Grant: Project Grant

Spinal cord injury (SCI) remains one of the most devasting conditions a person can experience. Aside from the obvious motor, sensory and bowel&bladder impairments, in the chronic stage of spinal cord injury, diabetes, obesity, inflammation in multiple organs, heart and blood vessel disease and cognitive decline contribute to a greatly reduced quality of life, and even worse, to a greatly reduced life expectancy that can be shortened by up to 2 decades depending on the injury type and age. It is generally accepted for the able-bodied population that the most effective health and lifespan modifying interventions are exercise and nutrition. However, nutritional recommendations for the chronic SCI population are merely extrapolations from the still emerging and often debated guidelines for the general population. Neither the guidelines for acute nor for chronic spinal cord injury are based on evidence, let alone randomized controlled studies. In the recent past we challenged the guidelines for acute SCI and demonstrated in rats that treatment with a Ketogenic Diet (KD) improved the functional outcomes from spinal cord injury, even if initiated after the injury. Ketogenic diets are high in fats, moderate in protein and low in carbohydrates. This diet is now being tested in a clinical trial for acute SCI. In this present project we hypothesize that dietary treatments can improve multiple deleterious aspects of chronic SCI. Of importance is that several of these deleterious aspects of chronic spinal cord injury are also encountered in rodents including the reduced life span. This strengthens the rationale for the present study in which we perform preclinical trials with what is known to be a healthy diet, Mediterranean diet (MedD), whereby the typical unhealthy Western diet serves as one of the controls. We will also compose ketogenic versions of MedD using either a modern (good fats) KD or supplementation of the MedD with ketone esters, creating a "diet in a bottle".