Various studies have concluded that in multiple sclerosis (MS) metabolic changes related to energy alterations are generated at the mitochondrial level. These changes produce loss of muscle mass and lead to high levels of oxidative stress related to low levels of the enzyme Paraoxonase 1 (PON1). The ketone bodies, mainly beta-hydroxybutyrate (BHB), restore this energetic alteration by improving muscular activity.

This pilot study was conducted over 4 months with 51 patients diagnosed with MS, randomly divided into: an intervention group that received an isocaloric diet of a Mediterranean origin supplemented with 60 ml of coconut oil; and a control group that received the same base diet but without coconut oil. Before and after treatment, anthropometric measurements and blood samples were taken, measuring serum PON1 and BHB concentrations, to determine the role of PON1 in muscle improvement after increased blood BHB in MS patients.

A significant increase in PON1 was obtained, associated with an increase in lean mass and an increase in BHB, so it was concluded that this enzyme appeared to be a good marker of decreased oxidation status in MS patients showing muscle improvement after increased BHB in blood.