Alzheimer’s and dementia are age-related neurodegenerative disorders that are the fifth leading causes of death worldwide. There is currently no known cure for these disorders, but there are treatment options that help slow down and manage symptoms.
The reason no cure exists is that we don’t know what exactly causes Alzheimer’s and dementia. Many theories have emerged over the years, and we do have some understanding of the mechanisms underlying them. This has helped direct research towards feasible treatment options, the latest of which is the ketogenic (keto) diet.
There’s some evidence that this low-carbohydrate and high-fat eating plan can help brains affected by neurodegenerative disorders by supplying the brain with an alternative fuel but also by reducing damage done to neurons. Below is a quick overview of what we currently know about the keto diet in helping manage these disorders.
Alzheimer’s as a Brain Fuel Problem
The term “dementia” refers to a broad category of brain diseases that usually happen in later life and that cause a gradual decline in the ability to think and remember, among other things. Alzheimer’s disease (AD) is the most common type of dementia, accounting for over 50% of all dementia cases. In this article, we’ll be focusing on AD since it is the most prevalent type of dementia.
One of the hallmarks of AD is the formation of protein plaques (amyloid plaques) and neurofibrillary tangles (NFTs). These changes cause problems in how brain cells communicate and they also cause the brain to shrink.
However, what precedes these brain changes is what’s really interesting. Research has long ago discovered that the brains of people affected by AD don’t use glucose as well as healthy brains. What’s more, inadequate metabolism of glucose was found to precede the onset of AD in most reported cases.
That doesn’t necessarily mean that AD is caused by poor brain glucose metabolism, but rather that poor brain glucose metabolism contributes to disease development. For this reason, researchers set out to see if improving brain fuel supply can help manage the disease and its symptoms.
One thing that could potentially improve brain fuel supply is ketones. Ketones are water-soluble molecules that replace glucose as an energy source. The body makes a small number of ketones naturally after an overnight fast and more during starvation, certain illnesses. One way to induce ketosis in order to get the therapeutic benefits of ketones is with the help of the keto diet.
How Keto Helps AD and Dementia
The keto diet was originally designed as an epilepsy treatment back in the 1920s because studies found that ketosis reduces seizure frequency. Ketosis is the metabolic state in which much of the body’s energy is supplied by ketones. Ketosis provides a range of health benefits, one of which is helping supply the brain with an alternative fuel.
The ketogenic diet is still being used for intractable epilepsy. However, there has been a lot of curiosity about the therapeutic potentials of this diet for other brain disorders, and researchers have examined the diet’s potential in helping with AD and dementia. One fairly recent study examining the keto diet as a potential AD treatment was carried out by researchers from the University of Kansas and nicknamed the Ketogenic Diet Retention and Feasibility Trial (KDRAFT).
The study involved 15 participants with mild to moderate Alzheimer’s, 10 of which completed the study. The participants were put on a keto diet for 4 months and they also took MCT supplements daily. At the end of this trial, test results examining cognitive functioning improved in 9 out of 10 participants. On average, the test scores improved better than with any available Alzheimer’s medication.
These results have confirmed earlier hypotheses that ketones could replace glucose for the aging brain as well as findings from studies confirming that Alzheimer’s brains can utilize ketones for energy.
Researchers suggest that much of the benefits of ketones comes from the fact that they increase mitochondrial efficiency in AD brains but also because they reduce inflammation and oxidative stress, which can also contribute to AD progression.
The Role of MCTs in AD Management
One reason the keto diet may not be a feasible AD treatment is that it is difficult to stick to. The diet involves restricting carbohydrates typically to fewer than 50g per day and increasing fat intake to make up 65% of a person’s daily calories. This is a radical shift from how most people normally eat and making patients with dementia switch to this diet can be challenging, to say the least.
For the above reasons, a lot of ketosis for AD research has focused on using MCT supplements in conjunction with the keto diet to increase ketone levels in people with neurodegenerative disorders. MCT supplements are concentrated sources of medium-chain triglycerides, types of fat proven to be more ketogenic than other any other fat. Studies have confirmed that they are able to induce ketosis at lower doses than other fats, which allows for a smaller fat to carbohydrate ratio.
A study that was published recently in the Journal of Alzheimer’s Disease set out to test whether brain uptake of ketones from MCTs would be the same as in healthy adults. The study involved AD patients who took 30g of MCTs daily for one month. The study found that brain ketone consumption doubled on at the same rate as it would in healthy young adults. Besides that, the ketones themselves increased brain energy metabolism.
Many previous studies have also confirmed that higher ketone levels in the blood of patients with Alzheimer’s correlated with higher scores on memory tests. However, more research is needed to confirm if MCTs and the ketones the help produce can help slow down the progression of this disease, which is considered incurable up until this day.
The ketogenic diet has been used successfully in the management of neurological conditions. For this reason, the diet was widely studied as a possible therapy for other brain disorders, including Alzheimer’s and other dementias. Research examining keto diets as Alzheimer’s cure is fairly new, but the results do seem promising. Keto diets that include MCT oil are considered as a more sustainable option for AD patients because they yield more ketones with less fat. However, more research is needed before we can know if and how keto diets can help these progressive brain diseases.