medication interactions. And then, finally, more large-scale human trials are really needed to fully understand the long-term effects of the keto diet on people with Parkinson's. So, in a nutshell, you'll notice I use the keywords may or potentially, because more data is needed to show specific benefits to motor and non-motor symptoms.

Speaker 1: 29:31

All right, let's briefly look at the two other potential benefits of the keto diet for people with Parkinson's, and let's start with the gut-brain connection, the gut microbiome. And what is that you may be asking? The gut microbiome is really a little bustling community of tiny living organisms, which are mostly bacteria that live in your intestines. They help digest food, they produce vitamins, they help protect against harmful bacteria, they prevent the harmful bacteria from causing infection, they help to boost your immune system by training the immune system to recognize and fight harmful invaders. And then they influence your mood and health. Now, you didn't realize you had all those little critters living in your GI tract, helping you to keep your health, did you? So it's important to eat a healthy, balanced diet with lots of fiber to keep those good bacteria flourishing All right. Now, where were we? Ah, yes, the gut microbiome and its role in Parkinson's.

Speaker 1: 30:29

Now, it's a rapidly evolving area of research and it's revealing some strong connections between gut health and neurological function. So how does your gut and your brain communicate with each other? No, they don't call each other or text on the cell phones. They communicate through what's called the gut-brain axis, which is a complex network involving neural networks, nerves, hormonal and immunological pathways. And disruption to this complex network's communication can contribute to the development and progression of disorders like Parkinson's.

Speaker 1: 31:05

And one of the key areas of research is with alpha-synuclein. And one of the features of Parkinson's is the accumulation of misfolded alpha-synuclein protein in the brain. Now, the misfolded and damaged alpha-synuclein protein in the brain Now the misfolded and damaged alpha-synuclein is detrimental to the neurons in the brain, killing off the neurons. Emerging evidence suggests that alpha-synuclein aggregation, or clumping, may actually begin in the 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.

Speaker 1: 31:40

Now, in addition to alpha-synuclein clumping, inflammation is another key area of study, and the gut microbiome plays a crucial role in regulating inflammatory inflammation. Imbalances in the gut microbiome, which is also known as dysbiosis, can lead to increased inflammation, which can contribute to neuroinflammation in PD. Now the chronic inflammation is thought to worsen neurodegeneration. And then, finally, the gut microbiome is involved in neurotransmitter production. So the gut microbiome can produce and metabolize neurotransmitters, including dopamine, which is deficient in people with PD, and alterations in the gut microbiome may affect neurotransmitter levels and even contribute to PD symptoms.

Speaker 1: 32:33

Okay, so let's look at how the keto diet may positively affect gut health. First is changes in the microbiome composition. The ketogenic diet alters the composition of the gut microbiome, potentially increasing the abundance of beneficial bacteria and reducing the abundance of harmful bacteria. In an article from the University of California, san Francisco, titled Ketogenic Diet Alters Gut Microbiome in Humans and Mice, by Nicholas Weiler, and the author notes that additional research in mice showed that so-called ketone bodies a molecule byproduct that gives the ketogenic diet its name directly impacts the gut microbiome in ways that may ultimately suppress inflammation, suggesting evidence for potential benefits of ketone bodies as a therapy for autoimmune disorders affecting the gut.

Speaker 1: 33:29

And then the next is increased short chain fatty acids. Some studies suggest that the ketogenic diet may increase the production of short-chain fatty acids, which are produced by beneficial bacteria in the gut, and short-term fatty acids have an anti-inflammatory and neuroprotective effect. And then, finally, improved gut barrier function. A leaky gut or increased intestinal permeabilityability, where things move across the membrane, can allow harmful substances to enter the bloodstream and contribute to inflammation. The keto diet may and again that's the keyword help to improve gut barrier function, reducing gut leakage. So what's the potential? And again, that's the keyword potential again, impact on PD progression. By positively influencing gut health, the keto diet may help slow the progression of PD by reducing neuroinflammation, potentially limiting the spread of alpha-synuclein, which was the clump proteins, and improving neurotransmitter balance. Now it's still important for me to note that research on keto diet and the gut microbiome is still in its very early stages. More research is needed to fully understand the long-term effects of the ketogenic diet on gut health and PD progression.

Speaker 1: 34:48

All right, let's briefly look at our last potential benefit of the ketogenic diet with Parkinson's, and that's inflammation, which plays a significant role in the progression of Parkinson's disease. And let's look at inflammation and PD and some of the factors involved. First is neuroinflammation. Parkinson's is characterized by neuroinflammation or inflammation within the brain. Some contributing factors to neuroinflammation include accumulation of the alpha-synuclein protein, which we talked about, and that triggers an immune response. Gut dysbiosis or the imbalance of gut bacteria can contribute to systemic inflammation, which can then affect the brain. Oxidative stress, which we talked about earlier, can also contribute to an inflammatory response. So the consequences of inflammation are that chronic or ongoing inflammation can contribute to neuron damage and helps accelerate neurodegeneration.

Speaker 1: 35:45

Now the keto diet's potential anti-inflammatory effects include improvements in gut health, positively influencing the gut microbiome. The keto diet can reduce gut inflammation, which could have a downstream effect on brain inflammation. Ketone bodies, particularly beta-hydroxybutyrate don't you love the way that just flows off the tongue and they've been shown to have anti-inflammatory properties. And then, finally, reduced oxidative stress. Since keto diet can reduce oxidative stress, this in turn reduces the inflammatory response that oxidative stress causes. Now the exact mechanisms are still being investigated, but it's likely to involve multiple pathways that may contribute to its potential neuroprotective effects in PD. So, in essence, the ketogenic diet again key word is may contribute to its potential neuroprotective effects in Parkinson's. Well, there you have it the potential benefits of keto on Parkinson's.

Speaker 1: 36:46

Now, for fair balance, let's look at some of the potential side effects and considerations for people with PD. Now some common side effects of the keto diet include the keto flu, which is really a collection of symptoms that some people not everybody experience when they start a ketogenic diet, and symptoms can include headache, fatigue, irritability, nausea, dizziness similar to the flu, hence the name the keto flu. These symptoms can last a few days as your body adjusts to burning fat as a fuel rather than carbs. Now some ways to prevent or lessen the Ketoflu include staying hydrated, so make sure you drink plenty of water to prevent dehydration, increase electrolytes, ensure you're getting enough sodium and potassium and magnesium, and you can add some pink Himalayan salt to your meals or drinks and that's going to give you some of the electrolytes. There's also Gatorade and some others out there. Get the zero, of course, gatorade zero, because you don't want the ones with sugar, and then gradual carb reduction. Instead of cutting calories drastically all at once, try reducing them gradually over a couple of days to help your body adjust to going into ketosis.

Speaker 1: 37:57

Eat enough fat. Eat enough healthy fats to provide your body with energy and get plenty of rest. Other common side effects include constipation. Nutritional deficiencies If you're not eating enough foods containing good vitamins and minerals and antioxidants. And make sure you're eating colorful, low-carbohydrate vegetables to help reduce that problem, and then the fiber will also help you with constipation. Some additional considerations for Parkinson's include medication interaction, so it's important to consult with your doctor to ensure that the keto diet is appropriate for your specific needs and doesn't interfere with your medications. And then nutritional adequacy Careful meal planning is important to ensure proper nutrient intake. So lots of colorful, low-carb veggies, healthy fats like avocados and olive oil. Again, make sure you stay hydrated to prevent dehydration, because keto helps you lose water and sodium.

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All right now we've journeyed through the intricate world of the ketogenic diet and its potential impact on Parkinson's. From understanding the metabolic shift to explaining the promising research on neuroprotection, gut health and inflammation, it's clear that this dietary approach holds significant interest for those seeking complementary therapies. However, let's be clear the ketogenic diet is not a magic bullet and any dietary changes, especially for individuals with Parkinson's, must be made under the guidance of a qualified healthcare professional. Every person's journey with Parkinson's is unique and what works for one may not work for another. The research is ongoing and, while potential benefits are exciting, it's essential to approach this topic with a balanced perspective.

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We're here to explore the science, share information and empower you to make informed decisions about your health. If you're intrigued by what you heard today and want to dig deeper, I encourage you to visit libparkinsonscom. There, you can subscribe to the free monthly newsletter, which is packed with the latest research, practical tips and inspiring stories. You'll also find a wealth of free materials and articles to further your understanding of Parkinson's, as well as other complementary therapies. Now, two books I recommend on the keto diet are the Easy Five Ingredient Keto Cookbook by Jen Fish I really love the keto root beer float and the orange cream float and the second book is the Complete Ketogenic Diet for Beginners by Amy Ramos.

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Now, if you're interested, I'll leave a link in the podcast description for both those books, and if you found value in this podcast and want to support our mission to provide accessible and reliable information, please consider visiting my Ko-fi page at ko-ficom. Slash Liz Parkinson's. Your support helps us continue to bring you reliable content and maintain our podcast and website. So thank you for joining me on this exploration on the ketogenic diet and Parkinson's disease. Remember, knowledge is power and together we can navigate the challenges of Parkinson's together with hope and resilience. Now, until next time, stay healthy, stay strong and, as always, live your best life with Parkinson's you.