stop migraine dr deb

Can the ketogenic diet help prevent migraine headaches?

Can the ketogenic diet help prevent migraine headaches?

stop migraine dr deb

Migraine headaches are characterized by recurrent episodes of moderate to severe throbbing pain that are typically associated with nausea, vomiting, along with light and sound sensitivity. Currently, it is estimated that between 12-14% of the population, or over 37 million people in the United States suffer from migraine headaches. Migraines are more common in females of childbearing age. One out of four women will have a migraine sometime during their lives. Despite the fact that it is the 3rd most prevalent and the 6th most disabling illness in the world, there are still very few effective treatment options.

As a headache specialist I am always looking for better treatment options for migraine headaches. For those who know me, know that I prefer conservative treatment options, such as exercise or dietary changes. For the past two years I have been doing research on all the potential neurological benefits of ketones and the ketogenic diet (KD).

The ketogenic diet mimics fasting by restricting the amount of carbohydrates that are eaten. This triggers the break down of fats, producing ketones. Research has shown that ketones have many beneficial effects both for the brain and the body. Specifically, research has shown that ketones decrease inflammation, decrease brain cortical excitability, improves mitochondria function, and decrease the amount of reactive oxygen species (ROS) thus reducing oxidative stress.

So why would the ketogenic diet or having ketones potentially help with migraine headaches?

Ketogenic diet has been used since the 1920’s for treatment for epilepsy. Many of the same medications are used to treat both conditions. Specifically, the anti-seizure medications, Topamax and Depakote are also used to prevent migraine headaches. Both migraine headaches and seizures involve paroxysmal excitability of the brain. So measures that decrease this excitability may improve both conditions. Ketones have been found to decrease the levels of the excitatory neurotransmitter glutamate. (Stafstrom, C. 2016) Decreasing glutamate levels decreases cortical excitability and decreases central sensitization. Central sensitization is a condition of the nervous system that is associated with the development and maintenance of chronic pain syndromes such as chronic migraine headaches and fibromyalgia.(Pomeror, 2017)

Decreased cortical excitability has also been shown in rat models looking at cortical spreading depression (CSD). CSD is a wave of cortical excitability that is thought to correlate with migraine aura and may be a trigger for the start of a migraine. (Stafstrom, C. 2016) It has been shown that rats treated with a KD had decreased CSD. (Di Lorenzo C. , 2015) Why CSD occurs is unclear but one hypothesis is that it is due to dysfunctional mitochondria. Mitochondria are where the cells produce ATP needed for cellular energy. When the mitochondria are dysfunctional, this lead to decreased ATP production. This decreased ATP then increases the occurrence of CSD and potentially migraines. (Sparaco, 2006) Thus, another reason ketones may be beneficial in preventing migraines is that ketones have been shown to improve mitochondrial function. (Di Lorenzo C. , 2013)

Another reason that ketones or being on the KD would be helpful in prevention of migraines is because of the anti-inflammatory effect of ketones. Neuroinflammation is inflammation medicated by the release of neuropeptides of the nerve fibers in the brain. It is the physiological mechanism of a migraine attacks. Indirect evidence that inflammation is the mediator of a migraine attack is during a migraine attack is based on the increased levels of inflammatory during a migraine and the fact that non-steroidal anti-inflammatory drugs are often effective treatment for acute migraine headache.(Pietrobon, 2013)

There are several different mechanisms for the anti-inflammatory effects of ketones.   First of all, compared to glucose metabolism, ketone metabolism produces fewer reactive oxygen species (ROS). ROS contribute to inflammation. Secondarily, the neurotransmitter Adenosine is increased with the KD. Adenosine has been shown to decreases both central and peripheral inflammatory. (Masino, 2013) (Dupuis, 2016) Lastly, ketones have been shown to block the NLRP3 inflammasome. Activation of NLRP3 inflammasome leads to the release of pro-inflammatory cytokines. (Youm, 2015)

So what does this mean clinically? Can the KD or having ketones in your body decrease the frequency of migraine headaches?

The first report of using the KD for migraine was in 1928. That study, 9 of the 28 patients reported some improvement, despite the fact that there was low compliance with the diet. (Stafstrom, 2016) More recently a larger observational study was done in 96 obese females. In this study, the females were randomized to either eat a KD or standard diet (SD) for 1 month. During the month on the ketogenic diet, there was a significant decrease in the frequency of migraine, the number of days with migraine, and medications used to treat migraine headaches. After that month all were transitioned back to a SD, during which their headaches again worsened. (Di Lorenzo C. , 2015) 

headache study

So, if you have migraine headaches, and would like to try something conservative as a means to decreasing the frequencies of your headaches consider starting a ketogenic diet. If starting making this significant dietary changes scares you, consider jumping in the easy way by starting a ketone supplement*. Other benefits that you might notice when you have ketones in your system include fat loss, improved energy, and improved mental focus. When was the last time you heard those ‘side effects’ when discussing medication options for migraines?!?

Bibliography

Di Lorenzo, C. (2013). Diet transiently improves migraine in two twin sisters: possible role of ketogensis. Functional Neurology, 28 (4), 305-308.

Di Lorenzo, C. (2015). Migraine improvement during short lasting ketogenesis: a proof of concept study. European Journal of Neurology, 22, 170-177.

Dupuis, N. P. (2016). Anti-inflammatory Effects of a Ketogenic Diet. In S. Masino (Ed.), Ketogenic Diet and Metabolic Therapies (pp. 147-155).

Masino, S. (2013). Ketogenic Diet and Pian. Journal of Child Neurology, 28 (8), 993-1001.

Pietrobon, D. M. (2013). Patholophysiology of Migraine. Annual Review of Physiology, 75, 365-91.

Pomeror, J. L. (2017). Ketamine Infusion for Treatment Refractory Headache. Headache, 57 (2), 276-282.

Sparaco, M. (2006). Mitochondrial dysfunction and migraine: evidence and hypotheses. Cephalalgia, 361-372.

Stafstrom, C. (2016). Dietary Therapy for Neurolgical Disorders. In S. A. Masino (Ed.), Ketogenic Diet and Metabolic Therapies. Oxford.

Stafstrom, C. (2012). The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in Pharmacology, 3, 1-8.

Youm, Y.-H. (2015). Ketone body Beta Hydroxybutrate blocks the the NLRP3 inflammasome-mediated inflammatory disease. Nature Medicine, 21, 263-269.

 

The medical information on this site is provided as an information resource only. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.
*These products are not intended to are not intended to diagnose prevent treat or cure any disease. If you are under medical supervision for any allergy, disease, taking prescription medications or you are breastfeeding contact your medical provider before adding any new supplements to your daily regimen.

 

Stethoscope listening to a heartbeat

Is the ketogenic diet safe for the heart?

Stethoscope listening to a heartbeat

I was asked the other day whether or not eating a low carbohydrate, high fat diet such as a ketogenic diet would be safe for the heart. My answer was YES. However, honestly, up until about two years ago this would not have been my answer.

I remember about 15 years ago when the Adkins diet was a popular diet. Some of my family and friends were on this diet and had great results with it. I however, gave them a hard time, ‘yes you will lose weight but you will die from a heart attack’.

The theory was that eating all that saturated fat would increase cholesterol levels, which would increase the risk for atherosclerosis or clogging of the arteries and then heart attacks. We have since learned that this is not true. As I discussed in another blog, it was shown that people who switched from eating saturated fat to vegetable oils, which at the time was thought to be the healthier type of fat, actually had an HIGHER risk of heart attacks and death. (Ramsden 2016) (Ramsden 2013)

Those studies however, just looked at changing the types of fat that were eaten, i.e. stopping saturated fats and start using vegetable oils, not increasing the amount of fats in the diet. So what happens to cardiac risk factors (obesity, specifically waist circumference, hypertension, diabetes, high triglycerides and high systemic inflammatory markers such as CRP) when start eating more fats and fewer carbohydrates as in low carbohydrates diet? Several studies, which were recently published, answered just that question.

The first was a study published in the journal Obesity Reviews in 2012. This study reviewed 23 studies with a total of 1,141 obese patients eating a low carbohydrate diet for weight loss. They found improvement of all major cardiovascular risk factors associated with eating a low carbohydrate diet.   Specifically, the study found a significant decreased in weight, body mass index and abdominal circumference. Systolic and diastolic blood pressures were also decreased.   Markers for diabetes were improved including, fasting plasma glucose levels, gylcated hemoglobin (HgA1c) and insulin levels. Cholesterol levels were also improved; with lower levels of triglycerides and increased levels of HDL. Lastly the marker of inflammatory, CRP levels, were also improved (Santos, 2012)

Another study looked at very low carbohydrate or ketogenic diet specifically. This study reviewed a total of 13 studies, in which a total 1577 individuals were randomized to either very low carbohydrate diet or a low fat diet. The very low carbohydrate diet group had significantly greater weight loss, improvement of diastolic blood pressures, lower triglycerides and higher HDL levels. Fasting blood glucose, insulin levels, HgA1c and CRP all showed improvement in favor of the very low carbohydrate group compared to low fat groups. (Bueno, 2013)

The LDL levels in the very low carbohydrate group were increased, as expected from eating more saturated fats. However, as discussed in a prior post, it is not the LDL particle itself that is the problem: instead, it is the size of the particle that matters. There are actually two different types of LDL based on size. There is small and large size LDL. The small LDL particles are the ones that are believed to be harmful, or more prone to cause the clogging of the arteries that is of clinical concern. When LDL is exposed to high carbohydrates and high triglycerides, it is more likely to become oxidized or damaged, making the LDL a small dense particle. Whereas, it has been shown the type of LDL particles that are elevated when the diet contains a higher saturated fat (not the inflammatory vegetable oils) combined with carbohydrate restriction, are the larger sized LDL particles, which are the less artherogenic than the small dense LDL. (Krauss, 2006)

Then lastly, a study published in the journal Circulation, used carotid ultrasound as a way to measure atherosclerosis. The participants were randomized into a low fat diet, a Mediterranean type diet or a low carbohydrate diet. After 2 years of dietary intervention, they found that all 3 groups had a significant regression of the atherosclerosis plaques. This suggested that the low carbohydrate diet is at least as effective as the other diets in showing regression. The study did not have the power to show differences between the groups, but there was a slight trend for the greatest improvement seen in the low carbohydrate diet. (Shai, 2010)   Thus, based on this study eating a low carbohydrate diet does not increase risk of atherosclerosis disease; instead it may actually decrease it.

So yes I have to apologize to my friends and family who were ahead of the game. They were right all along. Based on these studies and others, I now come to realize that going on a low carbohydrate, high fat diet such as ketogenic diet is indeed safe for the heart. Not only may the ketogenic diet help you lose weight, it may also improve your cardiovascular risk factors and does not increase your risk of atherosclerosis.

Need help with a ketogenic diet? First step is filling out this form and then I will be happy to help.

Your Name: *

Email Address: *

What interests you the most about the ketogenic lifestyle?:

Please leave this field empty.

Bibliography

Bueno, N. B. (2013). Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition (110), 1178-1187.
Krauss, R. (2006). Seperate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. American Journal of Clinical Nutrition (83), 1025-1031.
Ramsden, C. E. (2016). Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from the Minnesota Coronary Experiment (1968-73). British Medical Journal, 353, 1-17.
Ramsden, C. E. (2013). Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. British Medical Journal, 346, 1-18
Santos, F. (2012). Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obesity Reviews, 13, 1048-1066.
Shai, I. (2010). Dietary Intervention to Reverse Carotid Atherosclerosis. Circulation, 121, 1200-1208.

Ketones as a treatment for seizures

The treatment of recurrent seizures (epilepsy) thru the use of dietary changes, specifically starvation, has been reported since Biblical times. The metabolic benefits of starvation are due to the shift to fat metabolism resulting in ketone body production. Since the ketogenic diet has the same metabolic effects of starvation, it has been used for the treatment of epilepsy first by Dr. Russell M. Wilder from Mayo Clinic, in the 1920s. Dr. Wilder observed a reduction of seizures by 50%. (Keene, 2006)

The diet fell out of favor as anti-seizure medications were developed. Since 1994 there has been a renewed interest in the ketogenic diet after the publicity of a young boy named Charlie who was treated very successfully with the ketogenic diet. He remains seizure free today off medications despite now being off the ketogenic diet.

The anti-epileptic effects of the ketogenic diet have been well studied. It is most commonly used kids with medically intractable seizures. A meta-analysis of the studies that have been preformed since 1990 was published in Pediatric Neurology in 2006. This study found 15.6% of the children who were treated with ketogenic diet for 6 months became seizure free and a third had greater than 50% reduction of seizures. Of significance, is that these patients were intractable, meaning they continued to have frequent seizures despite being on multiple antiepileptic medications before starting the diet.(Keene, 2006) The ketogenic diet is has been shown to be effective for all types of seizure disorders both in kids and adults. What is amazing is that some of the patients treated with ketogenic diet can actually maintain a significant reduction in seizures frequency or remain seizure free even after discontinuing the diet. (Baranano, 2008)

The difficultly with this this treatment is not whether the ketogenic diet works but keeping people compliant with it. It is a very rigid diet composed of eating very high fats (as high as 80- 90% fats) and very low carbohydrates (5%). This requires detailed meal planning, prepping, and weighing of foods. If this is not maintained, such that amount of carbohydrates are increased even a slight amount (such as by eating an half of a banana), they will be kicked out of ketosis. Thus losing the anti-epileptic benefits of the ketones until they get back into ketosis, which may take several days.

The anti-epileptic effect of the ketogenic diet is believed to be from the ketone bodies (beta-hydroxybutyrate, acetoacetate and acetone) that are produced by the body when on ketogenic diet. Thus the next question is, if giving the ketones exogenously, as an oral ketone supplement, would it have the same benefits as the ketogenic diet? The simple answer to this question is yes.

There have been 3 studies using different animal models of seizures. They have all shown that the use of exogenously given ketone bodies has an anti-epileptic effect. One study looked at preventing grand-mal seizures induced by central nervous system oxygen toxicity. (D’Agostino, 2013) Another looked at rats treated with a pro-convulsant agent PTZ. (Viggiano, 2015) The third study used a mouse model that represents human temporal lobe epilepsy. Importantly, this study also documented that the administration of ketone bodies has a direct positive effect, independent of the hypoglycemia. (Kim, 2015)

The mechanisms underlying the anticonvulsant effects of ketone bodies are not completely clear. Research indicates multiple possible mechanisms including thru the neuro-protective properties of ketones. Ketone bodies also have been shown to decrease the release of the excitatory neurotransmitter glutamate and increase the inhibitory neurotransmitter GABA. Others potential benefits include increasing intracellular ATP levels, decreasing reactive oxygen species, and improvement of mitochondrial function.

For more information of the ketogenic diet check out my other blog posts including potential benefits in Alzheimer’s dementia. For more information on a commercially available exogenous ketone supplement click this link.

Please, if you do want to use the ketogenic diet for treatment of your epilepsy make sure you are under medical supervision and do not stop or alter your anti-epileptic medication without approval of your Neurologist.

Bibliography

Baranano, K. W. (2008). The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illness. Current Treatment Options Neurology , 10 (6), 410-419.

D’Agostino, D. E. (2013). Theraputic ketosis with ketone esters delays central nervous oxygen toxicity seizures in rats. Am J Physiol Regul Integr Comp Physiol , 304, R829-R836.

Keene, D. (2006). A Systemic Review of the USe of the Ketogenic Diet in Childhood Epilepsy. Pediatruc Neurology (35), 1-5.

Kim, D. Y. (2015). Ketone Bodies Mediate Antiseizure Effects through Mitochondrial Permeability Transition. Annuals of Neurology (78), 77-87.

Stafstrom, C. E. (2012). The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in Pharmacology , 3, 1-8.

Viggiano, A. D. (2015). Anticonvulsant properties of an oral ketone ester in a pentylenetetrazole-model of seizure. Brain Research , 50-54.

 

The medical information on this site is provided as an information resource only. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.

Fuel your body with the power of ketones

Ketones are an alternative fuel source for our brain and body.

Our bodies need energy to preform our daily activities. This energy is at the molecular level is called ATP. ATP is produced in the mitochondria of all cells. It however also takes energy to produce ATP. This energy comes from the break down of one of two different fuel sources, glucose or ketones.

  1. Glucose is the broken down to produce ATP by the process called glycolysis
    1. Glucose comes from
      1. Carbohydrates that we eat
      2. The break down of the stored glucose in the form of glycogen
      3. Protein from our diet that break down into amino acids into glycogen then into glucose
  2. Ketones are broken down to produce ATP thru the process called Beta- oxidation
    1. Ketones are formed by the break down of fats.
      1. There are 3 different ketones (ketone bodies):
        1. Acetoacetate
        2. Beta-hydroxybutyrate
        3. Acetone

How can I get into ketosis?

  1. Starvation
  2. Intense exercise
  3. Eating ketogenic diet (70% fats, 20% proteins and 5% carbohydrates)
  4. Adding endogenous ketone supplement

The majority of the US population is currently only fueled by glucose, since the body is not able to tap into the second fuel source of ketones until it has run out of glucose. Our bodies however are designed to use either ketones or glucose as a mechanism to protect our species in times of starvation. Just think about how we lived in the caveman days when there was not any grocery stores or McDonalds on every block.  In the summer and spring when food was plentiful, cavemen would eat more food and pack on and store the extra as fat.  Then in the fall and winter when food was scarce, the cavemen would live off that extra stored fat by switch over from using glucose to ketones as primary fuel source.

The brain actually prefers to use ketones as a fuel when it is available.

There are 3 main reasons why ketones are a better source of energy for your brain.

  1. Ketones produce more ATP than glucose.
  2. Ketones are a cleaner less toxic source of energy since they produce less carbon dioxide and free radicals than when the body uses glucose as a fuel source
  3. Unlike glucose, ketones do not depend on insulin to get into the cells for use.

Are you often fatigued in the middle of the day? Do you have a hard time and need more energy to get thru a busy day at work, a long workout or just for a day of play? If so, instead of reaching for a high calorie candy bar, soda or energy drink, which will cause you to crash in a couple of hours, consider changing your fuel source to ketone based instead of glucose.

 

Hello from Dr. Deb

 

An alternative approach to Neurology

Hello Dr. Deb here. I just wanted to say thanks for liking my Facebook page @ https://www.facebook.com/BrainBodyFitness/. I also wanted to introduce myself to those who do not know me. I am currently 48 years old. I am a wife and a mom of wonderful 2 young girls. I have been practicing neurology for over 18 years. I specialize in headache medicine but still manage all types of neurological diseases including Alzheimer’s dementia, seizures, strokes, multiple sclerosis and Parkinson’s disease. However pain and migraines are the conditions I see the most.

I started this website and my Facebook page because over the years my approach to the practice of medicine and specifically neurology has changed. I previously believed that my job was just to find the right pill for your symptoms. I since have come to the conclusion that sometimes the best medicine is not a pill that I can give, but a healthy life style that you choose for yourself. I have discovered this both thru my patients but also with my personal experience. I too suffer from migraines and depression but since making some changes with exercise and changes my diet to include ketosis I have had significant improvement in my symptoms.

Over the last couple of years I have been doing more and more research on the powers of exercise, nutrition and most recently the benefits of ketones. I will be making a series of videos over the next several of weeks so that I can share with some of what I have learned.  I hope that you will find some value in these videos.

Sincerely,

Dr. Deb

Closeup of bulletproof coffee with cold pressed extra virgin coconut oil and grass fed organic butter on wooden table, part of ketogenic diet

Ketogenic Diet Basics

What is the Ketogenic diet?

The ketogenic diet is a very low carbohydrate, high fat diet. Yes, I said high fat. Don’t worry: eating fats are no longer the enemy; they are actually our friend if you want a healthy brain and body. (Glucose and carbohydrates are actually the enemy). When you decrease the amount of carbohydrates and increase the amount of fats in your diet, your body goes into the metabolic state called ketosis. Ketosis is the process by which your body starts the break down fats and turns it into ketones. Ketones are another fuel source for our bodies, which then can be used as a fuel instead of glucose.

What are the potential benefits of eating a Ketogenic diet?

The research on the uses of the ketogenic diet is extensive and is still growing. The ketogenic diet has been used for the treatment of poorly controlled seizures since the 1920s. Research now shows potential benefits for many other neurological diseases such as Alzheimer’s, Parkinson’s, multiple sclerosis, migraine headaches, along with traumatic brain injury, depression, anxiety, ADD, and even autism. Besides the brain benefits, the ketogenic diet has been shown to help many medical issues including obesity, diabetes, cancer, and arthritis.

How do I start the Ketogenic diet?

A standard ketogenic diet consists of having your diet consist of 5% carbohydrates, 20% protein and 75% fats.

Foods to eat:

  • Meats: Red meats, sausage, bacon, ham, pork, game meat, chicken, etc. Also eat the fat on the meat as well as the skin on the chicken.
  • Fatty Fish: Salmon, trout, mackerel, and tuna
  • Eggs: Yes you can eat the whole egg!
  • Oils: Extra virgin olive oil and coconut oil
  • Butters, creams, and cheese: Use full fat options and all natural grass fed butter
  • Nuts: Walnuts, almond, macadamia nuts, flax seed, and pumpkin seeds
  • Vegetables: Brussel sprouts, cauliflower, broccoli, cabbage, asparagus, zucchini, eggplant and spinach
  • Avocados 

Foods to avoid:

caution-carbs-

Basically any food that are high in carbohydrates should be limited, especially watch for hidden carbs in the so-called ‘low fat foods’.

 

  • Foods high in sugars: soda, fruit juices, smoothies, candies, pasties etc.
  • Grains: wheat, pasta, oatmeal, cereals, and rice
  • High carb vegetables: potatoes, corn, and carrots
  • Beans: kidney beans, chickpeas, and refried beans
  • Artificial sweeteners and processed foods
  • Unhealthy fats: margarines and vegetable oils
  • Alcohol
  • Fruits 

Are there any side effects from the Ketogenic diet?

Often people notice symptoms when first starting a ketogenic diet called “the keto flu”. These symptoms of nausea, digestive discomfort, increased hunger, headaches and fatigue, typically improve after a few days. There are several suggestions that can help.  One is going a little slower with both decreasing off the carbohydrates and increasing the fats. Another suggestion is drinking more water. I also recommend adding some more minerals to your diet such as by adding Himalayan salt to your water along starting a magnesium supplement.

Are there any supplements that I should take?

As discussed above I typically recommend taking magnesium supplement. There are a couple of other ways to increase your ketone levels including adding MCT oils to your coffee or drink. Second there is a ketone salt supplement that I highly recommend which helps to keep you in a state of ketosis even when your diet is not 100% on tract.

Do you want help starting a ketogenic diet? Message me by filling out form below.

Your Name: *

Email Address: *

What interests you the most about the ketogenic lifestyle?:

Please leave this field empty.

Brain aging and memory loss due to Dementia and Alzheimer's disease with the medical icon of a group of color changing autumn fall trees in the shape of a human head losing leaves as a loss of thoughts and intelligence function.

Can Alzheimer’s disease be treated with ketones?

Brain aging and memory loss due to Dementia and Alzheimer's disease with the medical icon of a group of color changing autumn fall trees in the shape of a human head losing leaves as a loss of thoughts and intelligence function.

The brain’s main fuel source is glucose. However, it has been shown that the brains of people who have Alzheimer dementia (AD) are not able to utilize glucose as well as normal people. When there is not enough glucose to meet it’s metabolic needs, the neurons that work the hardest, i.e. those involved with memory and cognition are the first ones to be compromised and thus show impairment. So the question is: is there another fuel that the brain can use?

The answer luckily is yes! Ketone bodies (KB) or ketones are another fuel source for the brain and the body. Acetoacetate and Beta-hydroxybutrate are collectively known as ketone bodies (KB). KB are normal metabolites that are manufactured by the liver as an alternative fuel for the body and the brain when dietary sources of carbohydrates are in short supply, a process called ketosis. Ketone bodies can be produced in healthy individuals either during times of fasting or by eating a ketogenic diet. The ketogenic diet was first introduced, over 80 years ago, as a dietary treatment of uncontrolled epilepsy in children. The ketogenic diet is diet consisting of high amounts of fat and low amounts of carbohydrates. Other ways of producing ketones nutritionally are by eating high amounts of medium chain triglycerides (MCTG) such as coconut oil repetitively throughout the day.

When ketones are available they are a better fuel source for the brain in patients with AD for several reasons. First of all ketones do not need insulin for uptake into the cell, so it is easier for the brain to get this fuel source compared to glucose. This decrease usage of glucose is visible on brain PET scans, which look at the uptake of glucose. In patients with early AD, there is a 14% overall decrease in the uptake of glucose compared to normal controls. In contrast, when these same patient are placed in brain PET scans looking at the uptake of ketones, the uptake is the same both in the patients with early AD and normal controls.

Other possible theories on way ketones are a better source of fuel for patients with AD is that they are a more efficient source of energy. First of all ketones produce more energy (ATP) compared to glucose. Secondly, the mitochondria, the cells that produce the body’s energy, are believed to be impaired in patients with AD. Ketones, however, are able to bypass the blocked site of the energy pathway, the Krebs cycle, in the mitochondria. This allows the mitochondria to produce energy more efficiently when it is fueled with ketones.

There have been several published clinical studies looking at the effects of ketosis in patients with mild cognitive impairment and AD. The results have shown improved cognitive performance in patients who are in ketosis either from eating a ketogenic diet or from a diet consisting of very high dose of MCTG oils (20- 70 g/day). This improvement in memory was positively correlated the urinary ketone levels, i.e. the higher the level of ketones in the body, the better the cognitive effect.

Even more exciting than the fact that the ketogenic diet has been shown to help memory in people with AD, is that there is also evidence that being in ketosis might also have some disease modifying benefits in AD. In mouse models of AD, a ketogenic diet has been shown to actually improve the pathology associated with AD. Specifically, the mouse brains were found to have less beta- amyloid formation and less phospholated tau protein formation, the neuropathology associated with AD. Ketones have also been shown to have a neuro-protective effect on the hippocampal neurons from both glutamate and amyloid beta toxicity. The hippocampi in rats that are fed a ketogenic diet have also have an increase amount of mitochondria. The neuro-protective effect thus may result from enhanced energy reserves, which improves the ability of the neurons to resist metabolic challenges. Another possibility is that ketone metabolism as compared to glucose metabolism generates less free radicals and lower oxidative stress, thus resulting in improved antioxidant capacity, decrease CNS inflammation, and thus less cell death.

There are potentially 2 problems associated with the ketogenic diet. 1) It is very difficult to adhere to, especially in people who have dementia, who are not self motivated to stick with the diet. 2) Eating a high carbohydrate meal while on the ketogenic diet would potentially throw the person out of therapeutic ketosis and it   may take a day or two to get back in, thus taking several days before seeing any benefits again. Up until now the only other alternative to the ketogenic diet to produce therapeutic ketosis is the repetitive ingestion of high does of MCTG. The problem with it is: the doses high enough to produce therapeutic ketosis are often associated with significant GI side effects. Additionally, taste of MCTG is often difficult to swallow.

Luckily now there is a better way. There is a now a ketone supplement available to the public. This supplement, which is a proprietary blend of ketone mineral salts, puts your body into a state of therapeutic ketosis within 60 minutes of drinking it without having to be on a strict ketogenic diet.

Now, this ketone supplement is not an approved treatment by the FDA for treatment of AD or any other disease for that matter. However, I am so convinced, based on what the research suggests on what the Alzheimer’s brain needs to function at its optimal level. Along with what the potential benefits of being in the state of ketosis offers, including how it could work for the Alzheimer’s brain that I personally drink it myself and have also recommended it to my parents. Since there is no known cure for AD or proven treatment yet available, if something as simple as drinking this supplement twice a day would help with your memory would you give it a try?

Bibliography

Cunnane, S. C. (2016). Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer’s disease. Annals of the New York Academy of Sciences, 1367, 12-20.

Cunnane, S. e. (2011). Brain fuel metabolism, aging and Alzheimer’s disease. Nutrition (27), 3-20.

Gano, L. B. (2014). Ketogenic diets, mitochondria, and neurological diseases. Journal of Lipid Research, 55, 2211-2228.

Gasior, M. e. (2006). Neuroprotective and disease modifying effects of the ketogenic diet. Behavoral Pharmacology (17), 431-439.

Hashim, S. W. (2014). Ketone body therapy: from the ketogenic diet to the oral administartion of ketone ester. Journal of Lipid Research, 55, 1818-1826.

Krikorian, R. E. (2012). Dietary ketosis enhances memory in mild cognitive impairment. Neurobiology of Aging, 425 (e19).

Newport, M. T. (2015). A new way to produce hyperketonemia: Use of ketone ester in a case of Alzheimer’s disease. Alzheimer’s & Dementia, 11, 99-103.

 

The medical information on this site is provided as an information resource only. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.
fuel pump

Benefits of fueling your body with ketones

Why Ketones are a better fuel source than glucose

Where do our bodies get the energy to fuel our activities of daily living? 

Glucose is the main fuel source of our bodies, but there is another type of fuel that is available to our bodies, ketones.  Ketones are a natural by-product of fat metabolism.  When the body has run out of glucose to use as fuel it will switch fuel sources and start converting fat into fatty acids and then into ketones.  Our bodies were designed to use this duel source of energy based on how we lived in the caveman days.  In the summer and spring when food was plentiful, cavemen would eat more food and pack on the extra and store it as fat.  Then in the fall and winter when food was scarce, the cavemen would live off that extra stored fat.   Nowadays, since food supply is plentiful all year around and there is no physiological need or demand to live off the stored fat, thus we may just keep packing it on, all year around.

What are the differences between ketones and glucose as a source of energy?

Research suggests that ketones are a better, cleaner source of energy for the body and actually provide more energy than glucose.  Unlike glucose, ketones do not depend on insulin to get into the cells for use. Ketones produce less carbon dioxide and free radicals than when the body uses glucose as a fuel source thus are less toxic for our body, making it a cleaner fuel source. Unfortunately, ketones are harder energy source for our bodies to tap into since they require your body to be in either a starvation mode or at least be in a state of very low in carbohydrates.  Nowadays, the most common way of getting the body to produce ketones, or be in a state of ketosis, is by being on a very low carb diet i.e. a ketogenic diet.  Typically, a ketogenic diet consists of 5-10% carbohydrates, 20-25% protein and 65-75% fats.  As you can imagine this is not easy to achieve.

For those who do achieve ketosis, the benefits to the body and the brain are impressive.  Here are just a few of the benefits that are suggested by the research:

1) Better Brain Function

As a Neurologist this is the benefit of ketosis I have to list first.  If ketones are available, then they are the preferred fuel for the brain over glucose.  Subjectively, this means improved focus and mental cognition.  Objectively, it has been shown to improve memory in patients with Alzheimer’s dementia.  A ketogenic diet has been used for over 80 years in the treatment of difficult to control seizures.  It is also being studied in: Parkinson’s disease, ALS, traumatic brain injury, and hypoxic brain injury.  Ketosis has also been shown to be beneficial in patients with migraine headaches, ADD, PTSD and depression.

2) Better Athletic Performance

Forget carb loading, for better athletic performance.  Ketones are a better energy source for your workouts.  Ketones provides  more ATP (adenosine triphosphate) than glucose.  Subjectively, many people who achieve ketosis report feeling of increased energy levels.  Having more ATP means more energy to workout longer and harder. Objectively, several studies on endurance athletes have shown that athletes who are in ketosis are able to perform at a higher level for a longer period of time.

3) Fat Loss

When your body is in ketosis it is now literally a ‘fat burning machine’.  Without having carbohydrates/glucose around for energy, your body starts releasing stored fat, which then will be turned into ketones for energy. Thus, inches drop off faster than with a low-fat high carb diet because you are actively burning up your stored fat.  Additionally, high fat diet have a protein (muscle) sparing effect so if you are calorie restricted, your body will be protected against breakdown of skeletal muscle as a source of fuel.

4) Improved Diabetes

Diabetes is either due to a decreased insulin production (type 1 diabetes) or insulin resistance (type 2 diabetes). Insulin is required to transport glucose into the cells for use.   In type 1 diabetes, there is not enough insulin around for the amount of glucose in the body. In type 2 diabetes, the cells are ‘resistant’ to the insulin that is around, and the cells are not able to process the glucose. Since all carbohydrates we eat break down into glucose, treatment of diabetes is often focused around lowering the glucose level, thus eating a low carb diet is recommended. Studies in individuals with type 2 diabetes using either, a very low carbohydrate or a ketogenic diet have had impressive results. These studies have showed that the participants were able to decrease or completely withdrawal off of the use of insulin, along with having major weight loss in a matter of just a few weeks. Also, it has been reported that eating a high fat, ketogenic diet can also improve insulin sensitivity, meaning the insulin that is around works better.

5) Less Inflammation

One of the ketones produced by the body is beta-hydroxybutyrate, has been shown to have an anti-inflammatory effect. Reports show individuals eating a ketogenic diet have some symptomatic improvement from rheumatoid arthritis, polycystic ovary disease, migraine headaches, eczema, and other conditions caused by inflammatory processes.

If ketosis is so good for you then why isn’t everyone doing it?

Well, first of all, most mainstream nutritionists and the USDA still recommend carbohydrates as a main staple of our diet.  Second, we live in a world that is addicted to carbohydrates.  Thus, most people simply cannot adhere to the strict diet that is required to get into and stay in ketosis through nutritional adjustments of eating so few carbohydrates.

So what if there was a supplement of exogenous ketones that could put you in therapeutic ketosis within an hour, despite your diet, and allow you to potentially to tap into the above-mentioned benefits without having to be on a strict ketogenic diet?  Sounds too good to be true, doesn’t it?   Luckily, such a supplement was developed under US Department of Defense commissioned research for use in Navy Seal divers to prevent seizures that could occur in association with using high-oxygen re-breathers (oxygen toxicity).   A ketone supplement that was inspired based on that research and has been released for sale to the public.  If you would like more information about this new ketone supplement check it out.

If you would like some help starting a ketogenic diet I would be happy to help.

Your Name: *

Email Address: *

How may I help?

Please leave this field empty.

 

Bibliography

Di Lorenzo, C. e. (2015). Migraine improvement during short lasting ketogenesis: a proof-of concept study. European Journal of Neurology (22), 170–177.
D’Agostino, D. P. (2013). Therapeutic ketosis with ketone ester delays central nervous system oxygen toxicity seizures in rats. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 304, R829–R836.
Paoli, A. E. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition (67), 789-796.
Stafstrom, C. R. (2012). The Ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in Pharmacology, 3, 1-8.
Youm, Y. (2015). Ketone body β-hydroxybutyrate blocks the NLRP3 inflammasome-mediated inflammatory disease. Nature Medicine, 21 (3), 263–269.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to are not intended to diagnose prevent treat or cure any disease.
The medical information on this site is provided as an information resource only. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.