Nerve injury and repair in a ketogenic milieu: A systematic review of traumatic injuries to the spinal cord and peripheral nervous tissue

PLoS ONE, 2021 · DOI: https://doi.org/10.1371/journal.pone.0244244 · Published: January 4, 2021

Neurology Nutrition & Dietetics Regenerative Medicine & Stem Cells

Simple Explanation

The study investigates if special diets like intermittent fasting or the ketogenic diet can help nerves heal after an injury. These diets have shown promise in protecting the brain, but their impact on nerve repair after surgery isn't well-understood. The review found that these diets might indeed promote nerve protection and help them regenerate, but the research isn't consistent enough to draw firm conclusions. More studies are needed to confirm these benefits. The ketogenic diet involves eating meals high in fat and very low in carbs, mimicking a fasting state. Intermittent fasting involves alternating between periods of eating and not eating. Both approaches may trigger responses in the body that enhance repair at a cellular level.

Study Duration

Not specified

Participants

Animal models (rats and mice)

Evidence Level

Systematic Review

Key Findings

1
Intermittent fasting and the ketogenic diet may promote neuroprotection and facilitate the regeneration and repair of nerve fibers following injury.
2
Lack of consistency between the studies in terms of animal models, diet compositions, and timing of dietary interventions preclude synthesis of their outcomes as a whole.
3
Ketogenic diet supplemented with exogenous ketones improved forelimb motor recovery as measured by performance on the Montoya staircase test at 6 weeks post-injury.

Research Summary

This systematic review analyzes the effects of ketogenic diets (KD) and intermittent fasting on nerve regeneration and repair following traumatic injuries to the spinal cord and peripheral nerves. The review included 11 studies published between 1950 and 2020 that met the inclusion criteria, with seven articles examining the ketogenic diet and four examining intermittent fasting. The authors conclude that while these dietary interventions may promote neuroprotection and facilitate nerve regeneration and repair, inconsistencies in study design limit overall conclusions.

Practical Implications

Surgical adjunct

Ketogenic diet and related diets may be attractive adjuncts in peripheral nerve surgery and optimizing outcomes.

Prophylactic benefits

The preconditioning effect of intermittent fasting may be rendered preoperatively, in efforts to optimize outcomes in delayed or elective nerve reconstructions and transfers.

Clinical translation

Given the non-invasiveness of these dietary interventions and the encouraging results witnessed in patients with acute cerebral or spinal cord disease, a logical extension would be to apply them in the context of surgical management of peripheral nerve injuries and reconstructions.

Study Limitations

1
Paucity of rigorous clinical data.
2
Lack of consistency between studies in terms of animal model, precise formulation of the diets, and timing of dietary interventions.
3
Possibility that all articles related to this topic were not included in our analysis as only one database was utilized for this investigation.

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