Dr. Matthew Kennedy, Co-Founder & Chief Medical Officer, Neurovine
You might be familiar with the ketogenic diet, or at least heard of it, as in recent years it’s grown in popularity as a practice for fitness and weight loss. While there’s debate about how effective it is for these two goals, the reason for the buzz is that the ketogenic diet involves:
- Eating healthy fats: Provide energy for the body
- Eating high-protein foods: Essential for building and repairing muscle
- Reducing carbohydrate intake: Instead opting to get fuel from healthy fats
- Intermittent fasting: Stimulating beneficial biochemical changes found in the fasting state that also burn fat
But long before it became a fitness fad, the ketogenic diet was being studied as a treatment for brain injury. A growing body of research has been connecting our gut (and what we eat) to our brain, showing the importance of nutrition to long-term cognitive and physical health.
Research into ketogenic diets is starting to reveal the neuroprotective benefits of this nutrition-plus-fasting practice. It’s being studied and used to treat a variety of conditions affecting the brain including epilepsy, Alzheimer's, and traumatic brain injury.
What is it about the ketogenic diet that’s good for the brain? Let’s explore.
The origins of the ketogenic diet and brain health
Studies around the ketogenic diet and brain health are some of the earliest that explore the connection between nutrition and brain injury treatment.
Originally studied and developed to treat epileptic children in 1921. Ketogenic diets have been most studied in the context of pediatric epilepsy syndromes (Kossoff et al., 2009). The ketogenic diet offers the advantage of improved seizure control for some children, and in some cases, improved mental alertness with fewer medications.
What happens during ketosis?
Through intermittent fasting, the body goes into a state of ketosis: a metabolic state where the body resorts to burning fat in the absence of carbohydrates.
A few things happen in the body and brain during ketosis:
- Energy is produced from ketone bodies rather than glucose
- Anti-inflammatory processes activate
- The brain’s ischemic tolerance is improved, meaning reduced cell death
- Neurotransmitters glutamate, GABA, and adenosine are released, improving calcium levels and regulation (important to energy absorption in the cells)
- Two mitochondrial processes are active: shedding the old and generating new and healthier mitochondria
Overall, a ketogenic diet can lead to increased energy and improved cognitive function thanks to the anti-inflammatory and neuroprotective qualities of ketosis.
Read more: Insulin and the Brain: How Food Can Reduce Your Risk of Cognitive Decline
An example of what to eat and when
Combining intermittent fasting with a ketogenic diet should always be approached with the guidance of a healthcare team. Applied together, they encourage the state of ketosis—and there are flexible ways to introduce the two strategies together!
How long should I fast and when should I eat? Some people choose to cycle between a 16-hour fast, an 8-hour eating pattern. But others ease in by choosing a 12-hour fast cycle, which may feel like a more natural habit (fasting from 7 pm to 7 am for example).
During a ketogenic diet, a person can still be having three meals a day (breakfast, lunch, dinner) plus snacks.
What should I eat? In a ketogenic diet, about 60% to 80% of calories should come from fat instead of carbohydrates. Here’s an example of what a day’s meals can look like:
- Breakfast: Black coffee and scrambled eggs topped with avocado slices
- Lunch: Steak bowl with cauliflower rice, cheese, herbs, avocado, and salsa
- Dinner: Roast chicken with cream sauce and sauteed broccoli
- Snacks: Almonds, coconut chips, olives, salami, celery, and peppers with dip
What should I avoid? A ketogenic diet is all about limiting carbohydrates, so foods to avoid include:
- Bread and baked goods (wheat)
- Sweets and sugary foods
- Fruit
- Alcohol
For more brain foods, check out Dr. Matthew Kennedy’s recommendations.
CAUTIONS WHEN USING THE KETOGENIC DIET
While there are many animal studies on the brain benefits of the ketogenic diet, scientific studies on humans are limited. It’s true that fasting has a long history of use for the treatment of epilepsy (as early as 1921) and other brain conditions. But there are more human studies to do to understand the mechanisms at play and measure their benefits.
It can also be really difficult to stick to a ketogenic diet—especially in combination with intermittent fasting. It’s a very prescriptive and restrictive diet. While it’s often promoted for weight loss, there’s debate about its efficacy in that realm, even as it may benefit cognition and overall energy.
A ketogenic diet should always be explored under the guidance of healthcare practitioners and doctors for these reasons!
Since its early uses in the treatment of epilepsy, there’s been growing research and interest in the role of a ketogenic diet in potentially treating other diseases and traumatic brain injury.
The potential for its anti-inflammatory and neuroprotective benefits is truly exciting! When embarking on your journey into trying a ketogenic diet to improve brain injury symptoms, be sure to focus on nutrient-rich brain foods and follow the guidance of a medical team.
ADDITIONAL RESOURCES:
- Dr. Chris Palmer: Diet & Nutrition for Mental Health - Huberman Lab
- An Introduction to the Ketogenic Diet
- Ketogenic Diet - Nutrition and Traumatic Brain Injury
- Ketogenic Diet as a potential treatment for traumatic brain injury in mice | Scientific Reports
- Ketogenic diets likely to reduce damage from traumatic brain injury
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