Nutritionist Dr. Ed Blonz joins our expert Live Talks series to discuss the interplay between the keto diet and the brain.
As part of the Being Patient brain experts Live Talk series, our editor in chief Deborah Kan sat down with UCSF’s Dr. Ed Blonz, biochemist and nutrition researcher, to talk about how the brain may benefit from the Keto Diet — a diet rich in fat-based fuels called ketones. In the below video, we cover the following:
4:18 – Are ketones a better fuel source for the brain than glucose?
16:48 – Why diet matters for dementia risk
22:15 – Carbs, coconut oil and brain health: busting the myths
43:30 – The best diet for someone with dementia
51:45 – Concussions, ketones and dementia
What is the Keto Diet?
You’ve maybe heard of the keto diet — a diet named for the fatty acid molecules in our bodies that fuel metabolism and support muscle function. It’s high in fats, low in carbs and moderate in protein. A ketogenic breakfast, for example, might involve mixing your coffee with coconut oil, heavy cream and butter, and scrambling eggs with cream cheese, with a side of smoked salmon for protein. All these fats force your body to make and rely on the ketones that the body makes when you aren’t taking in enough carbohydrates. Ketones come from the breakdown of fat when there are not enough carbohydrates to keep the blood glucose within normal limits.
What are the potential issues with the Keto diet for Alzheimer’s?
While the keto diet can indeed provide a non-glucose source of energy for the brain, and ketones may have potential to affect the pathogenesis of Alzheimer’s disease, there are metabolic costs and nutrient sacrifices associated with this method. In other words, sticking to a ketogenic diet might provide your body with a needed alternate source of energy, but doing so could deprive the body and brain of many other essential nutrients that play a role in your overall vascular health—a key issue associated with the overall risk of Alzheimer’s disease.
The body treats ketones as a limited asset with associated risks. There are enzyme systems designed to prevent the blood level of ketones from getting too high. This can be a problem on a ketogenic diet, because the body cranks out a lot of ketones.
Ketones affect the pH (the acid-base balance) of the blood. We normally have a higher (less acid) pH, but ketones are acidic, and if present at elevated levels, they can lower blood pH, which can seriously mess with our metabolism. The condition called ketoacidosis, which occurs in out-of-control diabetes, can also occur in a poorly composed and monitored ketogenic diet, and this can be serious—even fatal.
On a biochemical level, using ketones as a source of energy for the brain does make some sense. In fact, the body relies on this alternative source of fuel when there is not food available—likely an evolutionary advantage for when the food supply is less stable.
However, a person does not need to adopt a ketogenic diet to produce ketones. In addition to messing with the body’s acid-base balance, carbohydrates get cut out of a keto diet, or down to a minimum, and this pushes many healthful foods–fruits and healthy grains—off the plate.