Ketogenic diet therapy for chronic migraines

Study participants will undergo a 12-week trial of a modified ketogenic diet (MKD) for the prevention of chronic migraine. Participants will undergo a 5-week baseline/screening period, and then under the supervision of an expert dietitian, transition to a MKD for 12 weeks. The diet will contain a ratio of 75% fat, 20% protein and 5% carbohydrates, however calorie quantities will be tailored to each participant. Participants will receive initial counselling and resources (roughly 1 hour duration for initial consultation), and regular review with the study dietitian (roughly 30 minute duration for subsequent visits on monthly basis). Initial consultation will be face-to-face to ensure anthropometrics and baseline blood tests can be collected. Subsequent visits can be face-to-face, telehealth or telephone reviews based on patient preference. Study activities will include daily urinary ketone monitoring, and two-weeks of continuous glucose monitoring (CGM) while on therapy, in addition to standard of care blood safety monitoring. Adherence will be monitored with a food diary and urinary ketones. The continuous glucose monitoring will occur during weeks 1-2 of the study (prior to starting ketogenic diet) and also weeks 17-18 of the study (weeks 11 and 12 of the diet). The study resources provided are used in clinical practice and clinical trials involving the ketogenic diet at our centre. They have been designed by Dr Neha Kaul, Senior Dietitian. The materials have been reviewed and approved by consumers and by the institution’s human research ethics committee.