Keto Diet: An Ally in Alzheimer’s Treatment

Brain Imaging Reveals Insights into Alzheimer’s Disease & Ketones

Dr. Palmer mentioned that neuroimaging studies, such as PET scans, have revealed glucose hypometabolism in patients with Alzheimer’s disease.

This finding suggests that cells in the brain are not receiving enough energy from glucose, which could be attributed to impaired insulin signaling or mitochondrial dysfunction. While there is ongoing debate about whether this is a primary driver of the illness, the expert believes it plays a significant role.

Interestingly, research conducted by Stephen Kunain has shown that ketone supplements, such as ketone esters or ketone salts, can correct these brain metabolism deficits in the short term, even in the absence of a ketogenic diet.

This suggests that providing an alternative fuel source for the brain could potentially mitigate the effects of glucose hypometabolism in Alzheimer’s patients.

Huberman shared his personal experience with liquid ketone esters, noting that they have improved his energy levels, mental focus, and sleep quality, even when consuming some carbohydrates each day.

The expert further elaborated on a pilot trial conducted in a nursing home, where simply reducing carbohydrate consumption at breakfast and lunch led to statistically significant cognitive improvements in some subjects, without the need for a strict ketogenic diet.

Relationship Between Ketones, Glucose, and Brain Health

Dr. Palmer explained that while some brain areas may require glucose and cannot solely rely on ketones, the presence of ketones can still play a crucial role in supporting brain health.

When ketones are available, particularly in high levels, they can be utilized by both healthy and metabolically compromised brain cells.

Healthy brain cells with abundant mitochondria are likely to continue using glucose as their primary fuel source, but they may also use ketones when available. However, the real impact of ketones is seen in metabolically compromised tissues, such as specific brain regions affected by conditions like Alzheimer’s disease.

When a brain cell is metabolically compromised, it sends out a distress signal, essentially calling for resources to support its energy needs.

If the cell cannot effectively use glucose, it will readily absorb ketones as an alternative fuel source. This process is critical because it allows the cell to increase its energy production, potentially reaching up to 90% of its preferred energy amount.

Once the metabolically compromised cell receives sufficient fuel, it can begin to repair itself. The human body prioritizes its functions, and when a cell senses defective molecules or proteins, it will start the repair process as soon as it has enough energy to do so.

Ketogenic Diet in Treating Alzheimer’s Disease and Age-Related Cognitive Decline

Dr. Palmer mentioned a small, randomized controlled trial that included 26 subjects who were assigned to either a low-fat diet or a ketogenic diet for 12 weeks, with a 10-week washout period in between.

The trial found that when patients were in ketosis, they experienced statistically significant improvements in activities of daily living and quality of life. Although there was an improvement in cognitive function, it did not reach statistical significance.

Animal models have shown that the ketogenic diet can improve biomarkers of Alzheimer’s disease, such as reducing plaques and tangles and improving cognitive impairment.

A few other small pilot trials in humans have also shown that the ketogenic diet improves biomarkers compared to low-fat or American Heart Association diets.

One of the biggest challenges in conducting larger trials is patient compliance. Johns Hopkins researchers attempted to conduct a study comparing the ketogenic diet to a control diet in Alzheimer’s patients. Despite screening over 1,300 people, only 27 enrolled, and only 14 completed the study. However, the subjects who achieved ketosis did show cognitive improvement.

Dr. Palmer suggests that providing intensive support, education, and even meals to participants could improve compliance.

He also notes that the consequences of going off the diet, such as the return of severe symptoms in his patients with schizophrenia and bipolar disorder, serve as a strong reinforcement for staying on the diet.

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