Could the keto diet help treat dementia?

In 2020, the global population of individuals living with dementia surpassed 55 million. By 2050, this figure is projected to reach 139 million.

Alzheimer’s Disease stands as the most prevalent form of dementia, encompassing 60–80% of cases.

As individuals age, it is natural for neurons, or brain cells, to diminish. However, in cases of dementia, neuron loss occurs on a larger scale, leading to the shrinking of brain regions and a progressive decline in memory and cognitive abilities.

While treatments can help slow dementia progression or alleviate symptoms, none can completely halt its advancement.

Researchers are exploring various interventions, including the ketogenic diet — a high-fat, very low-carbohydrate dietary approach.

Here, we delve into the evidence supporting this diet, but first, we examine why scientists find the keto diet worthy of investigation.

Several theories exist, but we will focus on three main ones: glucose control, mitochondrial impairment, and inflammation.

The ketogenic diet and glucose control

At ZOE, we advocate for a diverse diet as the healthiest option. However, for certain individuals, the keto diet proves to be a vital lifeline.

For over a century, scientists have utilized the keto diet to aid in the treatment of epilepsy with remarkable success.

Recent studies have also demonstrated the benefits of the keto diet in helping individuals with type 2 diabetes better manage their blood sugar levels.

On the keto diet, carbohydrate intake is minimized. When the body exhausts its carb stores, the liver metabolizes fats for energy instead.

This process generates ketones from fats, which serve as an alternative energy source. With reduced sugar levels in the body, blood sugar is maintained at lower levels. How does this relate to dementia?

If you’re interested in understanding the significance of blood sugar levels even without diabetes, you may find this article informative.

Sugar and brain function

Insulin resistance characterizes prediabetes and type 2 diabetes. This condition indicates that the body does not respond efficiently to insulin, leading to challenges in sugar uptake by cells from the bloodstream.

Individuals with Alzheimer’s disease also exhibit insulin resistance, specifically within the brain. This phenomenon is termed brain insulin resistance.

Additionally, individuals with Alzheimer’s experience impaired glucose metabolism, resulting in inefficient glucose utilization by the brain.

Some experts have labeled this as “type 3 diabetes.”

While the Alzheimer’s brain struggles to utilize glucose effectively, it can still utilize ketones for energy.

The hypothesis suggests that by providing the brain with ketones as an energy source, similar to the process on a keto diet, it may counteract glucose control issues and potentially restore cognitive function.

Mitochondrial Considerations

Aside from brain glucose metabolism, the keto diet may offer benefits to individuals with dementia through another mechanism.

Individuals with Alzheimer’s exhibit diminished mitochondrial numbers in brain cells — the cellular powerhouses. Given that neurons have high energy demands, this reduction poses a challenge.

Experts believe that the decrease in mitochondria contributes to the brain cell death observed in Alzheimer’s disease.

Keto, however, may aid in enhancing the creation of new mitochondria, potentially reducing cell death rates in dementia.

Addressing Inflammation

As individuals age, inflammation levels tend to rise, a phenomenon known as inflammaging.

Recent research has linked dementia to inflammation. In contrast, evidence suggests that the keto diet possesses anti-inflammatory properties.

This presents another potential pathway through which the keto diet could help decelerate dementia progression: by mitigating dementia-related inflammation through its anti-inflammatory effects.

Considering glucose control, mitochondrial impairment, and inflammation collectively, the proposition that the keto diet might aid in dementia treatment appears plausible.

But is there substantial evidence to substantiate this claim?

Evaluating the Evidence

To date, limited studies have explored the efficacy of the keto diet as a dementia treatment. Nevertheless, some of these studies have yielded promising outcomes.

A study published in 2021 recruited 26 individuals diagnosed with Alzheimer's disease.

The researchers compared a ketogenic diet with the participants' regular diets as a control. Additionally, they provided the control group with low-fat healthy eating guidelines and optional recipes.

Each participant followed one diet for 12 weeks, returned to their usual diet for 10 weeks, and then switched to the other diet for the final 12 weeks. Thus, all participants tested both diets, with a 10-week interval in between to 'wash out.'

Key Findings

The researchers assessed the participants before, during, and after each dietary intervention.

They evaluated their cognitive function, daily functioning, and quality of life.

The researchers noted that the keto diet enhanced daily functioning more effectively than standard medications typically do. Conversely, they highlighted the inconsistent effects of standard drugs on quality of life.

According to the authors, daily functioning and quality of life hold great importance for individuals grappling with dementia.

Cognitive function did show improvement on the keto diet, although the effect was not statistically significant. This suggests that the improvement could have occurred by chance rather than due to the diet.

Only 21 out of the 26 participants completed the 12-week keto diet intervention. Nevertheless, half of those who completed the regimen expressed intentions to continue the diet.

While the results are encouraging, there are limitations to consider.

Notably, the study involved a small number of participants, and the keto intervention spanned only 12 weeks.

The researchers also noted that the keto diet resulted in weight loss, which could have influenced the outcomes.

Further studies replicating these findings are necessary before healthcare professionals can recommend the keto diet to patients.

An Alternative Approach

A significant challenge in utilizing the keto diet as a dementia treatment is adherence, as long-term compliance can be challenging.

Some researchers have sidestepped this issue by administering a drug to participants that elevates specific ketone levels without necessitating dietary changes.

For example, a study involving 152 individuals diagnosed with Alzheimer’s disease yielded intriguing results.

The study concluded that individuals who received a ketone-elevating drug scored higher on cognitive tests compared to those who received a placebo.

Additional studies have explored the viability of this approach for individuals with mild cognitive impairment (MCI), a condition marked by memory loss and diminished cognitive abilities that may progress to dementia.

While some studies have shown improvements in cognitive function, others have not, leaving the efficacy of this approach inconclusive.

Conclusive Remarks

Presently, we cannot definitively assert that the keto diet alleviates dementia symptoms. However, it remains a promising avenue worth pursuing.

This discussion underscores the intricate nature of dementia and highlights the challenges in its treatment.

While we have only scratched the surface, we have glimpsed how glucose control, mitochondria, and inflammation contribute to the debilitating manifestations of dementia.

Various other factors also play significant roles in this context.

While medications can help slow dementia progression, more interventions are urgently needed.

As research progresses, hopefully, scientists will identify dietary interventions that offer tangible benefits to individuals grappling with these conditions.

When you become a part of ZOE, our at-home testing will evaluate how your blood sugar and blood fat levels respond to different foods. Additionally, we will analyze your gut microbiota.

From this data, we can furnish personalized nutritional guidance to support you in achieving your long-term health objectives.