The keto diet and ALS
Last updated May 21, 2025, by Agata Boxe
Fact-checked by Inês Martins, PhD
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that damages motor neurons and leads to gradual loss of muscle control.
Scientists are currently exploring whether following the keto diet, which is high in fat and low in carbs, can help to alleviate ALS symptoms and slow disease progression.
So far, there hasn’t been enough evidence to definitively prove that the diet can be beneficial to people with ALS, so you shouldn’t try it without medical supervision.
For most people with the disease, the best choice remains a balanced diet with adequate levels of all essential nutrients, including carbs, unless recommended otherwise by a healthcare provider.
What is the keto diet?
The ketogenic diet is high in fat, low in carbohydrates, and includes a moderate amount of protein.
Its goal is to shift your body into a state of ketosis. Ketosis occurs when fat is broken down into fatty acids (which include polyunsaturated fatty acids such as omega-3), which are then used to produce ketone bodies, or ketones, through a pathway known as ketogenesis. Ketones can be used as fuel instead of the glucose you’d typically get from carbs.
To reach and stay in ketosis, most people need to eat fewer than 50 grams of carbs per day. Foods commonly included in a ketogenic diet are:
- meat
- fatty fish
- avocados
- eggs
- full-fat dairy
- nuts and seeds
- non-starchy veggies
- olive oil.
Potential benefits of keto with ALS
Research in humans on keto and neurodegenerative diseases, such as ALS, is very limited. However, some scientists think the ketogenic diet may potentially be helpful for ALS for at least four reasons.
1. It may improve energy production in the brain
ALS can make it harder for the brain to get the energy it needs. The keto diet changes the body’s fuel source from sugar (glucose) to fat (ketones). This switch might improve brain metabolism and help the brain work more efficiently.
 2. It may protect brain cells from damage
People with ALS often have too much of a brain signaling chemical called glutamate, which can cause brain cells to fire too much and lead to nerve cell damage or death. The keto diet might help lower glutamate levels and protect brain cells.
3. It may reduce inflammation
Inflammation in the brain and the spinal cord is thought to promote disease progression with ALS. Scientists believe that the ketogenic diet may reduce inflammation, as demonstrated through research in animal models.
4. It may fight oxidative stress
Oxidative stress happens when there’s an excess of harmful molecules called free radicals, which cause damage to cells. It’s thought to play a role in ALS, and the keto diet may help to counteract this.
Although these possible benefits sound promising, they haven’t been proven in people with ALS. While there is one small report of a man with ALS who followed the keto diet and saw improvements on the Revised ALS Functional Rating Scale, indicating better function and quality of life, a single case isn’t enough to know for sure if the diet really helps.
Ultimately, much more research is needed to understand the potential benefits of keto for neuroprotection in ALS.
Possible risks and challenges
There is very little data on how safe a high-fat and low-carb diet is for ALS, but studies of people with other chronic diseases suggest that some risks may be involved.
One of them is weight loss, which could be particularly problematic for people with ALS, for whom this is already a common issue and linked with faster disease progression. It is one of the many reasons why you shouldn’t try keto or any other low-carb diet with ALS on your own, without consulting your doctor.
Other common issues with keto include:
- bad breath
- dehydration
- diarrhea
- flu-like symptoms
- inflammation of the pancreas
- issues with electrolytes
- kidney stones
- lower bone density
- nausea
- stomach pain.
Serious side effects, such as kidney stones, from the keto diet are rare, but they can still occur. Contact your doctor if you have any symptoms that last longer than a few days or weeks.
Should you try keto with ALS?
The keto diet is not something you should try on your own if you have ALS. There isn’t enough scientific evidence yet to recommend it as a standard diet for people with the disease. You should only follow it if your doctor specifically recommends it.
If your doctor decides it may be helpful for you, they or a registered dietitian can provide tailored keto meal ideas for ALS and help monitor your progress.
Regardless of the type of diet you follow, many people with ALS face challenges with eating due to issues with mobility and swallowing. These tips may help make meals easier and safer:
- Modify food textures as needed by chopping, mashing, or pureeing.
- Limit distractions while eating to focus on chewing and swallowing.
- Use adaptive tools such as easy-grip utensils, plate guards, and specially designed cups.
Current diet recommendations for ALS
With ALS, nutrition plays a key role in supporting overall health. It can help maintain muscle strength and prevent unwanted weight loss.
The most commonly recommended diet plan for ALSÂ includes foods rich in protein, fiber, healthy fats, vitamins, and minerals. Other notable recommendations include:
- drinking plenty of fluids to help prevent dehydration
- making sure you consume enough calories daily to maintain a healthy body weight and body mass index.
Overall, your doctor can determine whether dietary changes can be part of your treatment for ALS. With their guidance and support, you can come up with a diet that best suits your needs, symptoms, and other factors.
ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
