There is growing research about using a ketogenic diet as a treatment for Alzheimer’s disease as well as a possible prevention of Alzheimer’s disease. What does the science say about that? The findings are promising.
Keto as a Therapeutic Treatment
Research shows a higher fat, low-carb ketogenic diet may prevent or even reverse serious medical conditions like heart disease, type 2 diabetes, and cancer. Additionally, the ketogenic diet has successfully treated drug-resistant epilepsy since the 1920s.
Now scientists are learning the metabolic switch to ketosis may treat Alzheimer’s disease symptoms and potentially prevent its development, too.
What Causes Alzheimer’s Disease?
Alzheimer’s disease (AD), a progressive, neurodegenerative disorder characterized by declining memory loss and worsening cognitive impairment, affects nearly six million people. It’s the leading cause of dementia worldwide, and there’s still no standard cure or prevention model.
It’s widely believed that genetic and lifestyle factors contribute to the development of AD later in life. AD is typically diagnosed by an accumulation of tau protein tangles in brain cells (tau proteins are proteins that are abundant in neurons of the central nervous system) and amyloid plaques (undesirable aggregates of proteins that have been linked to the development of various diseases), which form between brain cell. This combination interferes with cell signals, which can lead to memory loss and roadblocks in thinking and communication.
Researchers agree on three major causes for this:
Genetics, specifically the gene APOE4 allele
Carriers of the apolipoprotein allele (APOE) gene variant are at a higher risk for developing AD. This variant is also known to disrupt blood-sugar levels and make insulin resistance worse. It even creates more reactive oxygen species (ROS). All these increase AD risk factors.
Oxidative damage and chronic inflammation
Oxidative stress occurs when ROS, or a group of free radicals, damage cells and cause inflammation throughout your body and brain. Unlike the gas, oxygen, ROS have a single electron, which makes them highly reactive. This extra oxygen harms healthy brain cells and can also trigger cell death, which may lead to the development of neurodegenerative disorders including AD.
Insulin resistance in brain cells
Experts refer to AD as “type 3 diabetes” or “late-stage type 2 diabetes” because insulin resistance contributes to its development. It is estimated that 70 percent of people who develop T2D will develop AD and experience sharp declines in cognitive function at a much greater rate.
What Is Insulin Resistance and What Does It Have to Do with AD?
Blood sugar levels rise when you eat carbohydrates (i.e., sugar). The hormone, insulin, goes to work shuttling glucose into your muscles and liver cells to use or store for later. A diet high in carbohydrates constantly wears out the body’s response to insulin. Eventually, cells ignore (resist) insulin, and glucose remains in the blood, causing high blood-sugar levels. This insulin resistance leads to type 2 diabetes.
Insulin resistance affects all cells, including brain cells. A hallmark of AD is the inability of brain cells to uptake and metabolize glucose. This means brain cells can’t absorb the fuel they need (i.e., glucose), so they starve, shrink, and die. This isn’t even the worst part.
Because your body senses extra sugar in your blood, it produces more insulin to eliminate it. Unfortunately, the enzymes that break down insulin are also the same enzymes that break down the aforementioned amyloids. Now overrun with processing high levels of insulin, amyloid breakdown, or the breakdown of potential disease-causing protein aggregates, takes a backseat. This directly leads to an accumulation of toxic amyloid plaque that blocks and poisons brain cells.
This is one of the main reasons why a low-carb (i.e., low-sugar) ketogenic diet may be a potential solution for AD. Studies show a keto diet triggers better blood sugar and insulin levels, improved verbal memory performance, and greater memory function in older adults with an increased risk for AD.
Three Reasons Keto for Alzheimer’s Shows Great Promise
Dr. Mary Newport pioneered the research and discussion on keto for AD. When her husband was diagnosed with AD, she used a keto diet rich in coconut oil, MCT oil, and exogenous ketones to improve his symptoms. Here’s what she and many subsequent researchers learned:
1. Ketones give brain cells a clean, alternative energy source.
When the glucose uptake road is blocked, cells need a different way to fill their energy needs. The good news is, glucose isn’t your body’s only fuel source. Once denied carbohydrates (sugar), your body turns to fat to produce and use ketone bodies beta-hydroxybutyrate (BHB), acetoacetate, and acetone as its main source of energy.
This may be helpful for Alzheimer’s because:
- Ketone uptake remains strong even when glucose uptake is impaired.
- Ketones give brain cells fuel when they can’t use glucose correctly.
- Glucose uptake is no longer an issue — it’s totally bypassed.
- Ketones provide more fuel than glucose. BHB, the most well-studied ketone, carries more energy per unit of oxygen than glucose.
- Ketones increase mitochondrial function (i.e., energy creation) in brain cells. Studies show the energy from ketones may awaken dormant cells and restore cell functionality.
- Ketones are a cleaner energy source than glucose because they produce fewer ROS when metabolized. Reducing extra oxygen in the brain may stop neurodegeneration in its tracks. Ketones also tell the enzymes that clean up free radicals to get to work.
- Ketone uptake remains strong even when glucose uptake is impaired.
2. Ketones tip the GABA/Glutamate scale in your favor.
There’s a sliding scale in your brain with gamma-aminobutyric acid (aka GABA, a naturally occurring amino acid that acts as a neurotransmitter in your brain) and glutamate (another neurotransmitter). Thomas DeLauer, celebrity trainer and health author, explains it well in this video. Essentially, GABA creates calm while glutamate is more excitable.
Studies indicate that people with higher glutamate levels also tend to have chronic inflammation and greater risks for neurodegenerative diseases.
However, a ketogenic diet results in less glutamate in the brain, so there’s more GABA. Ketones even stop brain cells from loading up on glutamate, so they’re less hyperactive and problematic.
3. A keto diet is rich in beneficial MCTs (medium-chain triglycerides).
Scientists have been using medium-chain triglycerides (MCT) to increase ketones in the blood since the 1950s. MCT oil, which makes up more than 50 percent of the healthy fats found in coconut oil, provides a fast way to boost ketone levels.
Numerous studies connect MCT oil (and higher ketone levels) with better cognitive functioning, memory recall, and immediate and delayed memory tests. According to research:
- Elderly patients experienced improvements in working memory, visual attention, and task switching after a single meal with MCT oil.
- 152 participants with mild to moderate AD showed statistically significant improvements in cognitive tests when given an MCT supplement for 90 days.
- Subjects with mild to moderate AD following a keto diet with MCT oil scored significant improvements in overall cognitive function as measured by the ADAS-cog, a 70-point test of memory, language, attention to detail, task completion, and spatial awareness.
- Participants with mild cognitive impairment and a heightened risk of AD consumed a drink with MCT once a day for six months and increased brain ketone metabolism by 230 percent. This improved episodic memory, language, executive function, and processing speed.
Bonus: MCT oil consumption increases ketone levels even if carbohydrates are present. This means you don’t have to follow strict keto to enjoy the benefits. However, improvements seen by many participants disappeared when they stopped eating keto or taking MCT oil.
The Final Word
The goal of neuroprotection is to either slow down or stop the process of brain cell death. Just as a ketogenic diet can reverse type 2 diabetes, evidence suggests it may also lower risk factors for AD. This includes lower blood sugar and insulin levels and less oxidative damage.
Additionally, powerful ketones produced on a ketogenic diet (or with MCT oil supplements) provide a clean energy source for those whose cells can’t properly use glucose. When brain cells are no longer starved for fuel, people may experience fewer AD symptoms and a better quality of life.
For more information on the ketogenic diet for the treatment and prevention of Alzheimer’s, watch this video.