Ketogenic Diet in Alzheimer’s Disease

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By Claire McDonnell Liu, Nutritionist at Leafie.org

Alzheimer’s disease is a devastating neurodegenerative disorder that’s increasing at an alarming rate.  Alzheimers is thought to be the most common form of dementia, contributing to 65 to 70 per cent of the 55 million dementia cases worldwide

The disease is characterised by memory, behavioural and learning impairment that can affect a person’s ability to carry out everyday tasks.  In advanced stages of the disease, severe loss of brain function can cause complications, such as infections, dehydration, or malnutrition, that can result in death.

There is a growing interest amongst some researchers that Alzheimer’s is a metabolic disease, influenced by lifestyle factors – particularly the modern diet. Given Alzheimers strong association with Insulin Resistance, some researchers are investigating the role ketosis could play in potentially improving symptoms, or even preventing the disease.

Brain Insulin Resistance

Alzheimer’s disease is also known as ‘Type 3 Diabetes’, due to a well-documented association with diabetes and brain insulin resistance.  

A comprehensive scientific evidence review published in 2008 found ‘strong evidence in support of the hypothesis that [Alzheimers] represents a form of diabetes’ (de la Monte et al, 2008).

The hormone insulin regulates how much glucose moves out of the bloodstream to be absorbed and utilised by cells all over the body. 

Autopsy research has shown that Alzheimer’s brains take in less glucose.  In fact, one study found that a staggering 81% of people with Alzheimers had type 2 diabetes or pre-diabetes (Janson et al, 2004).

Over time cells can become resistant to insulin, so that glucose can’t move into cells, despite glucose being available in the body.  Prolonged insulin resistance is a major risk factor for diabetes and Alzheimer’s Disease.  Brain cells in people with brain insulin resistance starve to death.

Diet Risk Factors

Much of the research to date has been centred on genetics. Although, a study found significant differences in rates of dementia and Alzheimer’s disease in two communities with similar genetic backgrounds (Hendrie 1995). Giving traction to the theory that nutrition and lifestyle factors may be significant risk factors, which can be managed to prevent or improve disease risk.

Dr. Paul Mason: ‘Reversing Dementia with Diet’

In his 2021 presentation, Dr Paul Mason recommends cutting down on ultra-processed foods. in order to prevent dementia. He makes clear that a diet high in processed food is implicated as a major cause of Alzheimer’s disease, particularly foods high in sugars and refined seed oils.

Dr. Mason sets out the case for ketosis for Alzheimers patients. Citing studies demonstrating improved brain function “Not only does a Ketogenic Diet improve current brain function, and prevent damage… Low Carbohydrate diets could even reverse existing damage”.

 

Ketone Brain Fuel

The brain can use two types of fuel for energy, glucose and ketone bodies, also known as ketones. Ketones, such as beta-hydroxybutyrate (BHB) and acetoacetate (AcAc), occur with fasting, or from a Ketogenic diet. There is some evidence that ketones represent a more efficient fuel in the brain.

Interest in ketogenic diet therapy in the treatment of Alzheimer’s disease and Parkinson’s disease is growing. Collectively the evidence from the research appears encouraging, raising the possibility that a ketogenic diet could be disease-modifying, rather than only improvising symptoms (Gasier et al, 2006).

A systematic review of randomised controlled trials noted that ketosis has the potential to improve cognition in patients with Alzheimer’s Disease ‘ketogenic therapy appears promising in improving both acute and long-term cognition among patients with [Alzhiemers Disease]’ (Grammatikopoulou 2020).

Interestingly, some studies have noted that high carbohydrate intake worsens cognitive performance and behaviours in patients with Alzheimer’s disease (Henderson, 2004Young et al., 2005).

Eating for Neurological Health

Dr. Georgia Ede is a Psychiatrist specialising in Ketogenic diet nutrition therapy as an alternative to medication management. She explores food’s effects on brain chemistry and neurological health.

Dr. Georgia Ede: Nutritional and Metabolic Strategies for Optimizing Mental Health

Dr. Ede presents at Low Carb Down Under on Nutritional and Metabolic Strategies for Optimizing Mental Health.

She reports in her article that “Preventing Alzheimer’s may be easier than you think.”  Highlighting the strong connection to Insulin Resistance and the potential to manage and improve insulin resistance with diet ( Psychology Today, 2016).

Dr. Ede concludes her article by encouraging individuals to be proactive “You don’t have to be a sitting duck waiting around to see if Alzheimer’s Disease happens to you'”

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