The Benefits of the Ketogenic Diet on People with AD
Non-communicable diseases only continue to increase across the nation. When thinking about the drastic escalation in health issues, it leaves the population questioning where these diseases are stemming from and what really is considered a non-communicable disease? A non-communicable disease cannot be contracted as they are considered a medical condition, slowly progressing over an individual’s life time, so essentially, they are lifelong.1 Furthermore, these non-communicable diseases that a given person may develop tend to be due to genetics, physiological, environmental, and behavior matters.2 Non-communicable diseases account for many deaths around the world. According to World Health Organization, 41 million deaths occur each year due to non-communicable diseases.2 This is comparable to 71% of total deaths worldwide.2 This is a very high percentage of deaths that occur around the world due to diseases that tend to alarm people because of their long-lasting effects. With the increasing rates of non-communicable diseases, many people are probably questioning who is most at risk. While anyone can develop a non-communicable disease, there have been reports that show people between the ages of thirty and sixty-nine years old accounting for 15 million deaths, while research portrays at least 85% of these deaths will appear in lower to middle-income countries.2 While cardiovascular disease, chronic respiratory disease, diabetes, and cancer are four of the more common non-communicable diseases, Alzheimer’s disease is also considered a non-communicable disease.3 Alzheimer’s Disease is a very alarming sickness as many people who develop Alzheimer’s have to accept that they will eventually lose function in their brain. According to Alzheimer’s Society, Alzheimer’s Disease is frequently what leads individuals to developing dementia.4. Symptoms of Alzheimer’s disease are typically the same across all individuals, but symptoms may still vary. Main symptoms include memory loss, communication difficulties, difficulties staying on task and processing, and perception issues.4. There are many different factors that put someone at risk of developing Alzheimer’s Disease. Some include age, gender, genetics, and lifestyle habits.4 Health and lifestyle habits may be one of the most important to consider when discussing those who are at risk of developing Alzheimer’s Disease. It had been proven that other health issues including diabetes, heart difficulties, stroke, high blood pressure, and obesity escalate an individual’s chance of developing Alzheimer’s Disease.4. Although someone cannot control their age, gender, or genetic inheritance, they are given the opportunity to choose healthy diets and lifestyles. Following a diet regimen such as the ketogenic diet can help positively increase memory, attentiveness, and brain function among an individual with Alzheimer’s Disease.
Choosing to follow healthy lifestyle choices is crucial to a given individual’s overall health. There are many different nutrients that make up a healthy, nutrient-filled, diet on a daily basis. Some foods that are healthy for one’s diet may include vegetables, fruits, lean pieces of meat, and whole grains. All of these may serve as a nutritional value to someone’s health, but it is also important to consider what an average consumption of these food products entail. One important food to be aware of are carbohydrates. Yes, carbohydrates may give off flavor to certain foods, but consuming excess amounts of carbohydrates may not necessarily be beneficial to one’s health. One study had shown links between excess carbohydrate intake and early onset of mild cognitive impairment, which can lead to Alzheimer’s Disease.5 According to USA Today, elderly people are four times more likely to develop mild cognitive impairment through excess consumption of carbohydrates.5 The study mentioned by USA Today also exposed participants who followed a healthier high-fat diet and resulted in reduced risks of developing cognitive impairment by 42%.5 Furthermore, participants who followed leaner protein diets which included chicken, fish, and meat, also revealed reduced risks of developing cognitive impairment by 21%.5 These rates demonstrate the importance of the ketogenic diet on reducing the development of Alzheimer’s Disease in individuals worldwide because of the diet’s low carbohydrate intake.
The ketogenic diet is most known for its low carbohydrate intake, while increasing consumption of healthy fats in order to use these healthy fats as a source of energy to fuel the body.6 Energy has been shown to help protect the brain against many diseases. It has been proven that by following a diet such as the ketogenic diet, increases in mitochondria are seen within the brain, that helps fuel energy.7 Scientific American also discussed a recent study that found increased numbers of mitochondrial enzymes in the hippocampus, which in the brain, is responsible for learning and memory.7 Furthermore, class types that cause neuronal stress in the brain, “oxidants,” can eventually lead to aging, strokes, and neurodegeneration, but the ketogenic diet may as well, be able to prevent these oxidants.7 Scientific American briefly discussed the result of a ketogenic study that administered a ketogenic pill and a placebo to 152 participants with mild-to moderate Alzheimer’s Disease. After ninety days, while following a standard diet, participants taking the ketogenic pill had shown cognitive improvement.7 Although there aren’t an abundant number of studies to back up this testament, there has been evidence to depict the positive effects that the ketogenic diet may have on patients with Alzheimer’s Disease and mild cognitive impairment overall.
There is much hope for the world of Alzheimer’s Disease. Although it is a very alarming and lifelong disease that can lead to death, the studies that have been done show the courage and benefits that the ketogenic diet can potentially bring to an individual living with this disease. There was one study conducted that was posted in Science Direct. The study focused on a 57-year old female suffering from mild cognitive impairment and metabolic syndrome, while mild cognitive impairment is known to lead to Alzheimer’s Disease.8 The study was conducted over a 12-week period and over this time period, the patient followed a ketogenic diet, while also participating in high-intensity training. Her memory progression was tracked through the PEAK brain app. Montreal Cognitive Assessment was utilized before and after the study to evaluate the patient’s overall memory. Once the results were tracked, it had shown that ketosis had been met early on into the 12-week program. According to Science Direct, average ketosis levels are between 0.5-2.0 mg/dL, while the patient’s ketosis level rose to 1.1 mg/dL.8 This was a result of low carbohydrate intake during the 12-week program. The patient’s triglycerides had also decreased by almost half percent during the first few weeks of the program as well.8 It is important to track your triglycerides levels because often. For instance, it was noted that the patient suffered from metabolic syndrome. Metabolic syndrome typically causes high triglycerides due to the conditions rising blood pressure, cholesterol, and blood sugar levels.9 Lastly, it was noted that the patient’s Montreal Cognitive Assessment scores increased significantly. At the baseline phase, the patient’s score remained at 22/30, while the normal range is a score between 26-30, the patient’s score by the end of the 12-weeks had reached 30/30.8 The intention of the Montreal Cognitive Assessment is to evaluate attention, concentration, executive functions, memory, language, visuoconstructional skills, conceptual evaluations, and orientation among patients with mild cognitive dysfunction.10 According to the patients scores by the end of the 12-week program, it is clear that following a ketogenic diet, while incorporating high intensity workouts, increased these domains tremendously. The patient’s PEAK brain training scores also increased substantially. According to the results, problem solving increased 114%, focus increased 115%, memory increased 27%, mental agility increased 105%, and language increased 30%.8 Although this patient had not yet been diagnosed with early-onset Alzheimer’s Disease, there is a very high chance that because of her mild cognitive dysfunction, she could develop it at some point. This study proves the possibilities that the ketogenic can pose on a given individual with cognitive impairments. Furthermore, scores that assessed brain function increased drastically. The patients scores by the end of the 12-week program had almost doubled her scores at the baseline phase. According to Science Direct, ketone bodies, which occur during ketosis, have been proven to help supply mitochondrial enzymes, cerebral energy, and increase neuronal growth.8 The only limitation of the study included a small population and suggests that male figures are incorporated in future studies.8 This study shows the overall benefits that the ketogenic diet could have on preventing early onset-Alzheimer’s Disease among patients already suffering from mild cognitive impairment.
According to The Charlie Foundation, among the research that has been conducted regarding Alzheimer’s Disease, much has disclosed the effects that diet has on overall brain function.11 While there is currently no cure for Alzheimer’s Disease, there are still options such as diet and physical health that can overall help reduce many of the side effects of the disease. There have been many studies that have shown the beneficial effects that the ketogenic diet has on people with epilepsy. Considerable amount of research indicates the connection between neurological disorders and it is believed that certain dietary treatments, such as the ketogenic diet, could help people with Alzheimer’s Disease as they frequently suffer from seizures as well.11 Medium-chain triglycerides have also shown to have positive effects on people with neurological conditions. According to Medical News Today, medium-chain triglycerides are found in specific oils and dairy products in the form of fats.12 There is research regarding the effects of medium-chain triglyceride oils on people who want to lose weight or add overall energy to their daily habits. What is important to know about medium-chain triglycerides is that they are ultimately converted into ketones as a source of energy.12 As stated previously, evidence has shown the positive effects that ketones have on a person living with Alzheimer’s Disease fueling the brain with energy. Mary Newport, a neonatologist, issued a review in 2010, based on sixty people living with dementia. These patients were all distributed medium-chain triglycerides. By the end of the study, at least one region of memory, cognition, social interaction, speech, continuation of previous activities, sleep, appetite, and vision had improved, as reported by 90% of patient caregivers.11
There has been a lot of controversy over whether or not the ketogenic diet can serve as a prevention or temporary relief for side effects of the disease. A study done through the University of Kansas helped prove that more research and studies must be done in regards to whether or not the ketogenic diet serves as a beneficial diet plan for people with Alzheimer’s Disease. The study was named the Ketogenic Diet Retention and Feasibility Trial. The study posed three questions that the research and trials would focus on. Can the ketogenic diet be followed by someone already living with Alzheimer’s Disease, is it safe for people with Alzheimer’s Disease to follow the ketogenic diet, and can the ketogenic diet positively increase memory and cognition for people living with Alzheimer’s Disease?13 The study took place over a 4-month period and fifteen patients with mild to moderate Alzheimer’s disease participated.13 Their diets would be monitored and adjusted in the form of a ketogenic diet where they reduced their carbohydrate intake and increased their protein and fat intake. Multi-chain triglyceride oil supplements were also provided daily, in the form of a fat, eventually produced into ketones.13 Each participant took a cognitive test before the study, three months into the study, and during the last month of the study, the fourth month. The cognitive tests utilized were the Mini-Mental Status Examination and the Alzheimer’s Disease Assessment Scale-cognitive subscale.13 As the results came in, it was noted that ten out of the fifteen participants, with the help of a caregiver, were able to complete the four-month ketogenic diet.13 Cognitive tests improved enough to confirm more beneficial than Alzheimer’s medication according to Psychology Today.13 Although cognitive tests improved, blood ketone levels improved, but immediately decreased once the three-month mark it. Before the study, an average blood ketone level would be 0.11 mmol/L, while a month into the diet the blood ketone levels rose to 0.52 mmol/L, but by the third month decreased down to 0.31 mmol/L.13 The study further explained that once participants began following their original diets again upon completion of the study, the cognitive improvements faded.13 Although this study illustrated cognitive improvements in patients with Alzheimer’s disease, the sample size was too small. There also wasn’t any evidence that suggested other factors contributed to the cognitive improvements. For example, attention from caregiver or participation in something more fun and exciting than a normal day for these patients could have also contributed to cognitive improvements.13 Lastly, the ketone levels were always varying from patient to patient during the four-month trial, while researchers were not familiar with specific foods they were fed on the ketogenic diet, which could have also effected their insulin and ketone levels.13 Needless to say, this study proves that more research and trials must be completed regarding the idea that the ketogenic diet can ultimately benefit someone living with Alzheimer’s Disease.
It is clear that there is hope for people living with Alzheimer’s Disease through the ketogenic diet. Through studies, it has been shown that the ketogenic diet can positively increase cognitive levels in patients. Through the enhancement of mitochondrial enzymes in the brain, the ketogenic diet may benefit an individual living with Alzheimer’s Disease by providing energy to the brain. More studies must be completed though, in order to determine the full effects of the ketogenic diet on people with Alzheimer’s Disease. Many of the studies completed have been smaller trial studies, whereas larger studies need to be done with bigger sample sizes. As noted in the Kansas City trial, it is also important for researchers to identify whether foods given to patients in future studies are natural or processed foods. In the Kansas City study, researchers were also unaware if whether or not dairy and sugar alternates were supplied to the patients, which is important because these food products could have also affected patient insulin and ketone levels.13 Needless to say, knowing exactly what patients are given is important when evaluating whether or not the ketogenic diet is beneficial. Even further, future studies should research more into why participants return back to normal baseline states of decreased cognitive impairments once trials are completed. Instead, future research should be recognizing and continuing to develop ways that after trial periods, patients remain in ketosis and continue benefiting from the effects of the ketogenic diet. According to Gasior et al.14 through further research of the ketogenic diet’s effects on people with Alzheimer’s Disease, it will provide further opportunities to develop different therapeutic approaches that involve ketogenic patterns so patients will not always have to follow the strategic diet plan. As future studies are conducted, it is crucial to monitor ketosis levels in patients, levels of cognitive brain function, and how well patients react to following a deliberate diet regimen on a daily basis.