For a study, the researchers sought to determine the safety and tolerability of a ketogenic diet (KD) in relapsing MS patients and the influence on patient-reported, laboratory, and clinical outcome measures. Investigators included 65 people with relapse MS in a 6-month prospective KD study. Daily urine ketone testing was used to track adherence to the regimen. In addition to fasting adipokines and relevant MS-related clinical outcome metrics, patient-reported fatigue, depression, and quality of life scores were gathered at baseline. Metrics from the baseline trial were repeated after 3 and 6 months on KD. The KD was followed by 83% of the participants for the duration of the research. From baseline to 6 months on a diet, subjects had lower fat mass (41.3±16.1 vs 32.0±14.1 kg, p<0.001) and lower fatigue and depression levels. Diet improved MS quality of life physical (67±16 vs 79±12, p<0.001) and mental (71±17 vs 82±11, p<0.001) composite scores. EDSS scores improved (2.3±0.9 vs 1.9±1.1, p<0.001), as did the 6-minute walk (1631±302 vs 1733±330 feet, p<0.001), and the 9-hole peg test (21.5±3.6 vs 20.3±3.7 seconds, p<0.001). At 6 months on KD, fasting serum leptin was lower (25.5±15.7 vs 14.0±11.7 ng/mL, p<0.001), whereas adiponectin was greater (11.4±7.8 vs 13.5±8.4 mcg/mL, p=0.002). Throughout 6-month research, KDs were safe and tolerated, with improvements in body composition, fatigue, depression, quality of life, and neurologic impairment in people with relapsing MS. KDs cause an increase in anti-inflammatory adipokines and a decrease in pro-inflammatory adipokines.