Ketosis and Brain Function -
Ketogenic diets have been most studied in the context of pediatric epilepsy syndromes Kossoff et al. The ketogenic diet offers the advantage of improved seizure control for some children, and in some cases, improved mental alertness with fewer medications.
Through intermittent fasting, the body goes into a state of ketosis: a metabolic state where the body resorts to burning fat in the absence of carbohydrates.
A few things happen in the body and brain during ketosis:. Overall, a ketogenic diet can lead to increased energy and improved cognitive function thanks to the anti-inflammatory and neuroprotective qualities of ketosis.
Read more: Insulin and the Brain: How Food Can Reduce Your Risk of Cognitive Decline. Combining intermittent fasting with a ketogenic diet should always be approached with the guidance of a healthcare team.
Applied together, they encourage the state of ketosis—and there are flexible ways to introduce the two strategies together! How long should I fast and when should I eat? Some people choose to cycle between a hour fast, an 8-hour eating pattern. But others ease in by choosing a hour fast cycle, which may feel like a more natural habit fasting from 7 pm to 7 am for example.
During a ketogenic diet, a person can still be having three meals a day breakfast, lunch, dinner plus snacks. What should I eat? Treatment with lamotrigine mg was initiated, and these symptoms decreased in frequency to 6—10 episodes per week.
This resulted in another pound weight loss with a BMI of She required adult day care when her ability to navigate obstacles was compromised. For example, when attempting to hand her mother an item when positioned on the opposite side of a table, Mary failed to navigate around the table without specific instructions.
She began to require around-the-clock care when her reasoning skills diminished further, as evidenced by eating raw meat and other spoiled foods out of the trash. Table 1. ADCS—Activities of Daily Living Inventory and resources needed to care for Mary. The resources required to care for Mary at this time included the following: adult day care, complete bathing assistance, complete toileting assistance, adult incontinence undergarments, locked cupboards, locked refrigerator, locked garbage bins, door alarms preventing unnoticed entries or exits, nanny cams to monitor sleep, a memory-care team including geriatrician, social worker, and caregiver support group.
Alprazolam was needed several times per week to help with anxiety. She had already noted that the restriction of carbohydrates to 75 g was insufficient for Mary to enter ketosis, with serum measurements reading less than or equal to 0.
Several remarkable improvements occurred over the following 6 weeks. Within two weeks, she was fully continent and no longer experienced dissociative episodes or displayed any further evidence of seizure activity. She awoke unprompted, stopped napping, enjoyed more energy, and her mood improved.
I understand. By the end of the fourth week, Mary regained interest in leaving the house, attending social events, and no longer required adult day care. Her obsessive-compulsive symptoms also resolved, and she resumed a varied wardrobe again.
She was able to walk the dog unaccompanied and free of anxiety. Thus, the diagnosis of presumed AD was removed from her chart.
This case represents a dramatic improvement in symptoms of cognitive impairment in a woman with Down syndrome after starting a ketogenic diet. Her ADCS-ADL decreased from her baseline of 57 to severe impairment of 34 in her fifth decade of life.
Only when her diet resulted in a persistent state of ketosis did she experience improvement in cognition and her activities of daily living.
Comparing euploid AD to Down syndrome brains, both show the same neuropathology and expected attrition in memory and overall function. Synaptic losses correlate with glucose hypometabolism and cognitive impairment in AD patients Weight loss tops the list of modifiable risk factors for dementia Her weight loss occurred over 6 years and coincided with the progressive symptoms of dementia.
Additionally, ketone bodies have direct cell-signaling properties, acting on cell-surface G-protein couple receptors through signal transduction pathways, modifying epigenetics by acting as histone deacetylase inhibitors, and serving as substrate for direct post-translational modifications of intracellular proteins and enzymes 23 , Multiple clinical visits thoroughly charted her baseline cognition, behavior, and mood, along with their decline and rise.
It is well-established that the ketogenic diet can be an effective treatment for seizures. Nonetheless, AD is often associated with the development of new-onset seizures, so these two diagnoses may not be distinct and inseparable.
It took some time for me to decide to go all the way to 20 total carbs or less with her because she loves food so much. I wondered if she would adjust to such a diet.
Adding the ketone fingerstick tester was huge in helping us to know if we were achieving nutritional ketosis. Mary has adjusted to the new way of eating quite well.
She loves the food we eat and so does our family. It takes supervision and the support of the family but it is very sustainable for us. We plan to eat this way for the rest of our lives.
Ethical review and approval were not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent was obtained from the individual s for the publication of any potentially identifiable images or data included in this article.
AB conducted participant interviews, reviewed the medical records, gathered, synthesized, and analyzed the data, and wrote and edited the manuscript. VL wrote the abstract, helped to organized the manuscript, and contributed to the discussion section.
CP helped to organized and edit the manuscript. BS designed the graphics and tables. All authors contributed to the article and approved the submitted version. We are grateful to Mary and her family for their cooperation with the preparation of this case report and their willingness to share their incredible story.
AB receives royalties for the books Anyway You Can, ketoCONTINUUM , and ketoCONTINUUM Workbook , and the sales of products from BozMD. CP declares receiving royalties for a book, Brain Energy. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Ballard C, Mobley W, Hardy J, Williams G, Corbett A. Lancet Neurol. doi: CrossRef Full Text Google Scholar.
Hartley D, Blumenthal T, Carrillo M, DiPaolo G, Esralew L, Gardiner K, et al. Alzheimers Dement. However, other diets and lifestyle changes can help with many of these issues as well, so is the ketogenic diet anything special? Yes, but not when we look at the diet from a macronutrient and micronutrient perspective.
The power that the ketogenic diet has to improve health lies in what it makes the body do — burn ketones. First, we burn through our glycogen stores.
Once glycogen is depleted, the body starts breaking down muscle to convert into sugar via a process called gluconeogenesis. According to Dr. Chris Masterjohn, we would need to lose up to 2. Luckily, the body has a backup plan called ketogenesis. To prevent excess muscle loss, the body starts burning more fat for fuel and converting some of the fatty acids from that fat into ketones via a process called ketogenesis.
But why should our bodies even bother turning fat into ketones? The main reason why the body has an alternative for fat is because the fats we burn for fuel in cells throughout the body cannot be used by the brain cells. Because of this, the liver developed the ability to convert fatty acids into an alternative energy source for the brain called ketones.
Altogether, ketogenesis the process of burning ketones for fuel cuts down the amount of lean mass lost during fasting by 5-fold. In other words, rather than breaking down grams of muscle per day, using ketones for fuel reduces our need to burn muscle for fuel to 40 grams of muscle per day.
This allows us to survive for more extended periods of time without food than we would be able to without the help of ketones. The same holds true for those who are on the ketogenic diet, but to a lesser degree because moderate protein consumption helps prevent muscle loss.
To say it more succinctly, the unique benefits of keto are all in your head. Ketones are burned using different pathways and enzymes than sugar, causing a cascade of effects that improve brain health. Whether you want to boost brain function, prevent neurodegenerative disease, or reduce the severity of a brain-related issue, the ketogenic diet one of the best ways to do it.
As an added bonus, you will be eating highly-satiating, healthy foods that will help you eat fewer calories, improve health, and lose fat rapidly.
This is what makes the ketogenic diet a win-win for many people, especially those with neurological conditions. Of the diseases and disorders that are most perplexing, neurological-based conditions tend to be the most difficult to treat. The interplay between neurons, astrocytes, neurotransmitters, genetics, and environmental factors is enough to make your head spin perhaps because of having too much glutamatergic tone.
However, by studying the effects that ketones have on the brain, scientists have been able to understand many neurological conditions on a deeper level, allowing us to open the door to better treatments — and it all started with epilepsy.
Many clinical studies have found that the ketogenic diet helps reduce the quantity and severity of seizures. Animal model evidence suggests that this is due to the effects that using ketones for fuel have on the brain.
For more on how the ketogenic diet helps those with epilepsy, follow this link. Some animal model evidence even suggests that the disease can be reversed with the ketogenic diet.
For example, studies have found that the ketogenic diet can vastly improve milder cases of autism, while case studies indicate that it may even help patients with more severe cases of autism.
To dig deeper into the research on the ketogenic diet and autism, click here.
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