Randomized crossover trial of a modified ketogenic diet in Alzheimer's disease.

BACKGROUND: Brain energy metabolism is impaired in Alzheimer's disease (AD), which may be mitigated by a ketogenic diet. We conducted a randomized crossover trial to determine whether a 12-week modified ketogenic diet improved cognition, daily function, or quality of life in a hospital clinic of AD patients. METHODS: We randomly assigned patients with clinically confirmed diagnoses of AD to a modified ketogenic diet or usual diet supplemented with low-fat healthy-eating guidelines and enrolled them in a single-phase, assessor-blinded, two-period crossover trial (two 12-week treatment periods, separated by a 10-week washout period). Primary outcomes were mean within-individual changes in the Addenbrookes Cognitive Examination - III (ACE-III) scale, AD Cooperative Study - Activities of Daily Living (ADCS-ADL) inventory, and Quality of Life in AD (QOL-AD) questionnaire over 12 weeks. Secondary outcomes considered changes in cardiovascular risk factors and adverse effects. RESULTS: We randomized 26 patients, of whom 21 (81%) completed the ketogenic diet; only one withdrawal was attributed to the ketogenic diet. While on the ketogenic diet, patients achieved sustained physiological ketosis (12-week mean beta-hydroxybutyrate level: 0.95 ± 0.34 mmol/L). Compared with usual diet, patients on the ketogenic diet increased their mean within-individual ADCS-ADL (+ 3.13 ± 5.01 points, P = 0.0067) and QOL-AD (+ 3.37 ± 6.86 points, P = 0.023) scores; the ACE-III also increased, but not significantly (+ 2.12 ± 8.70 points, P = 0.24). Changes in cardiovascular risk factors were mostly favourable, and adverse effects were mild. CONCLUSIONS: This is the first randomized trial to investigate the impact of a ketogenic diet in patients with uniform diagnoses of AD. High rates of retention, adherence, and safety appear to be achievable in applying a 12-week modified ketogenic diet to AD patients. Compared with a usual diet supplemented with low-fat healthy-eating guidelines, patients on the ketogenic diet improved in daily function and quality of life, two factors of great importance to people living with dementia. TRIAL REGISTRATION: This trial is registered on the Australia New Zealand Clinical Trials Registry, number ACTRN12618001450202 . The trial was registered on August 28, 2018.

Biosorption of Pb(II) from contaminated water onto Moringa oleifera biomass: kinetics and equilibrium studies.

The present study aims at evaluating a batch scale biosorption potential of Moringa oleifera leaves (MOL) for the removal of Pb(II) from aqueous solutions. The MOL biomass was characterized by FTIR, SEM, EDX, and BET. The impact of initial concentrations of Pb (II), adsorbent dosage, pH, contact time, coexisting inorganic ions (Ca2+, Na+, K+, Mg2+, CO32-, HCO3-, Cl-), electrical conductivity (EC) and total dissolved salts (TDS) in water was investigated. The results revealed that maximum biosorption (45.83 mg/g) was achieved with adsorbent dosage 0.15 g/100 mL while highest removal (98.6%) was obtained at adsorbent biomass 1.0 g/100 mL and pH 6. The presence of coexisting inorganic ions in water showed a decline in Pb(II) removal (8.5% and 5%) depending on the concentrations of ions. The removal of Pb(II) by MOL decreased from 97% to 89% after five biosorption/desorption cycles with 0.3 M HCl solution. Freundlich model yielded a better fit for equilibrium data and the pseudo-second-order well described the kinetics of Pb(II) biosorption. FTIR spectra showed that -OH, C-H, -C-O, -C = O, and -O-C functional groups were involved in the biosorption of Pb(II). The change in Gibbs free energy (ΔG = -28.10 kJ/mol) revealed that the biosorption process was favorable and thermodynamically driven. The results suggest MOL as a low cost, environment-friendly alternative biosorbent for the remediation of Pb(II) contaminated water.

Biosorption of lead by cotton shells powder: Characterization and equilibrium modeling study.

Lead (Pb) is a toxic heavy metal causing serious health risks to humans and animals. In the present study, cotton (Gossypium hirsutum L.) shells powder was used as adsorbent for the treatment of synthetic Pb-contaminated water. The batch scale biosorption capacity of cotton shells powder was evaluated to study the effects of Pb concentrations, adsorbent doses and contact time at constant pH (6) and temperature (25 °C). Results revealed that sorption of Pb increased (q = 0.09-9.60 mg/g) with increasing Pb concentration (1-15 mg/L) and contact time (15-90 min) while decreasing adsorbent dose (1-0.1 g/100 mL). The maximum Pb removal (90%) was achieved at Pb concentration (1 mg/L), contact time (90 min) and adsorbent dose (1 g/100 mL). Freundlich isotherm model proved best fit for Pb sorption (R2 = 0.99). The cotton shells powder has microporous structure confirmed by SEM, and has BET surface area (45 m2/g) and pore size (2.3 µm). These surface moieties along with various functional groups (C-H, C-O, C=O, O-H, S=O) confirmed by FTIR analysis might involve in Pb removal by complexation and ion exchange mechanisms. The cotton shells powder biomass could be considered as promising adsorbent for the removal of Pb from contaminated water.