In this solo presentation, Dr. David Perlmutter introduces the concept of using a ketogenic diet—high‑fat, low‑carbohydrate—to treat neurological disorders, focusing on Parkinson’s disease. He highlights the scarcity of clinical trials but points to a 2005 feasibility study published in Neurology that placed five Parkinson’s patients on a very ketogenic diet, monitored adherence and serum ketone levels, and evaluated outcomes with the Unified Parkinson’s Disease Rating Scale (UPDRS). The video walks through the study’s results, showing dramatic reductions in UPDRS scores for activities of daily living, motor function, and total scores after the dietary intervention, suggesting functional improvements that surpass many current pharmaceuticals. Perlmutter explains the underlying rationale: Parkinson’s brains have impaired glucose‑based energy metabolism, and ketone bodies can bypass this defect. He concludes with a call for more research into ketogenic interventions for neurological diseases, while emphasizing the need to integrate basic science and animal data into clinical recommendations.
Chapters
Hi folks, Dr. David Perlmutter here. Welcome to The Empowering Neurologist. You know, clearly we've had a lot of discussions, a lot of guests here on the program talking about the ketogenic diet. In other words, powering the body with fat as opposed to carbohydrates, and we have certainly covered the brain benefits of being in ketosis as well. And a lot of people have asked, where are there— are there any clinical studies that actually show improvement in a particular neurological problem when people are placed on ketogenic diet. As a matter of fact, those studies are few and far between. But there was one study done many years ago that actually instituted a very ketogenic diet in 5 patients who were suffering from Parkinson's disease and noted some very significant changes. Let's just jump right to the studies. So let's take a look at the study. The study is entitled Treatment of Parkinson Disease with Diet-Induced Hyperketonemia Feasibility Study. And right off the bat, the notion of treating Parkinson's disease with any diet is certainly exciting, in this case by increasing ketones. A study published way back in 2005 in the highly respected journal Neurology— that's the Journal of the American Academy of Neurology. We know that there is a defect in the way brain cells make energy in Parkinson's, and ketones are able to bypass that defect. Just 5 patients— a dietitian determined whether they were adherent to the diet or not and also evaluated their serum ketone levels. They went— underwent what's called the UPDRS study. That is the Unified Parkinson's Disease Rating Scale that looks at mentation and mood, ADLs, activities of daily living, motor function, and treatment complications, and comes up with a total. And when we look at the activities of daily living, you know, self-care, etc., in yellow is before the dietary intervention and in blue is after. These are the 5 patients. A dramatic improvement. brought on by the ketogenic diet. Let's look at motor function before and after going into ketosis. And again, really across the board, some pretty dramatic improvements. Lower scores on the UPDRS means improvement. And let's look at the total UPDRS across the board, dramatic changes when you look at the percentage decrease in the The UPDRS demonstrating better functionality, pretty profound findings in terms of what this ketogenic diet was able to do, really better than across the board than anything pharmaceutical that's available right now. Well, this was an interesting report, isn't it? Showing dramatic improvement in the various parameters of the Unified Parkinson's Disease Rating Scale. By simply going on a ketogenic diet. And again, this was a long, long time ago when the study was published. I really am hopeful that more researchers will want to try using a ketogenic diet in neurological problems. We understand why ketones are so beneficial for the brain and hope to see more of this research. In the meanwhile, I think we have to continue to understand What the basic science and the animal research is telling us and try to leverage that information in terms of recommendations for all of us. So, interesting information. Thanks for joining us. I'm Dr. David Perlmutter.
