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一项关于生酮饮食作为帕金森病治疗方法的混合方法可行性研究。

A mixed methods feasibility study of a ketogenic diet as treatment for Parkinson's disease.

作者信息

Worster Kate, Colgan Dana, Vita Alexandra, McClure Christine, Buttolph Lita, Hodges Romilly, Senders Angela, Erlandsen Andy, Elbarbry Fawzy, Zwickey Heather

机构信息

Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States.

Department of Neurology, School of Medicine, Oregon Health Science University, Portland, OR, United States.

出版信息

Front Nutr. 2025 Jul 23;12:1601446. doi: 10.3389/fnut.2025.1601446. eCollection 2025.


DOI:10.3389/fnut.2025.1601446
PMID:40771211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12325006/
Abstract

OBJECTIVE: People with Parkinson's disease (PD) have been shown to benefit from a ketogenic diet (KD). However, evidence suggests the traditional KD's high dairy consumption may exacerbate PD symptoms. This patient-initiated study assessed the feasibility and acceptability of a novel ketogenic diet limiting dairy products in patients with PD. Quality of life and functional movements were also evaluated. METHODS: Twelve people with PD followed a modified, low dairy KD for 12 weeks. We provided support and nutritional education to assist with adherence. Subjects recorded daily food diaries, from which total macronutrients were calculated. Every 4 weeks blood (complete blood count (CBC), lipid panel, vitamin D, beta-hydroxybutyrate, electrolytes), urinalysis (calcium, creatinine), vitals, height, weight, quality of life [Parkinson's Disease Questionnaire-39 (PDQ-39)] and functional movement assessments [Unified Parkinson's Disease Rating Scale (UPDRS), Freezing of Gait, mini-Balance Evaluation Systems Test (mini-BEST), 360° Turn] were collected. RESULTS: All subjects completed the study and 75% recorded at least three-quarters of their daily food diary entries. Average macronutrient levels (70% fat, 18% protein, 5% net carbohydrate) and beta-hydroxybutyrate levels ( < 0.005) confirmed nutritional ketosis was maintained. Clinical improvements were found in total UPDRS, UPDRS Part III, miniBEST, Freezing of Gait, and quality of life. All participants lost weight; 58% reported no change in constipation and 8% reported improvement. CONCLUSION: This exploratory study deemed the modified ketogenic diet feasible and acceptable. Findings suggest a low dairy KD may provide similar benefits to a traditional KD for those with PD, while reducing potential risks associated with consuming higher amounts of animal dairy products.

摘要

目的:帕金森病(PD)患者已被证明能从生酮饮食(KD)中获益。然而,有证据表明传统生酮饮食中大量摄入乳制品可能会加重帕金森病症状。这项由患者发起的研究评估了一种新型的限制乳制品的生酮饮食在帕金森病患者中的可行性和可接受性。同时还评估了生活质量和功能运动情况。 方法:12名帕金森病患者遵循改良的、低乳制品的生酮饮食12周。我们提供支持和营养教育以帮助患者坚持。受试者记录每日饮食日记,据此计算总宏量营养素摄入量。每4周采集血液样本(全血细胞计数(CBC)、血脂、维生素D、β-羟基丁酸、电解质)、尿液分析(钙、肌酐)、生命体征、身高、体重、生活质量[帕金森病问卷-39(PDQ-39)]以及功能运动评估[统一帕金森病评定量表(UPDRS)、步态冻结、简易平衡评估系统测试(mini-BEST)、360°转身]。 结果:所有受试者均完成研究,75%的受试者记录了至少四分之三的每日饮食日记条目。平均宏量营养素水平(70%脂肪、18%蛋白质,、5%净碳水化合物)和β-羟基丁酸水平(<0.005)证实维持了营养性酮症。在总UPDRS、UPDRS第三部分、miniBEST、步态冻结和生活质量方面发现了临床改善。所有参与者体重均减轻;58%的参与者报告便秘无变化,8%的参与者报告便秘改善。 结论:这项探索性研究认为改良生酮饮食是可行且可接受的。研究结果表明低乳制品生酮饮食可能为帕金森病患者带来与传统生酮饮食类似的益处,同时降低因大量食用动物乳制品而带来的潜在风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/3436c8827dee/fnut-12-1601446-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/cc8890ac9891/fnut-12-1601446-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/16c162573046/fnut-12-1601446-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/3436c8827dee/fnut-12-1601446-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/cc8890ac9891/fnut-12-1601446-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/16c162573046/fnut-12-1601446-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfe/12325006/3436c8827dee/fnut-12-1601446-g003.jpg

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本文引用的文献

[1]
Associations of milk, dairy products, calcium and vitamin D intake with risk of developing Parkinson´s disease within the EPIC4ND cohort.

Eur J Epidemiol. 2024-11

[2]
Emerging role of microglia in inter-cellular transmission of α-synuclein in Parkinson's disease.

Front Aging Neurosci. 2024-10-9

[3]
Consumption of milk and other dairy products and incidence of Parkinson's disease: a prospective cohort study in French women.

Eur J Epidemiol. 2024-9

[4]
Impact of a keto diet on symptoms of Parkinson's disease, biomarkers, depression, anxiety and quality of life: a longitudinal study.

Neurodegener Dis Manag. 2024

[5]
Trial of Lixisenatide in Early Parkinson's Disease.

N Engl J Med. 2024-4-4

[6]
A randomized feasibility trial of medium chain triglyceride-supplemented ketogenic diet in people with Parkinson's disease.

BMC Neurol. 2024-4-1

[7]
Inflammation and oxidative stress in epileptic children: from molecular mechanisms to clinical application of ketogenic diet.

Rev Neurosci. 2024-6-25

[8]
Differential peripheral immune signatures elicited by vegan versus ketogenic diets in humans.

Nat Med. 2024-2

[9]
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Lancet. 2024-1-20

[10]
Study on the Correlation between Blood Urea Nitrogen, Creatinine Level, Proteinuria and Parkinson's Disease.

Neurol India. 2023

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