{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:01:51Z","timestamp":1791594111683,"version":"4.3.4"},"reference-count":39,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Aims: We aimed to evaluate the efficacy of three different ketogenic diets on migraine and fatigue in chronic and high-frequency episodic migraineurs. Methods: 76 patients with migraine were treated with the KD for at least three months. Three different KD protocols were used (2:1 KD, LGID, and VLCKD). We evaluated the fatigue severity scale (FSS), migraine frequency, migraine intensity, MIDAS, and HIT-6 at the baseline and 3-month follow-up, and we compared the results. We also correlated the mean FSS reduction with the mean migraine frequency, migraine intensity, BMI, fat mass, free-fat mass, MIDAS, and HIT-6 reduction. Results: FSS improved from 4.977 \u00b1 1.779 to 3.911 \u00b1 1.779 at the 3-month follow-up (p &lt; 0.001). This improvement was significant in both high-frequency and chronic migraineurs. Moreover, the three KD protocols effectively improved migraine intensity, frequency, MIDAS, and HIT-6. There was a mild correlation between mean FSS reduction (p &lt; 0.001), mean MIDAS (p = 0.001), and HIT-6 (p = 0.002) reduction. Conclusions: The VLCKD, LGID, and 2:1 KD may improve migraine intensity, frequency, and fatigue in chronic and high-frequency episodic migraineurs.<\/jats:p>","DOI":"10.3390\/nu15204334","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T08:18:57Z","timestamp":1697012337000},"page":"4334","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Effect of Three Different Ketogenic Diet Protocols on Migraine and Fatigue in Chronic and High-Frequency Episodic Migraine: A Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4200-761X","authenticated-orcid":false,"given":"Yan","family":"Tereshko","sequence":"first","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2062-2547","authenticated-orcid":false,"given":"Simone","family":"Dal Bello","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0845-5694","authenticated-orcid":false,"given":"Cherubino","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Pittino","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Filippi","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Belgrado","sequence":"additional","affiliation":[{"name":"Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lettieri","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-9529","authenticated-orcid":false,"given":"Giovanni","family":"Merlino","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Luigi","family":"Gigli","sequence":"additional","affiliation":[{"name":"Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Valente","sequence":"additional","affiliation":[{"name":"Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100 Udine, Italy"},{"name":"Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S0140-6736(04)15440-8","article-title":"Migraine","volume":"363","author":"Silberstein","year":"2004","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.bbacli.2014.04.001","article-title":"Association of Mitochondrial Dysfunction and Fatigue: A Review of the Literature","volume":"1","author":"Filler","year":"2014","journal-title":"BBA Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/S0140-6736(04)15794-2","article-title":"Fatigue in neurological disorders","volume":"363","author":"Chaudhuri","year":"2004","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jocn.2018.01.032","article-title":"Significance of fatigue in patients with migraine","volume":"50","author":"Seo","year":"2018","journal-title":"J. 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