Can a low carb diet help slow down Alzheimer’s disease?

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It is estimated that Alzheimer’s disease (AD) affects about 50 million of people worldwide, and dementia is currently the fourth cause of death. This global estimate is even more disconcerting when considering the early stages of Alzheimer’s disease, which leads to an estimate of 416 million of people affected worldwide, across the AD continuum, or 22% of all persons aged 50 and above (1).

Understanding how to prevent or slow down the development of Alzheimer’s disease is a critical step in taking care of our aging population. As researchers are looking for treatments and causes of AD, diet is appearing to have a significant impact on the disease. In particular, the ketogenic diet has revealed very promising effects on the cognitive abilities of patients with AD.

The ketogenic diet (KD) is a diet that severely limits carbohydrates, which in turns forces the body (and the brain) to rely on fats to produce energy. Sub-products of this metabolism are ketones, which can be measured in the blood or urine and indicate whether ketosis was actually achieved.

It is suspected that glucose transporters are altered in Alzheimer’s disease, leading to poorer brain metabolism and decreased cognitive abilities. The ketogenic diet, by providing an alternative source of energy, could provide a compensatory pathway by which the brain of AD patients could regain more functionality (2).

Several studies looked at the effects and potential benefits of the ketogenic diet on AD populations, and even though not all studies are reporting improvement, several did measure an increase in cognitive function in mild and moderate Alzheimer’s disease (2). However, the ketogenic diet can prove difficult to achieve and sustain, due to the severe restriction required in carbohydrates and the necessary increase in fats. It can even be dangerous for specific populations with abnormal fat metabolism, kidney dysfunction, osteoporosis or atherosclerosis (3). A specific type of ketogenic diet modified from Mediterranean diets supplemented with Medium Chain Triglycerides (MCT) can alleviate some of the difficulties encountered with KD (3).

Photo by Tijana Drndarski on Unsplash

Further studies are required to confirm those encouraging results and to delineate more precisely which elements of the ketogenic diet need to be present for the effects to be observed and maximized.

1: Gustavsson, A, Norton, N, Fast, T, et al. Global estimates on the number of persons across the Alzheimer’s disease continuum. Alzheimer’s Dement. 2023; 19: 658– 670.

2: Tabaie EA, Reddy AJ, Brahmbhatt H. A narrative review on the effects of a ketogenic diet on patients with Alzheimer’s disease. AIMS Public Health. 2021 Dec 22;9(1):185-193. doi: 10.3934/publichealth.2022014. PMID: 35071677; PMCID: PMC8755961.

3: Devranis P, Vassilopoulou Ε, Tsironis V, Sotiriadis PM, Chourdakis M, Aivaliotis M, Tsolaki M. Mediterranean Diet, Ketogenic Diet or MIND Diet for Aging Populations with Cognitive Decline: A Systematic Review. Life (Basel). 2023 Jan 6;13(1):173. doi: 10.3390/life13010173. PMID: 36676122; PMCID: PMC9866105.

Ketogenic diet: variations on a classic (including the Atkins diet)

Ketogenic diets pie

Ketogenic diets pie (Photo credit: Wikipedia)

The ketogenic diet is a high fat, low-carbohydrate and adequate protein diet, which was originally developed to treat epileptic individuals (see my previous posts about the use of the diet for epilepsy and the mechanisms of action of the diet). The diet produces remarkable  results on subjects suffering from intractable seizures but also revealed quite useful for a variety of other conditions, such as narcolepsy and autism and shows promises for the treatment of Alzheimer’s disease, Parkinson, Amyotrophic Lateral Sclerosis, Multiple Sclerosis, migraine headache, depression and type-2 diabetes (see my post on the use of ketogenic diet beyond epilepsy).

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The ketogenic diet: beyond epilepsy

The ketogenic diet was developed in the 1920′ as a treatment for intractable epilepsy. In more than 20% of individuals, the diet offers complete remission from seizures, and it decreases by 75% the frequency of attacks in more than half of the patients (see my previous post on the use of the ketogenic diet for epilepsy).

English: PET scan of a human brain with Alzhei...

English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)

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How does the ketogenic diet work?

English: of beta-hydroxybutyric acid. Created ...

English: of beta-hydroxybutyric acid. Created using ACD/ChemSketch 10.0, and vim. (Photo credit: Wikipedia)

The ketogenic diet is a high fat, adequate protein, low carbohydrate diet, which has been used for almost a century to treat cases of epilepsy resisting to anticonvulsant medications (see my previous post for more details). However, although its efficiency is now widely accepted, the exact mechanisms by which it operates are still not completely understood. Continue reading