The Genesis Protocol · Research

Research on ketogenic diet, fasting, autophagy and exercise in Parkinson's

We are confident in what we coach — and we want you to see the evidence for yourself. Below are the published studies that inform the Genesis Protocol, summarised in plain language, with links to the original papers.

A note on how to read this page: most of these are small or early-stage studies. They show promise and plausibility; they do not prove that any diet or lifestyle programme changes the long-term course of Parkinson's. We say “may support”, not “cures”, for good reason.

Ketogenic diet in Parkinson's

Phillips MCL, Murtagh DKJ, Gilbertson LJ, et al. (2018). Low-fat versus ketogenic diet in Parkinson's disease: A pilot randomized controlled trial. Movement Disorders, 33(8), 1306–1314. (Erratum: 34(1), 157.)

The most rigorous diet study in Parkinson's to date. 47 participants were randomized to a low-fat, high-carbohydrate diet or a ketogenic diet for 8 weeks; 44 started the diets and 38 completed the study (86% of those who started). Both groups improved in motor and non-motor scores (MDS-UPDRS). The ketogenic group improved significantly more on non-motor symptoms (MDS-UPDRS Part 1: −4.58 points, a 41% improvement from baseline, versus −0.99 points or 11% on the low-fat diet; P < 0.001), with the biggest differences in urinary problems, pain and other sensations, fatigue, daytime sleepiness and cognitive impairment. There were no between-group differences for motor parts 2–4. The most common side effects were excessive hunger in the low-fat group and intermittent worsening of tremor or rigidity in the ketogenic group. The authors concluded it is plausible and safe to maintain a ketogenic diet for 8 weeks under supervision and called for further study. How we use it: it supports our careful, supervised approach to nutritional ketosis.

https://doi.org/10.1002/mds.27390

VanItallie TB, Nonas C, Di Rocco A, et al. (2005). Treatment of Parkinson disease with diet-induced hyperketonemia: A feasibility study. Neurology, 64(4), 728–730.

An early, small, uncontrolled study. Of the participants who started, five of seven volunteers adhered to a very high-fat ketogenic diet for 28 days; those who did showed improvements in UPDRS scores. Because there was no control group, a placebo effect could not be ruled out. Its main value is showing that ketosis is achievable for some people with Parkinson's — and that adherence is hard, which is exactly why coaching matters.

https://doi.org/10.1212/01.WNL.0000152046.11390.45

Krikorian R, Shidler MD, Summer SS, et al. (2019). Nutritional ketosis for mild cognitive impairment in Parkinson's disease: A controlled pilot trial. Clinical Parkinsonism & Related Disorders, 1, 41–47.

A small randomized pilot (7 per group) in people with Parkinson's and mild cognitive impairment. Over 8 weeks, the low-carbohydrate ketogenic group improved in lexical access and memory compared with a typical high-carbohydrate diet, with lower body weight and higher ketone levels; motor function was not affected. Small sample, short duration — but it fits with the non-motor and cognitive signals seen by Phillips et al.

https://doi.org/10.1016/j.prdoa.2019.07.006

Fasting and metabolic switching

Mattson MP, Moehl K, Ghena N, Schmaedick M, Cheng A. (2018). Intermittent metabolic switching, neuroplasticity and brain health. Nature Reviews Neuroscience, 19(2), 63–80.

A widely cited review describing how switching between glucose and ketone fuel — through fasting and exercise — triggers adaptive responses in the brain, including improved stress resistance, mitochondrial function, neuroplasticity and autophagy. Much of the evidence is from animal research. It is the scientific backbone of our fasting approach.

https://doi.org/10.1038/nrn.2017.156

Autophagy and Parkinson's biology

Lynch-Day MA, Mao K, Wang K, Zhao M, Klionsky DJ. (2012). The role of autophagy in Parkinson's disease. Cold Spring Harbor Perspectives in Medicine, 2(4), a009357.

A review explaining how autophagy — including mitophagy, the clearance of damaged mitochondria — is connected to Parkinson's. It covers the links between autophagy and alpha-synuclein, and genes associated with Parkinson's such as PINK1 and parkin that operate in these pathways. This is mechanistic, largely laboratory science; it explains why we focus on cumulative autophagy, not proof of clinical benefit from any diet.

https://doi.org/10.1101/cshperspect.a009357

Exercise in Parkinson's

Schenkman M, Moore CG, Kohrt WM, et al. (2018). Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: A phase 2 randomized clinical trial. JAMA Neurology, 75(2), 219–226.

The SPARX trial randomized 128 people with early Parkinson's not yet taking dopaminergic medication to high-intensity (80–85% max heart rate, n = 43) or moderate-intensity (60–65%, n = 45) treadmill exercise four days a week, or a wait-list control (n = 40), for 6 months. Mean UPDRS motor score change was 0.3 points in the high-intensity group versus 3.2 in the control group (P = .03); only the high-intensity group met the predefined non-futility threshold, and the investigators judged high-intensity exercise suitable for a larger phase 3 trial. It informs our live movement classes.

https://doi.org/10.1001/jamaneurol.2017.3517

What the research does not yet tell us

There are no large, long-term trials showing that a ketogenic diet, fasting or any lifestyle programme slows the progression of Parkinson's. We are watching this field closely and will update this page as new studies are published. If you see a study you would like us to look at, email [email protected].