NJ. Reddy, NZY. Benjamin, PH. Reddy, A. Thai, HMA. Rawashdeh, C. Saravanan, P. Prajjwal, Y. Tekuru, P. Inban, et al. (2025). The role and benefits of ketogenic diet in modulating inflammation in multiple sclerosis: A systematic review and meta-analysis. Disease-a-month : DM, 71(11), 102013. https://doi.org/10.1016/j.disamonth.2025.102013

PubMed 41067991

[Abstract]
BACKGROUND: The ketogenic diet, known for its anti-inflammatory and neuroprotective effects, has gained attention as a potential therapeutic approach for modulating inflammation and improving clinical outcomes in Multiple Sclerosis patients.

OBJECTIVES: To systematically evaluate and synthesize clinical and preclinical evidence on the ketogenic diet's role in modulating inflammation in Multiple Sclerosis patients and quantitatively assess its effects on inflammation.

RESULTS: The meta-analysis revealed significant effects of the KD on inflammatory markers in MS patients. At 3 months, Leptin levels decreased significantly (mean difference: -2.63 ng/mL, 95 % CI: -3.03 to -2.24, p < 0.00001), and Adiponectin levels increased (mean difference: -1.78 mcg/mL, 95 % CI: -2.26 to -1.29, p < 0.00001). At 6 months, Leptin again decreased (mean difference: -2.18 ng/mL, 95 % CI: -2.92 to -1.43, p < 0.00001), and Adiponectin increased (mean difference: -1.65 mcg/mL, 95 % CI: -1.93 to -1.36, p < 0.00001). However, Neurofilament Light Chain (NfL) showed no significant change (mean difference: -0.10, 95 % CI: -0.61 to 0.40, p > 0.05), suggesting stable neurodegeneration biomarkers. The overall results suggest that the ketogenic diet reduces Leptin, increases Adiponectin, but does not worsen neurodegeneration, highlighting its anti-inflammatory effects.

CONCLUSION: The ketogenic diet shows promise in improving inflammation, fatigue, depression, and quality of life in MS patients. While neurodegenerative biomarkers like NfL remain stable, deeper ketosis may enhance neuroprotection. Further long-term studies are needed to confirm these effects.