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While ALS is characterized by enormous oxidative stress, the Mediterranean diet has been seen to have high antioxidant power. Therefore, the aim of this study is to determine how the Mediterranean diet can improve mitochondrial activity, establishing the specific nutrients and, in addition, observing the pathogenic mechanisms related to the disease that would achieve this improvement. To this end, a comprehensive review of the literature was performed using PubMed. KBs have been observed to have a neuroprotective effect to improve energy balance, increasing survival and the number of motor neurons. This ketogenesis can be achieved after following a Mediterranean diet which is associated with great benefits in other neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and ALS. These benefits are due to the high antioxidant power especially based on polyphenols contained mainly in olive oil, wine, nuts, or berries. In short, KBs could be considered as a promising option to treat ALS, representing an alternative source to glucose in motor neurons by providing neuroprotection. In addition, treatment results can be improved as ketogenesis can be achieved (increase in KBs) by following a Mediterranean diet, thanks to the high antioxidant properties which, at the same time, would improve the high oxidative stress that characterizes the disease.<\/jats:p>","DOI":"10.1002\/fsn3.1324","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T13:26:27Z","timestamp":1576502787000},"page":"23-35","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Therapeutic alternative of the ketogenic Mediterranean diet to improve mitochondrial activity in Amyotrophic Lateral Sclerosis (ALS): A Comprehensive Review"],"prefix":"10.1002","volume":"8","author":[{"given":"Jordi","family":"Caplliure\u2010Llopis","sequence":"first","affiliation":[{"name":"Doctoral Degree's School Catholic University of Valencia Valencia Spain"},{"name":"University Hospital la Ribera Alzira Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thal\u00eda","family":"Peralta\u2010Chamba","sequence":"additional","affiliation":[{"name":"Department of Nursing Catholic University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Carrera\u2010Juli\u00e1","sequence":"additional","affiliation":[{"name":"Doctoral Degree's School Catholic University of Valencia Valencia Spain"},{"name":"Faculty of Medicine and Odontology Catholic. 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