• Ketogenic diets and ketones are broadly neuroprotective
• Positive benefits for the treatment of neurodegenerative disorders and bipolar type 2 disorder have been shown
• The benefits are likely to be due to a combination of factors including improved fuelling, reduced excitation of neurones, increased neural repair, reduced inflammation and oxidation, and positive changes to supportive glial cells of the brain and nervous system
Ketosis refers to the metabolic state that typically occurs during fasting or carbohydrate restriction. In this state ‘ketone bodies’ are created from fats and some amino acids. In the early stages of carbohydrate restriction, the body continues to use considerable amounts of glucose provided by liver glycogen, a process known as ‘HGO’ or hepatic glucose output. When these glycogen reserves become depleted, an alternative fuel source is needed, especially for the central nervous system (CNS), including the cells of the brain and spinal cord, which cannot effectively use fat for fuel and so, they rely on glucose.[a] Some dietary fats, such as short and medium-chain triglycerides (found in lesser amounts in full-fat dairy and coconut oil) can easily cross the blood-brain barrier and can be used extensively by neurons, but they are not plentiful in the diets of most people.
Neuroprotection and Neurodegeneration
Neurodegenerative disorders (NDs) are increasingly common. They result in progressive debility and short survival times. For example, the average survival time after diagnosis with Alzheimer’s Disease is only 3-9 years. Neurodegenerative disorders result from the loss of structure and function of neurons (brain and nervous system cells). The NDs include Alzheimer’s disease, amyotrophic lateral sclerosis, Parkinson’s disease, and Huntington’s disease. These disorders are considered to be primarily genetic, i.e. ~ 70% in AD, but also result from environmental and lifestyle factors, especially head injuries and hypertension, and in the case of Parkinson’s, past pesticide exposure.
In addition to the NDs, there is an increasing awareness of ‘brain health’ in general. Most people suffer some degree of age-related cognitive decline as they age, and in the internal polling of our network of patients and colleagues, improved cognition, clarity, and ‘energy’ are the most common desired results from seeking treatment and this is in contrast to the most desired outcome ~10 years ago, which was overwhelmingly weight loss. This is both positive (that there is a greater focus on function and health of the body rather than simply weight) and also somewhat worrying that cognitive decline and poor mental health are becoming so prevalent, for so many…