What to Consider When on a Keto Diet for Dementia

What to Consider When on a Keto Diet for Dementia

Many people whose loved ones are affected by dementia think that nothing much can be done to stop the disease from progressing. But is this really true?

If there’s one thing we can agree on, it is that diet plays an important role in one’s ability to cope with a disease. There’s more evidence showing that the ketogenic diet can be a disease-modifying therapy for dementia.

Want to learn more about keto and dementia? We prepared this guide for you. In this guide, we cover the following topics:

  • Definition of dementia
  • Definition of the ketogenic diet
  • Keto diet considerations for dementia

What Is Dementia?

The National Institute on Aging defines dementia as “a loss of cognitive functioning.” This includes your ability to remember, reason out, solve problems, and focus. Keep in mind that dementia is not a specific disease but rather a broad term that describes mental decline.

Out of the many causes of dementia, Alzheimer’s disease is the most common. Alzheimer’s disease is the 6th leading cause of death in the United States.

What happens in the brain of a person with Alzheimer’s?

Let’s start with the fact that the brain demands more energy than any other organ. It needs a quarter pound of glucose to function. In Alzheimer’s disease patients, the cerebral metabolic rate for glucose is drastically reduced [1].

The ketogenic diet increases your body’s ketone levels, thereby providing the brain with an alternative energy source.


What Is the Ketogenic Diet and How Does It Help with Dementia?

The ketogenic “keto diet” is a diet where a person consumes high fat, moderate protein, and very few carbohydrates. Anyone who’s on this diet gets the following calorie percentage per macronutrient:

  • 55% to 60% of calories from fat
  • 30% to 35% of calories from protein
  • 5% to 10% of calories from carbohydrates

For 2000 kcal per day diet, carbohydrate consumption is kept around 20-50g.

The goal of the keto diet is to achieve a natural metabolic state called ketosis. People who follow a standard diet acquires energy mainly from carbohydrates. When carbohydrates are depleted, as in the keto diet, the body breaks down fat and produces ketones.

Ketones are beneficial in that they offer an alternative energy source present in the brain of an Alzheimer’s patient. Ketones increase mitochondrial mass and upregulate energy metabolism.

11 Things to Consider When on Keto Diet for Dementia


1. Healthy fats

A fat-fueled brain is a healthy brain. When it comes to the type of fat, be sure to choose the healthy type of fat. Omega-3 fatty acids are beneficial fats found in whole foods like salmon, tuna, walnuts, chia seeds, and flaxseed.

One study that involved 5,386 participants showed that consuming fish makes a person less likely to develop dementia [2].

2. Real vs processed food

The quality of foods we eat affect brain health. High-fat processed foods are found to cause damage to the hypothalamus -- a small portion of the brain responsible for emotional response, sleep, hormonal balance, and metabolism.

You will also be surprised to know that ultra-processed foods, foods with hydrogenated oils and artificial flavors, have more sugars. Popular examples include cookies, cakes, breakfast cereals, and fruit drinks [3].

To get the benefits of keto for brain health, stay away from anything processed as it may contain hidden sugars. Whole foods offer more vitamins and minerals.

3. Physical activity

Being physically active stimulates the growth of new blood vessels in the brain and maintains the survival of existing ones. Epidemiological studies demonstrate that exercise delays the progression of dementia in older patients [4].

When dementia patients are just starting keto, exercising helps them get into ketosis faster. It’s important to keep exercise fun and simple. Be sure to match the exercise with the patient’s current physical and mental level of function.

4. Fasting

The ketogenic diet is often used with fasting, specifically intermittent fasting, to speed up ketosis. Intermittent fasting is also beneficial against Alzheimer’s disease. Β-hydroxybutyrate that’s produced during ketone body metabolism protects the brain from oxidative stress [5].

There are different ways to fast intermittently. One is to do a 24 hour fast once a week. Another is to skip meals from time to time. If a dementia patient isn’t hungry, he or she can skip that meal and take the next one instead.

5. Electrolytes

Electrolyte levels can get out of balance when carbohydrate intake is too low. Restrictive diets like keto may create electrolyte imbalances because many foods are cut being cut out. Someone entering ketosis also pees more than usual because the body loses glycogen.

Electrolyte disturbances lead to neurological symptoms such as headaches, brain fog, and irritability. Addressing electrolyte imbalances when on a keto diet is essential. Pay attention to electrolytes such as sodium, calcium, potassium, and magnesium [6].


6. Ketone measurements

Whether a person has dementia or not, taking ketone measurements helps one know if ketosis has been achieved. There are three ways to test for ketosis. You can use blood testing, urine testing, and breath testing. Blood testing is the most accurate way to measure ketones.

You can also tell if your loved one or patient with dementia has entered ketosis with the following signs and symptoms: Fatigue, digestive issues (diarrhea or constipation), and a lack of appetite.

7. Multiple food options

People with dementia may refuse to eat and often change their food preference. Today, a dementia patient may like meat. Tomorrow, he may not. Offering a variety of healthy keto foods such as seafood, low-carb vegetables, cheese, and nuts can be very helpful.

8. Vitamin D

There is a strong link between low levels of vitamin D and dementia and mental health disorders. However, there is no certainty whether vitamin D triggers the onset of dementia or vice versa [7].

Either way, a person on a keto diet should consider consuming vitamin D rich foods for brain health. Examples of keto foods rich in vitamin D are tuna, salmon, mackerel, cheese, and egg yolks.

9. Sleep

Dementia and Alzheimer’s disease caregivers cite sleep disturbances among patients. One quarter and one-half of adults with Alzheimer’s disease and dementias experience disrupted sleep. Also, a person who’s new into the keto diet may also report insomnia.

For a dementia patient, medical professionals recommend interventions such as increasing activity during daytime or exposing the person to natural sunlight. Avoiding daytime naps and getting exercise also improve sleep [8].

10. Cholesterol levels

There is a connection between high LDL (bad) cholesterol levels and cerebral beta amyloid deposition in the brain. An increase in cerebral beta amyloid could initiate Alzheimer’s disease.


A properly planned keto diet can increase HDL (good) cholesterol levels which then decreases LDL levels. HDL works by removing LDL that builds up in the arteries. To improve good cholesterol for dementia patients on keto, one should consume more fatty fish and engage in regular exercise.

11. Dementia medication side effects and keto flu

Medications that treat dementia may cause common side effects in some patients such as headaches, dizziness, tiredness, insomnia, and muscle pain.

Such symptoms the same symptoms experienced by people who are still adjusting to keto. These symptoms are collectively known as the keto flu. It’s important for caregivers and loved ones of dementia patients to plan for them. The keto flu usually lasts about one week. Getting enough sleep, drinking more water, and keeping exercise light help relieve symptoms.


Glucose is the brain’s primary source of fuel. However, it can rely on a secondary source in the absence of glucose -- ketones.

For individuals who want to explore a ketogenic diet for dementia, considering food choices, physical activity, electrolyte supplementation, cholesterol levels, and other factors can be helpful in achieving desirable results.


  1. Iadecola C. Sugar and Alzheimer’s disease: a bittersweet truth. 2016 January -
  2. Kalmijn S et al. Dietary fat intake and the risk of incident dementia in the Rotterdam Study. 1997 November -
  3. Martínez Steele E et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. 2016 January -
  4. Teri L, Logsdon RG, McCurry SM. Exercise Interventions for Dementia and Cognitive Impairment: The Seattle Protocols. 2008 August -
  5. Achanta LB, Rae CD. β-Hydroxybutyrate in the Brain: One Molecule, Multiple Mechanisms. 2016 November -
  6. Balcı AK et al. General characteristics of patients with electrolyte imbalance admitted to emergency department. 2013 -
  7. Anjum I et al. The Role of Vitamin D in Brain Health: A Mini Literature Review. 2018 July -
  8. Rose KM, Fagin CM, Lorenz R. Sleep disturbances in dementia: What they are and what to do. 2010 May -

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