Ketogenic Diet for the Treatment and Prevention of Dementia: A Review

Abstract

Dementia (major neurocognitive disorder) is an increasingly common syndrome with a significant burden on patients, caregivers, the health-care system, and the society. The prevalence of dementia will certainly continue to grow as the US population ages. Current treatments for dementia, though, are limited. One proposed nonpharmacologic approach for the delay or prevention of dementia is the use of a ketogenic diet. The ketogenic diet was originally employed to treat refractory epilepsy and has shown promise in many neurologic diseases. It has also gained recent popularity for its weight loss effects. Several preclinical studies have confirmed a benefit of ketosis on cognition and systemic inflammation. Given the renewed emphasis on neuroinflammation as a pathogenic contributor to cognitive decline, and the decreased systemic inflammation observed with the ketogenic diet, it is plausible that this diet may delay, ameliorate, or prevent progression of cognitive decline. Several small human studies have shown benefit on cognition in dementia with a ketogenic diet intervention. Future, large controlled studies are needed to confirm this benefit; however, the ketogenic diet has shown promise in regard to delay or mitigation of symptoms of cognitive decline.

Mechanical, sensory, and consumer evaluation of ketogenic, gluten‐free breads

“…Ketogenic diets are a growing trend for both weight loss and as a means of treating diabetes (Bolla et al, 2019; Churuangsuk et al., 2018; Merrill et al., 2020; Westman et al., 2018; Yancy et al., 2019). Studies also indicate a ketogenic diet could be beneficial in treating and reducing the effect of neurological disorders, including Autism, Alzheimer's, Parkinson's disease, and as an alternative for treating/reducing seizures (Castro et al., 2015; Davis et al., 2020; Li et al, 2020).…”

“…There are multiple health benefits, as well as substantial health concerns, associated with inducing a state of ketosis, especially as an extended lifestyle option. This paper will not address all the specifics around benefits and concerns with ketogenic diets as its focus is to address properties of ketogenic bread and will, however, include a sample of additional papers which are available in the literature for further review (Davis et al., 2020; Johnston et al., 2006; Kossoff & McGrogan, 2005; Kraft & Westman, 2009; Li & Heber, 2020; O'Neill & Raggi, 2020; Ruiz Herrero et al., 2020).…”

Dysbiosis and Alzheimer’s Disease: A Role for Chronic Stress?

“…The KD (a diet rich in fat and proteins and poor in carbohydrate content) is well recognized for its antiepileptic role in pediatric epilepsy has also shown beneficial results in AD. The KD shows anti-inflammatory effects, decreases apolipoprotein E glycation, modulates neurotransmitter levels, improves mitochondrial deficits, increases insulin sensitivity, and alters the state of hypometabolism (GLUT-1 deficiency) [ 143 , 144 ] prominent in AD [ 95 ]. Many of these effects are attributed to neurotransmitter modulation, epigenetic modifications, and altered microbiota [ 145 ].…”

Ketogenic diets and the nervous system: a scoping review of neurological outcomes from nutritional ketosis in animal studies

“…Nutritional therapies that limit substrate availability and produce ketosis (such as fasting, calorie restriction and ketogenic diets) directly impact metabolism and cellular energetics (2,4) . Ketosis has been reported to be effective in neurological conditions characterised by neurodegeneration (5)(6)(7)(8)(9) , psychological disorders (10) , brain injury (6,11) and nervous system excitability (12)(13)(14)(15) . More recently, the presence of ketones has been suggested to influence pain mechanisms (16)(17)(18) .…”