Alzheimer's Disease, Type 3 Diabetes, and the Ketogenic Connection
- ketogenicfasting
- Mar 25, 2023
- 7 min read
Did you know that a ketogenic lifestyle may play an important role in supporting brain health? Over the past several decades, researchers have uncovered strong links between metabolic dysfunction and neurological conditions such as Alzheimer's disease, epilepsy, depression, bipolar disorder, and dementia.
In this blog post, we're looking back at one of the most important discoveries in modern neuroscience: the recognition that Alzheimer's disease is closely associated with insulin resistance and impaired glucose metabolism within the brain. This growing body of research has led many scientists and physicians to refer to Alzheimer's disease as "Type 3 Diabetes."
Numerous peer-reviewed studies have shown that the brains of Alzheimer's patients often lose their ability to efficiently utilize glucose for energy. As a result, brain cells may become energy-starved long before significant cognitive symptoms appear. These findings have sparked tremendous interest in ketogenic nutrition because ketones can serve as an alternative fuel source for the brain. Unlike glucose, ketones may continue to provide energy even when glucose metabolism is impaired.
Let's explore what this connection means for brain health, and why ketogenic nutrition has become an important area of investigation in the fight against cognitive decline.
Could a ketogenic diet be one of the tools we've been waiting for in the fight against Alzheimer's disease?
A growing body of research suggests that ketogenic diets and ketone-producing therapies may help improve cognitive function, quality of life, and the ability to perform daily activities in some individuals living with Alzheimer's disease. Scientists believe this may be because ketones provide the brain with an alternative source of fuel when glucose metabolism becomes impaired—a hallmark of Alzheimer's disease.
Researchers have also been investigating the role of coconut oil and MCT oil, both of which can increase ketone production. Several studies have reported improvements in memory, cognition, and daily functioning among some Alzheimer's patients following ketogenic interventions or supplementation with ketone-producing fats.
While more research is needed and no formal dietary approach has yet been established to prevent or cure Alzheimer's disease, the evidence supporting ketones as an alternative brain fuel continues to grow. This exciting area of research is changing the way many scientists think about brain energy metabolism and cognitive decline.
Watch the following video to learn more about how ketones, coconut oil, and ketogenic nutrition may support brain health.
For a devastating condition with few truly effective treatment options, this emerging research could mark the beginning of a new era in Alzheimer's care. While much remains to be learned, the growing evidence supporting ketogenic therapies and ketones as an alternative brain fuel offers hope to patients, families, and researchers seeking better ways to slow cognitive decline and improve quality of life.
In this next segment of our blog post, we take a look at an article by Rebecca A. Clay that was published in 2013 by the American Psychological Association (APA), one of the nation's leading scientific organizations, representing more than 146,000 researchers, educators, clinicians, consultants, and students. Here is a link to the original publication: http://www.apa.org/monitor/2013/02/alzheimers.aspx
According to the work of neuro-pathologist Suzanne M. de la Monte, MD, of Brown University and her research team, Alzheimer's disease may be fundamentally linked to a form of diabetes affecting the brain. In fact, Dr. de la Monte and her colleagues coined the term "Type 3 Diabetes" to describe this phenomenon.
In Type 2 diabetes, the body's cells gradually lose their ability to take up glucose from the bloodstream. This can occur because the pancreas produces insufficient insulin or because cells become resistant to insulin's signals—a condition known as insulin resistance. According to Dr. de la Monte, Alzheimer's disease involves a similar process, except that the insulin resistance occurs primarily within the brain.
In a paper published in Current Alzheimer Research, Dr. de la Monte reviewed a growing body of evidence suggesting that Alzheimer's disease is fundamentally a metabolic disorder in which the brain's ability to utilize glucose and generate energy becomes impaired. In one study, she and her colleagues demonstrated that blocking insulin signaling to the brain resulted in Alzheimer's-like neurodegeneration in laboratory rats.
Even more concerning, Dr. de la Monte noted that the compound used to block insulin activity in the experiment bears similarities to nitrites commonly found in many processed foods. According to her research, high-fat diets may further exacerbate the neurodegenerative effects associated with nitrite exposure.
Dr. de la Monte also pointed out that age-adjusted trends in Alzheimer's disease and Type 2 diabetes show striking similarities. Since inherited forms of Alzheimer's account for only a minority of cases, the rapid increase in prevalence suggests that environmental and lifestyle factors may play a significant role. As she wrote, the evidence indicates that Alzheimer's disease "is a metabolic disease with virtually all of the features of diabetes mellitus, but largely confined to the brain."
These findings underscore the importance of healthy lifestyle choices, says psychologist Margaret Gatz, PhD, whose own research has identified diabetes as a significant risk factor for Alzheimer's disease.
"We know that if people observe good habits with respect to diet and exercise, it can make a difference in their risk of diabetes and, in turn, their risk of dementia," says Gatz, a professor of psychology, gerontology, and preventive medicine at the University of Southern California. "That's another reason psychologists should absolutely be encouraging good health behaviors and helping people make lifestyle changes."
While Gatz agrees with the general premise of the research, she is less enthusiastic about labeling Alzheimer's disease as "Type 3 Diabetes."
"I wouldn't want diabetes to be the only focus," says Gatz. Researchers continue to investigate numerous other factors that may influence Alzheimer's risk, including intellectual engagement, social interaction, cholesterol levels, physical activity, and other lifestyle behaviors. As Gatz explains, "We know that cholesterol, physical exercise and a panoply of other behavior changes could also affect the risk of dementia in later life."
While researchers continue to debate the terminology, there is little disagreement that brain metabolism, insulin signaling, and lifestyle choices play important roles in cognitive health. This growing understanding is one reason ketogenic nutrition has attracted so much attention among Alzheimer's researchers.
Dietary Ketosis Enhances Memory in Mild Cognitive Impairment
One particularly interesting study examined whether a very low-carbohydrate ketogenic diet could improve memory and cognitive function in older adults with mild cognitive impairment—a condition often considered a precursor to Alzheimer's disease.
Researchers randomly assigned 23 older adults to either a high-carbohydrate diet or a very low-carbohydrate diet for six weeks. At the end of the study, participants following the low-carbohydrate ketogenic diet demonstrated significantly improved verbal memory performance compared to those consuming a high-carbohydrate diet.
The ketogenic group also experienced several important metabolic improvements, including:
Reduced body weight
Smaller waist circumference
Lower fasting blood glucose levels
Lower fasting insulin levels
Perhaps most importantly, researchers found that higher ketone levels were associated with better memory performance. This finding supports the growing understanding that ketones may serve as an efficient alternative fuel source for the brain, particularly when glucose metabolism becomes impaired.
The researchers concluded that even short-term nutritional ketosis may improve memory function in older adults who are at increased risk for Alzheimer's disease. While some of the benefit may be related to improvements in insulin regulation, they suggested that other factors associated with ketosis—including reduced inflammation and enhanced brain energy metabolism—may also contribute to improved cognitive function.
Although this was a relatively small study, the findings add to a growing body of evidence suggesting that ketogenic nutrition may play an important role in supporting brain health and cognitive performance during the early stages of neurodegenerative decline.
As the researchers noted, further studies are warranted to better understand the mechanisms involved and to evaluate the long-term preventive potential of ketogenic therapies in Alzheimer's disease and related conditions.
By Robert Krikorian, Marcelle D. Shidler, Krista Dangelo, Sarah C. Couch, Stephen C. Benoit, Deborah J. Clegg; Feb. 2012 Original article published at Neurobiology of Aging: Dietary Ketosis Enhances Memory in Mild Cognitive Impairment
Final Thoughts
Taken together, these findings paint a compelling picture. While ketogenic nutrition is not a cure for Alzheimer's disease, a growing body of scientific evidence suggests that improving metabolic health and providing the brain with an alternative fuel source may offer meaningful benefits for some individuals at risk for cognitive decline. The concept of Alzheimer's disease as a metabolic disorder has opened new avenues of research and has challenged long-held assumptions about the disease.
Perhaps the most encouraging aspect of this research is that many of the factors associated with brain health—including nutrition, physical activity, blood sugar control, sleep quality, and social engagement—are within our ability to influence. As scientists continue to explore the connection between metabolism and neurodegeneration, ketogenic nutrition remains one of the most promising and widely studied approaches for supporting healthy brain function. The future of Alzheimer's prevention and treatment may ultimately involve many strategies working together, but the evidence increasingly suggests that what we put on our plates today could have a profound impact on the health of our brains tomorrow.
Thank you for taking the time to read this blog post. Our hope is that it has given you a deeper appreciation for the powerful connection between metabolic health and brain health.
While the science continues to evolve, one thing is becoming increasingly clear: the choices we make every day matter. What we eat, how we move, how well we sleep, and how we care for our metabolic health may all influence our cognitive well-being as we age.
As a chef, Chef Janine is passionate about creating delicious ketogenic meals that make healthy eating both enjoyable and sustainable. As someone who has witnessed the transformative effects of nutritional ketosis in many people's lives, she is encouraged by the growing research exploring its potential role in supporting brain health and overall wellness.
Thank you for being part of our Comfort Keto community. Chef Janine looks forward to continuing this journey of learning, discovery, and good health with you.
To your health,
Chef Janine.
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