Can Ketones Help Alleviate Symptoms of Alzheimer’s Disease?
Can Ketones Help Alleviate Symptoms of Alzheimer's Disease?
Alzheimer’s Disease affects around 44 million people, and with no known cure, a diagnosis can feel like a death sentence. But is there a solution right under our noses?
Emerging research indicates that dietary changes – specifically those geared towards improving metabolic health – can have a profound effect on sufferers of Alzheimer’s and other cognitive disorders.
Indeed, there was an entire section of presentations at the Alzheimer’s Association International Conference (AAIC) dedicated to brain ketone metabolism and advanced ketone strategies.
In essence, dietary interventions “train” the brain to use ketone bodies instead of glucose for energy, with attendant benefits for cognitive function and energy supply.
In this article, we’ll take a closer look at the evidence.
Ketones for Alzheimer’s: The Basics
Ketosis is a natural metabolic state wherein the body produces ketone bodies out of fat, and uses them for energy instead of carbs.
It is the principle of the ketogenic diet, which has become massively popular in recent years but has also been used in epilepsy cases for over a century.
Ketone bodies are molecules generated in the liver which are capable of crossing the blood-brain barrier and providing energy in the absence of glucose.
That’s right, ketones are perfectly able to meet the brain’s energy needs.
Alzheimer’s is caused by cellular dysfunction and an abnormal buildup of protein in and around brain cells, leading to their decreased function and eventual death.
The main risk factors are age (risk doubles every five years after you reach 65), family history, cardiovascular disease and head injuries.
With the brain unable to effectively metabolise glucose, ketones step in as a welcome alternative energy source – and a neuroprotective one, at that.
A weight of scientific evidence indicates that ketones can alter the brain’s metabolism in ways that reduce neuropathology and alleviate behavioural symptoms.
Ketones have anti-inflammatory and antioxidant effects, serving to prevent damage to cells in the brain.
Ketones for Alzheimer’s: The Available Evidence
A 2019 University of Sherbrooke study underlined the benefits of ketogenic medium-chain triglycerides (kMCT) for seniors with mild cognitive impairment.
Over a period of six months, the 52 subjects were given a daily placebo or the aforementioned kMCT supplement, and their results recorded.
The results were astonishing: measures of episodic memory, language, executive function and processing speed improved in the kMCT group, with increased brain ketone uptake positively linked to several cognitive measures.
“The energy problem in the brain can be corrected by supplying ketones to replace the problem with glucose,” said lead author Stephen Cunnane.
Also in 2019, a small study published in the Journal of Alzheimer’s Disease sought to test the efficacy of a high-fat, low-carbohydrate diet.
The Johns Hopkins Medicine researchers found small but measurable improvements on standardised brain function/memory tests in 14 older adults with mild cognitive problems suggestive of early Alzheimer’s.
According to Jason Brandt, PhD, professor of psychiatry and behavioural sciences and neurology, “Using dietary changes to mitigate cognitive loss in early-stage dementia would be a real game-changer. It’s something that 400-plus experimental drugs haven’t been able to do in clinical trials.”
In 2018, meanwhile, a clinical trial testing the feasibility of the ketogenic diet for Alzheimer’s Disease found that cognition was improved in seven very mild and four mild AD patients.
In this one, subjects had to faithfully follow the keto diet while also taking MCT supplements over a period of three months.
Those who did so exhibited a 4.1 point improvement in cognition on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale Test (ADAS-Cog).
Given that a 4 point improvement is deemed clinically meaningful, this was no small feat. All scores returned to normal when the participants returned to their normal diets.
Earlier studies have had similarly impressive results. In 2012, for example, older adults following a low-carb diet benefited from “improved verbal memory performance”, with elevated ketone levels believed to be responsible.
As noted in the study, “While this effect may be attributable in part to correction of hyperinsulinemia, other mechanisms associated with ketosis such as reduced inflammation and enhanced energy metabolism also may have contributed to improved neurocognitive function.”
In 2016, a further study was conducted to determine if ketones could help a 63-year-old male patient with younger-onset Alzheimer’s.
Amazingly, gradual improvements occurred over the course of a year, including in memory recall, word finding, task completion, conversation and social participation.
It’s worth reading the entire study to appreciate just how life-changing ketone supplementation was for this particular individual.
How to Increase Ketone Production
There are many methods of reaching ketosis. One is by fasting, which depletes the body’s glucose stores and in the process induces natural ketone production.
Another is by following a high-fat, low-carb ketogenic type diet, perhaps with the inclusion of medium chain triglycerides such as coconut and MCT oil which boost ketone production.
Other things which can help you more readily get into ketosis include intense physical exercise (fasted cardio is particularly effective), consuming an adequate protein intake and drinking coffee in the morning.
You might also consider supplementing with exogenous ketones. These can increase ketone concentration in the blood without activating starvation mode. Exogenous ketones make it easier to enter ketosis and also mitigate common side effects of the keto diet.
If you’re keen to maximise ketone generation, you could try all of the above in combination: pursue a ketogenic diet, intermittent fasting, a busy exercise protocol and exogenous ketone supplementation.
A 2017 study published in Alzheimer’s Research & Therapy suggested that one third of Alzheimer’s cases could be preventable if people take action to address modifiable risk factors. As we have demonstrated above, there is also hope for those already diagnosed.
Remember, in the early stage of Alzheimer’s disease the brain is unable to efficiently use glucose as an energy source. The principle of replacing glucose with ketones is a sound one, and offers promise for those wishing to preserve cognitive function into their senior years.
The important thing is to cut out the sugar and starches to help the body make a metabolic switch.
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