Can the Ketogenic Diet Improve Cognitive Health?
Nutritional ketosis or the Ketogenic Diet (KD) - "keto" for short – was originally developed as a treatment for epilepsy in children in the 1920s. As such, the KD has always had its roots as a treatment for mental disorders.
The keto diet has been scientifically proven to reduce markers for cognitive decline such as pain and inflammation, as well as improve mitochondrial respiration (helping our cells breath) and reduce oxidative stress.
The diet is now being studied for its efficacy in the treatment of a wide range of cognitive diseases such as Alzheimer’s disease (AD), Parkinson's disease (PD) and depression, due to its neuroprotective effects.
In this article, we shall take a closer look at the ketogenic diet and investigate its implications for brain health specifically.
Why is Keto Trending Now?
You might be wondering why we are just learning about the keto diet now, if it’s been around for almost a century and has so many healing effects on the body and mind.
There are many reasons for the KD being pushed back. Both the interests of commerce and the discovery of diphenylhydantoin (an anti-seizure medication) in 1938 shifted the focus of physicians. It’s easier to prescribe a drug than to tailor a ketogenic diet for each patient.
The viability of the KD is often put into question when it’s administered incorrectly. For example, if the macronutrients are not given in the correct proportions. For this reason, in 2015 Raymund Edwards invented the Optimal Ketogenic Living (OKL) chart, which is an easy way to make sure you get what you need from your keto diet to reap the best rewards.
Another reason the ketogenic diet has been put on the back burner is that in the mid-19th century, ketones were found in patients with advanced diabetes. This finding led many physicians to vilify the KD, despite thousands of reports to the contrary.
Since then, many studies have been carried out to discover the exact mechanisms of ketones in the body. Recent findings have uncovered the many healing benefits of the ketone metabolites on metabolic diseases.
Low-Fat vs High-Fat: A Brief History
The low-fat, high-carb diet craze swept the world in the 1960’s as the correlation between high-fat and heart disease became popularised.
After 1980, the low-fat hype had firmly taken hold and was accepted as the “healthy choice”. In fact, the low-fat ideology began back in the 19th century as both an aesthetic practice and a healing modality.
This approach assumed that fat was the main factor for disease and totally washed over all of the other elements needed for good health. Removing all of the fat from food resulted in high amounts of refined carbs, sugar and salt being used extensively to give the food taste.
Without the additives, ultra-processed food that has had its fat removed is bland and tasteless. Now we have scientists creating chemical concoctions that manipulate our senses with fake foods that hit the “bliss point” – tricking our brains into thinking that the food is good.
For a deep dive on dietary fat, check out our blog Good Fats, Bad Fats.
A New Era for the Ketogenic Diet
Fast forward to 2019 and we have an obesity epidemic, chronic illness and heart disease is the number one killer. Go figure.
The low-fat high-carb approach doesn’t seem to be working for health or weight loss. So we need a new approach. Hence the KD is gaining massive popularity worldwide.
Ketogenic diets are re-emerging as a viable way to reduce inflammation in the brain and other areas of the body to reclaim health.
Brain inflammation can be fatal in head injuries, where it does the opposite of its desired effect. Instead of helping to heal the brain, inflammation makes matters worse. Suppressing inflammation is a key issue after brain injury.
Additionally, excitatory cells are also more active in injured brain tissue, which can lead to cellular death.
Neuroprotective Effects of the Keto Diet
The neuroprotective benefits of the keto diet cannot always be followed in brain injured patients due to their physical condition. For this reason, a group of neuroscientists led by Chris Dulla at Tufts University School of Medicine have created a KD mimicker drug called 2-deoxyglucose (2-DG).
Their trial showed some promising results, as the 2-DG treatment reduced cell excitation, lessened cellular death and prevented the development of epileptic brain activity.
The KD drug is only intended as a short-term solution for brain-injured patients who cannot follow the ketogenic diet due to physical constraints.
A new research paper has been released studying a previously unmanageable brain tumour called Glioblastoma, or GBM for short. Glioblastoma is the most aggressive form of brain cancer and mortality from this condition is largely connected to systemic inflammation.
As with all cancers, the fuel is glucose and glutamine. One pivotal way to suppress tumour growth is to remove the fuel source, reducing cancer viability and invasion.
In the study, they prescribed a calorically-restricted ketogenic diet (KD-R)to reduce sugar circulating in the blood. (Neuroprotective ketone bodies are increased when following the KD.)
Another approach to following the KD-R is combining Intermittent Fasting with the Ketogenic Diet to amplify its effects.
The Effect of Ketones on the Brain
Ketone bodies protect the brain from neurodegeneration (depletion of the neurons in the brain). While our bodies are using ketone bodies (fat) as a fuel source, there is a significant decrease in glucose, leptin, insulin and pro-inflammatory markers. This makes the ketogenic diet a good choice for those with brain conditions including brain injury.
The ketogenic diet has been found to have both anti-oxidant and anti-inflammatory properties. Ketone bodies activate the body’s Nrf2 antioxidant defence mechanism, which is a process by which the body up-regulates its detoxification pathways.
When this process is activated, harmful free radicals that stimulate inflammation are mopped up.
The blood ketone levels of ?-hydroxybutyrate and acetoacetate increase when we are in ketosis. Both compounds are neuroprotective and non-fermentable. Being non-fermentable is a key component in its healing capacities, as cancer cells have gone through several stages of mutation and use ancient fermentation pathways for fuel.
Tumours are incompatible with the healthy energy production of the oxidative phosphorylation (OxPhos) pathways. Cancer does not use oxygen or ketone bodies for fuel, so the KD-R is an ideal approach in the treatment of brain cancer.
The Metabolic Switch
When switching the diet from using glucose as fuel to using ketone bodies (fat), we change how the body produces and uses energy.
The brain is not static in its fuel options. Previously we thought that the brain, once formed, was fixed. However, that has not proved to be the case. The brain is highly adaptable.
Switching up the fuel source to ketone bodies has proven to adapt neural networks and enhance resistance to stress, injury and disease.
As mentioned earlier, the Ketogenic Diet was originally designed as a treatment to heal brain disorders – but it is proving to have far more wide-reaching health benefits.
Ongoing research in both animal and human models further explains the intricacies of how the body adapts to using fat for fuel. The KD has neuroprotective, anti-inflammatory and antioxidant properties that can enhance cognitive abilities and promote brain healing.
If you’ve found this article interesting, and are considering embarking on the keto diet – for cognitive benefits or perhaps to lose weight – you’ll want to avoid keto flu. Our blog on the subject is required reading!
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The low-fat high-carb approach doesn’t seem to be working for health or weight loss. We need a new approach.