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Review
. 2019 Dec 16;8(1):23-35.
doi: 10.1002/fsn3.1324. eCollection 2020 Jan.

Therapeutic alternative of the ketogenic Mediterranean diet to improve mitochondrial activity in Amyotrophic Lateral Sclerosis (ALS): A Comprehensive Review

Jordi Caplliure-Llopis  1   2 , Thalía Peralta-Chamba  3 , Sandra Carrera-Juliá  1   4 , María Cuerda-Ballester  3 , Eraci Drehmer-Rieger  5 , María Mar López-Rodriguez  6 , Jose Enrique de la Rubia Ortí  3
Affiliations
Review

Therapeutic alternative of the ketogenic Mediterranean diet to improve mitochondrial activity in Amyotrophic Lateral Sclerosis (ALS): A Comprehensive Review

Jordi Caplliure-Llopis et al. Food Sci Nutr. .

Abstract

Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease which is pathogenically based on the mitochondrial alteration of motor neurons, causing progressive neuron death. While ALS is characterized by enormous oxidative stress, the Mediterranean diet has been seen to have high antioxidant power. Therefore, the aim of this study is to determine how the Mediterranean diet can improve mitochondrial activity, establishing the specific nutrients and, in addition, observing the pathogenic mechanisms related to the disease that would achieve this improvement. To this end, a comprehensive review of the literature was performed using PubMed. KBs have been observed to have a neuroprotective effect to improve energy balance, increasing survival and the number of motor neurons. This ketogenesis can be achieved after following a Mediterranean diet which is associated with great benefits in other neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and ALS. These benefits are due to the high antioxidant power especially based on polyphenols contained mainly in olive oil, wine, nuts, or berries. In short, KBs could be considered as a promising option to treat ALS, representing an alternative source to glucose in motor neurons by providing neuroprotection. In addition, treatment results can be improved as ketogenesis can be achieved (increase in KBs) by following a Mediterranean diet, thanks to the high antioxidant properties which, at the same time, would improve the high oxidative stress that characterizes the disease.

Keywords: amyotrophic lateral sclerosis; ketone bodies; mediterranean diet; mitochondria.

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Conflict of interest statement

The author declares that I do not have any conflict of interest.

Figures

Figure 1
Figure 1
Diagram of the pathogenesis of amyotrophic lateral sclerosis (ALS) observed mainly after the genetic mutation in the SOD1 gene, and which causes the death of the motor neuron by damaging mitochondrial activity
Figure 2
Figure 2
Activity proposal of the Mediterranean ketogenic diet on the different pathogenic mechanisms of amyotrophic lateral sclerosis (ALS)
See this image and copyright information in PMC

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