Ceren Yarar-Fisher, PT, PhD, Assistant Professor Department of Physical Medicine and Rehabilitation UAB School of MedicineCeren Yarar-Fisher, PT, PhD, Assistant Professor in the Department of Physical Medicine and Rehabilitation at UAB, is one of four current CCTS KL2 Awardees. Yarar-Fisher learned about the program via the CCTS’ Training Academy, specifically Director Ryan Outman. She had been considering an award application, she said, and this one caught her eye.
“The application was very easy to follow, and Ryan was very helpful,” she says. “It was well explained in the materials provided, and fairly straightforward.”
Yarar-Fisher is a physical therapist—in training who completed her PhD and postdoctoral work on spinal cord injury and secondary health complications. Her career goal, she says, is to use nutrition and early rehabilitation interventions to improve neuro-recovery and metabolic health in people with spinal cord injury. Her CCTS KL2 grant is aimed at acute care in the form of a nutritional intervention to improve neuro-recovery in spinal cord injured patients. The title of her project is, “Utilizing a ketogenic diet to improve neuro-recovery following spinal cord injury.”
“To date, no pharmacologic therapy has demonstrated significant improvement effects in the neurological or functional recovery in spinal cord injury patients”, Yarar-Fisher says. “Changing a diet to a more neuro-protective one during acute care of SCI can be implemented anywhere in the world at low cost and without major regulatory hurdles. Proposed nutrition intervention in animal models has shown promise. This would be groundbreaking if it worked in humans because it’s very easy to do in clinics.”
The idea is to feed patients high-fat, or “ketogenic” diets (KD), the KD is a high-fat, low carbohydrate diet designed to mimic the metabolic and biochemical changes seen during calorie restriction. Ketone bodies have been shown to exert their neuro-protective effects via preventing oxidative damage; attenuating neuroinflammation and glutamate excitotoxicity; and inhibiting apoptosis in the brain and spinal cord. The diets have been used in children with epilepsy who are resistant to prescription treatments for years, Yarar-Fisher says.
“No one has thought about using these diets in spinal cord injuries,” she says. “Our goal in this study will not be to change how these patients are are already being treated, but to add this diet to support those approaches.”
Yarar-Fisher is working with a big research team including trauma surgeons, physical medicine and rehabilitation physicians, scientists, and dieticians. Betty Darnell, Director of the CCTS’ Bionutrition Unit, will design and implement the diets. “UAB Bionutrition Unit will provide all of the food for the study and transfer it to the hospital. The patients will be on the diet for eight weeks,” Yarar-Fisher explains.
This KL2 grant will assist Yarar-Fisher with her salary support over its duration, as well as provide what she calls “stellar” training that includes a sabbatical at Duke University’s Department of Nutrition Sciences. In addition she will work with UAB’s Dr. Barbara Gower to study metabolism, Dr. Amie McLain to study neuro-recovery and with the CCTS’ Dr. Robert Oster for biostatistics training.