Brain Health: Ketogenic Diet

Interest has exploded in medical and research communities in the potential benefits for brain health and mental health that might be achieved by following a ketogenic pattern of eating.

This got its start with a resurgence in the use of the ketogenic diet and related dietary treatments for epilepsy, particularly in children, in the 1990s. Once awareness spread of the tremendous therapeutic benefits of ketogenic diets for kids dealing with uncontrolled epilepsy, there has been no turning back. Over the past 3 decades, therapeutic ketogenic diet treatment teams have spread from being present in just a handful of hospitals to being a feature of basically every major hospital that provides paediatric neurology care. Research has also shown its benefits for adults living with epilepsy.

One of the major changes in understanding that has increased the focus on ketogenic diets is the realization that the extremely strict and very difficult classic ketogenic diets of decades ago are not the only effective versions. Today, ketogenic diets and similar therapeutic diets are much more user-friendly. Many people choose to follow a ketogenic way of eating over years, for many reasons, and enjoy varied and very delicious meals. There are countless cookbooks, blogs, podcasts devoted to the growing interest in ketogenic living.

There also is a bottomless pit of confusion that swirls online as people pass around and opine on half-understood concepts and factual errors.

One sources of confusion that can really interfere with people’s best decisions is simply a difference in use of terminology between that used in the paediatric neurology field and the way the rest of us use the same terms. For decades, the only people talking about ketogenic diets were those in the paediatric neurology community – regarding its use for treatment-resistant epilepsy in kids. They were communicating among themselves about a detailed and exacting specific diet protocol that they all understood. So simply using the term “ketogenic diet” worked for them. When they say this, they mean the whole detailed protocol, not just whether ketones are produced or not.

The thing is, there are many other versions of diet intake patterns that will also result in a person being in ketosis. For example, to the paediatric neurologists, their protocol called “Modified Atkins” (again a protocol that is much more detailed and specified that the term suggests) is not included in what they call a “ketogenic diet” even though (as long as it is not high protein) it is, in fact, ketogenic and most everyone else would call it a ketogenic diet.

The main harms of this confusion are two:

  • the “classic ketogenic diet” was extremely restricted and extremely demanding. When people see mention of “ketogenic diets” as being extremely arduous or basically impractical to implement, this falsely colours the perception of the sort of ketogenic diets widely used now by many people happily over years or decades.
  • the “classic ketogenic diet” is so restrictive that it is marginal in nutritional quality. Historically, it was also tightly controlled for calories to the point of growth restriction for the kids and also in the past for restricted in fluids. Keep in mind that the children being treated with the diet protocols had no other means of controlling their seizures and those aspects of the diet were the best understanding at the time of how to keep the kids as well as possible under difficult circumstances. When research reports difficulties and side-effects of such extreme diet protocols, generally they simply use the term “ketogenic diet”. Again, among themselves they are using a common language, but endlessly this is misunderstood when others outside the epilepsy treatment field read these research reports or case reports and think these kind of harms or side effects should be common or expected in the sort of ketogenic diets in wide use today.

In medical and research communities, interest has turned to the potential benefits of ketogenic diets in other neurological conditions. This is now a very active area of research. Researchers are taking this topic very seriously in these and other conditions related to brain health:

  • Alzheimer’s Disease
  • Parkinson’s Disease
  • recovery from brain injury
  • migraine headache
  • cluster headache

In this video, Dr. Jong Rho, MD of Alberta Children’s Hospital discusses the research, mechanisms and potential promise of ketogenic diets in health.

 

For an example of the sort of research that is being done and why – the video below is about the neuroprotective effects of ketosis and how this may be beneficial in brain trauma. (spring 2016)

From the video description:

“I will discuss the theoretical and known neuroprotective mechanisms of the ketogenic diet and ketone bodies in the nervous system.

Briefly these mechanisms include

  • replenishing neuronal energy stores,
  • lowering reactive oxygen species,
  • increasing antioxidant and anti-inflammatory pathways,
  • and decreasing apoptosis.”

If you want to go straight to the exciting part, start at 24 minutes. (If you do that, perhaps go back and catch up on the rest later.) This presentation is very technical, so if you give it a try and don’t enjoy it, maybe skip it and go to Dr. Phinney’s presentations below.

You might be interested to know that UBC is one of the research centres where the potential benefit of ketogenic diets in the treatment of brain trauma is being explored.

 

 

These two videos are an excellent over-view of low carb and ketogenic diets. Dr. Stephen Phinney is one of the most experienced and knowledgable practitioners and researchers on these topics in the context of general application not epilepsy. Recorded fall 2016.

From the video description: “Dr. Phinney is a physician-scientist who has spent 35 years studying diet, exercise, fatty acids, and inflammation. He has published over 70 papers and several patents. He received his MD from Stanford University, his PhD in Nutritional Biochemistry from MIT, and post-doctoral training at the University of Vermont and Harvard.”

 

 

Resources:

Charlie Foundation  charliefoundation.org

Matthews Friends  matthewsfriends.org

Article: How Changing My Diet Has Dramatically Helped with My Migraines  LINK

Virta Health (mentioned by Dr. Phinney)   virtahealth.com

 

Food and Recipes:

A basic intro to changing to a low carb or ketogenic diet – foods and meal examples and recipes:  Diet Doctor  dietdoctor.com/low-carb

Low Carb Yum  lowcarbyum.com

Low Carb Maven  lowcarbmaven.com

Google any old type of food you are thinking of – and put low carb in the search. For example: low carb Mexican or low carb pizza or low carb pumpkin muffins or low carb waffles or whatever. There are countless recipe sites and books. Just be careful of the guidance info or diet/health advice they give – may be great or misleading.

See elsewhere on this site for more info and resources.