Alzheimer’s disease leads to a significant impairment in the brains ability to utilize glucose/glycogen (stored carbohydrates for energy). Our neurons, especially those in memory centers of the brain, are starving for fuel and begin to deteriorate.
While there is impairment in the ability to utilize glucose, there is NO impairment in the ability to utilize ketones for energy.
What are ketones?
Ketones are produced in the liver from free fatty acids (our own body fat!) in times of fasting/caloric restriction or carbohydrate restriction. This is a survival mechanism- our ancestors were forced to go long periods of time without food, in order to survive the brain found an alternative energy source.
Today, most of us never access this alternative energy source because of our over consumption of carbohydrates. However, more and more research is showing that tapping into this alternative energy source has some incredible health benefits for the body, and particularly the brain. This holds true for both healthy individuals and those with some type of disease or illness.
Ketosis improves “Alzheimer’s disease” in animal models
Scientific research in animal models has shown fascinating results when animals with pathologies of Alzheimer’s disease are fed a ketogenic diet or given ketogenic supplements. The results include but are not limited to:
- Improved memory and cognition
- Decrease of amyloid beta load- the toxic protein that accumulates in AD patient’s brain’s
- Enhanced blood flow to the brain
- Decreased inflammation (AD brains are so inflamed it has been said they look like that of a “brain on fire”).
A 3-month diet comprised of 70% fat improved cognition in Alzheimer’s disease patients better than any anti-amyloid drug that has ever been tested.
Alzheimer’s patients following the University of Kansas’s ketogenic diet improved an average of 4 points on one of the most important cognitive assessments for patients- the Alzheimer’s Disease Assessment Scale-cognitive domain (ADAS-cog). This is a level of improvement that has never been seen before.
Consider that, on average, patients decline about 5 points on this scale per year, so a 4 point improvement is quite significant.
Diet can significantly reduce risk of Dementia
The change in glucose metabolism seen in AD patients actually develops several years before dementia and disease onset. So this has relevance for prevention.
It is now established that modifying diet can help prevent Alzheimer’s disease (AD) and dementia. Processed foods and high sugar consumption increase inflammation along with risk for dementia and Alzheimer’s disease, while adopting a healthy diet can reduce risk. For example, the Mediterranean diet- consisting of about 33% fat, 38% carbohydrates, and 26% protein encompasses whole grains, beans, nuts, fruits, vegetables, salads, fish, and poultry, and reduces risk for AD by up to 53%.
But the ketogenic diet blows this out of the water, showing even greater potential for prevention. It consists of 70% fat, and cuts out whole grains, most beans and fruits because of the high sugar content, and includes butter, cream, eggs, nuts, animal fat and other sources.
What the hell is happening in the brain?
This manipulates the brains energy metabolism; when carbs are limited or absent, circulating insulin decreases and glucagon increases. This promotes lipolysis (the breakdown of our stored fats). Ketones (primarily beta-hydroxybutyrate and acetoacetate) are formed in the liver from the newly released fatty acids, and released into the circulation. They eventually are carried across the blood brain barrier (BBB) by specific transporters, and enter into mitochondria cells of the brain. Our mitochondria are like tiny little power plants- they use these ketones to generate ATP which is then used for energy by our neurons.
Voila, our neurons can then send signals to each other (and facilitate memory).
References http://www.sciencedirect.com/science/article/pii/S2213453016301355  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282589/  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219306/  https://www.ncbi.nlm.nih.gov/pubmed/25686106
University of Kansas study- http://www.mdedge.com/internalmedicinenews/article/145220/alzheimers-cognition/fueling-alzheimers-brain-fat