Keto for Alzheimer’s dementia

To cope with extreme situations such as food scarcity, our brain can generate energy from both glucose (carbohydrates) and ketones. Two other potential energy sources available to the body’s cells—fats and proteins—are switched off in the brain to protect its delicate structures.

Glucose can cross the blood–brain barrier depending on insulin, and once inside the brain it is taken up into neurons through the insulin-independent GLUT1 transporter to be used in the mitochondria for energy production.

When a diet high in carbohydrates and sugar leads to hyperinsulinemia, cells—including brain cells—protect themselves by reducing the number of insulin-specific “locks” (downregulation of insulin receptors) to defend against excess glucose, which behaves much like a drug with a narrow therapeutic range. On one hand, glucose is an essential and necessary source of energy; on the other hand, in excess it causes glycation of vital cellular structures, making them sticky and dysfunctional. These compounds are known as AGEs (Advanced Glycation End Products).

The resulting insulin resistance of the brain leads, paradoxically, to a lack of glucose in the brain, despite excess glucose in the bloodstream, because the receptors are deactivated. This creates an energy deficit in the brain, and neurons essentially “starve at a full table.”
Due to insulin resistance, glucose is no longer available, and the brain’s backup fuel—ketone bodies—cannot be produced because elevated insulin levels block ketogenesis.

The plant-based ketogenic diet developed by Dr. Karner addresses this problem at its root. Strictly limiting carbohydrates (30–50 g per day) lowers insulin levels. Over time, cells and the blood–brain barrier respond by rebuilding more “locks” for the insulin “key” (upregulation of insulin receptors) into their membranes. Hyperinsulinemia and insulin resistance, along with all their negative consequences, can therefore be reversed. At the same time, low insulin levels allow the liver to produce ketone bodies, which can serve as an efficient energy source for all body cells, but especially for brain cells. When ketones are available, the brain will always prefer them.

The research group led by Prof. Cunnane in Canada found in several studies that the brain’s ability to produce energy from glucose decreases with age. This normal aging process is far more pronounced in individuals with Alzheimer’s disease. The ability to generate energy from ketones, however, remains equally effective throughout life. With this in mind, it makes sense to reduce carbohydrate intake in favor of healthy fats and balanced protein. We need fats and ketones to produce sufficient cellular energy and maintain cognitive clarity. Over the past ten years, we have explored and refined in detail how this works.

Transitioning from the typical carbohydrate- and sugar-rich diet to the truly healthy ketogenic nutrition approach according to Dr. Karner requires strong motivation. Direct medical supervision is essential to avoid deficiencies, and support from a positive social environment is equally important.

After many years of intensive scientific research, long-term patient care, and our own clinical experience, we know:
The effort is worth it.