Cognitive Effects of a Ketogenic Diet on Neurocognitive Impairment in Adults Aging With HIV: A Pilot Study.
Shannon A Morrison, Pariya L Fazeli, Barbara Gower and 4 others
PMID 31725105WHAT IT FOUND
A 12-week ketogenic diet group with delivered meals, dietitian education, and ketone monitoring had better speed and executive test scores than usual diet in 14 older adults with HIV-related cognitive impairment, but the gains were not seen after six weeks and adherence was unclear.
Key findings
01At week 12, the group assigned to the ketogenic diet protocol performed better on Trails A and Trails B (p = 0.035 and p = 0.039).
02At week 18, no between-group cognitive differences remained, suggesting the week 12 gains were not sustained.
03Only five of 14 completers routinely assessed capillary ketones as instructed, leaving diet adherence uncertain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study targeted 20 participants but only 14 completed, so it was underpowered. Participants and study staff could not be blinded to diet assignment. No alpha corrections were performed for multiple comparisons. Adherence was poorly measured: five of 14 completers routinely assessed ketones, and seven participants returned logs inconsistent with monitor memory. The sample was 62.5% female and 87.5% African American, limiting generalizability. People with diabetes, renal insufficiency, other metabolic disease, or severe cognitive impairment were excluded. The cognitive advantage was limited to Trails A and Trails B and was not present at week 18. Daily function and safety were not established.
Declared interests
The authors report no real or perceived vested interests related to the article.
The easy way to misread this
Do not conclude that a ketogenic diet alone improves cognition in older adults with HIV. The intervention also included delivered meals, dietitian education, and ketone monitoring, the study had only 14 completers and no blinding, and the week 12 cognitive advantage was not present at week 18.