Health

The Ketogenic Diet and Alzheimer’s Disease: Studies and Findings

Published on: September 10, 2019

The Ketogenic Diet and Alzheimer’s Disease: Studies and Findings

The ketogenic diet is a low-carb, high-fat eating plan originally developed to help treat epilepsy. But now, preliminary studies show that keto may be a promising therapy for a completely different brain disease - Alzheimer's.

Alzheimer's is a chronic neurodegenerative brain disease with no known cure. Instead, treatment is geared towards slowing down disease progression (i.e. buying time) and easing symptoms.

But why don’t we have a cure for this problem despite modern medicine?

One reason why researchers still haven't come up with an effective remedy for Alzheimer's is that nobody knows what causes it. On the bright side, the mechanisms underlying the disease as well as its risk factors are better understood, and this has helped geared research towards the ketogenic diet as an Alzheimer’s antidote.

Studies found that keto may help fuel Alzheimer's brains and even reduce damage to neurons. In this article, we cover a couple of those studies and explain what research has found so far when it comes to using the ketogenic diet for Alzheimer's.


Disclaimer:

All opinions expressed in this article are those of the author and do not reflect the views of Kiss My Keto.


ketogenic-diet-alzheimer's-prevention

What Is Alzheimer’s Disease?

Alzheimer's disease is the most common type of dementia, accounting for 60–70% of cases [1].

Ok, but what is dementia?

The term "dementia" refers to a decline in mental functioning that is severe enough to disrupt normal day-to-day living. All dementias, Alzheimer's included, are considered diseases of old age. It usually affects people aged 65 and older, and less than 10% of cases occur in younger people [2].

Medical experts refer to Alzheimer’s as a neurodegenerative disease, meaning it leads to progressive damage to neurons. This damage manifests as a slow and irreversible decline in basic mental functions like [2]:

  • Memory
  • Comprehension
  • Language
  • Attention
  • Reasoning
  • Judgment

However, the first and most prominent Alzheimer's symptom is short-term memory loss. Patients and family members may notice changes like trouble remembering names, losing track of time, and becoming lost in familiar places.

With time, those affected develop psychiatric problems (depression, anxiety, irritability, insomnia, and paranoia). As the disease progresses, people will need constant care because even walking, using the restroom, and swallowing becomes hard.

definition-of-dementia

Sadly, Alzheimer's has no cure, and the average life expectancy after diagnosis is 4-8 years [2]. Treatment options are limited to drugs that help slow-down memory loss as well as antidepressants, sleep aids, and other drugs for symptom relief [3].

On a positive note, scientists are working hard to find a solution.


ketogenic-diet-for-neurodegenerative-diseases

Studies on the Ketogenic Diet and Alzheimer’s Disease

The brains of Alzheimer's patients have characteristic proteins called plaques and tangles as well as dying neurons in brain regions responsible for learning and memory [4]. New studies suggest these hallmarks Alzheimer’s brain changes may be due to something called "mitochondrial dysfunction [5]."

“What’s that?” you ask.

Mitochondrial dysfunction is when the mitochondria (the powerhouses of cells) don't work as well as they should, depriving cells of energy. One reason why this may happen in people who develop Alzheimer's is due to impaired brain glucose metabolism [5].

Yes, but what does this have to do with the ketogenic diet for Alzheimer’s?

Well, the reason we need to mention this is that, as you'll see in the lines below, the keto diet can be an antidote to this exact problem.

Here's why.

studies-about-alzheimer's

The ketogenic diet causes ketosis, which is when the body and brain switch from utilizing glucose to utilizing ketones for fuel. Researchers suggest ketones may be a good fuel alternative to glucose in Alzheimer's brains [6].

Besides that, preliminary studies found fewer plaques and tangles as well as mild improvements in the memory of patients using the keto diet [7].

This inspired many clinical trials, many of which came with promising results:

  1. An early study involving 20 subjects either with Alzheimer’s disease (AD) or mild cognitive impairment (MCI). The subjects consumed an MCTs drink or a placebo during two study visits. The researchers took blood samples before the start of the study and 90 minutes after subjects drank the beverages. After that, they performed cognitive and blood tests [8].
  2. A randomized control trial involving 23 subjects with MCI. They were put on either a very low- or high-carbohydrate diet for six weeks. The researchers tested for improvements in verbal memory improvements [9].
  3. A study published last year tested MCT supplements to see if they help increase ketone levels and if they can help compensate for brain glucose deficits in patients with Alzheimer's. The patients had mild to moderate Alzheimer's and they were given 30g of two different MCT supplements daily for one month [10].
  4. And finally, a study carried out recently by researchers from the University of Kansas called The Ketogenic Diet Retention and Feasibility Trial (KDRAFT). It is one of the first studies to truly test how feasible and effective that diet could be in these patients. It's a single-arm pilot clinical study and involved 15 patients with mild to moderate Alzheimer's. They were put on an MCT-supplemented ketogenic diet for three months [11].

ketogenic-diet-reverses-dementia

Findings

The four studies listed above led to improvements in different aspects of Alzheimer's disease. Researchers found out that ketones and MCTs can compensate for poor glucose use in the brains of Alzheimer's patients.

The first study found that all participants given MCTs had elevated blood ketone levels. Higher ketone levels surprisingly led to better memory compared to placebo. However, only patients without a specific genetic risk factor for Alzheimer's showed improvements in attention, memory, language, and performance.

In the second study, the higher the ketone levels, the better the verbal memory performance scores in the test subjects. The researchers concluded that low-carb diets, even in the short-term, can improve memory in older adults at risk of Alzheimer's.

The third study tested MCT supplements, which are products that contain medium-chain triglycerides (MCTs). The body uses MCTs to produce immediate energy or ketones. You can learn more about their effects on brain health specifically here. And what this study found that brain ketone use doubled on MCT supplements. The MCTs increased brain energy metabolism.

kiss-my-keto-bottle-of-MCT-oil

The last study was the most promising one. Out of the 15 participants, 10 completed the study. Memory, language, attention, and task completion was improved in 9 out those 10 participants as tested with the ADAS-cog, a test used to measure mental changes in dementia trials. These improvements, however, disappeared once the participants returned to their normal diets.

Researchers believe that any improvements in Alzheimer's patients put either on a keto diet or MCT supplements are due to:

  • Ketones serving as an alternative fuel to glucose.
  • Ketones improving mitochondrial efficiency because they produce more energy with less oxygen.
  • Ketones protecting the brain from oxidative stress, which can be damaging to neurons if unchecked.
  • Reduced inflammation due to calorie restriction, which is common with the keto diet.

Of course, these are still only theories.

Researchers don't know yet how the keto diet is providing these benefits in Alzheimer's disease.

Besides that, keep in mind that the above studies have serious limitations. For example, most were relatively small and did not include a control group. It's also hard to tell in some of these studies if the benefits were due to the ketogenic diet and MCTs or due to greater attention and care given to the participants during the study period.


sticking-to-the-ketogenic-diet-can-be-difficult

Another problem is sustainability.

The keto diet is notoriously difficult to stick to even for people without debilitating conditions. Alzheimer's patients and their caretakers already have a lot on their hands, so sticking to a strict diet regimen can put additional strain on them. The diet may also cause digestive problems in people with Alzheimer's, and some even worry it may not be nutritionally adequate.


Conclusion

Alzheimer's disease is a devastating condition with no known cause or cure. Treatment involves managing symptoms as best as possible. Luckily, researchers are working hard to develop therapies that can at least make functioning for people with this disease easier.

The keto diet has been at the focus of Alzheimer's research recently after studies found that the brains of those with Alzheimer's don't use glucose as effectively as healthy brains. The keto diet can provide a fuel alternative to glucose, and, so far, research in this field is promising.

Ketones provide more energy and use less oxygen than glucose, which can keep Alzheimer's brains functional. They may also slow down disease progression thanks to their anti-inflammatory and antioxidant benefits.

However, we're still far away from any conclusive evidence. All research is still preliminary, and no doctor can recommend the keto diet to Alzheimer's patients just yet. Hopefully, things may change in the near future.


Takeaways

  • Alzheimer's disease is the most common form of dementia.
  • Brains affected with Alzheimer's can't use glucose effectively for energy, but it’s a different story with ketones.
  • The keto diet and MCTs can help provide fuel to Alzheimer's brains.
  • Ketones seem to reduce damage to neurons and reduce plaque formation in Alzheimer's patients.
  • Research on the keto diet as an Alzheimer's treatment is still in its infancy, but the current evidence seems promising.

References:

  1. World Health Organization. Dementia. 2019 May 14 - https://www.who.int/news-room/fact-sheets/detail/dementia
  2. Kumar A, Tsao JW. Alzheimer Disease. 2019 January - https://www.ncbi.nlm.nih.gov/books/NBK499922/
  3. National Institute on Aging. How Is Alzheimer's Disease Treated? 2018 April 1 - https://www.nia.nih.gov/health/how-alzheimers-disease-treated
  4. Schachter AS,... View all references

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