Ketogenic diet and brain energy
An article in the current issue (May 2007) of Nature Medicine discusses the mechanism underlying the well-known anti-seizure effect of the ketogenic diet.
I found a few statements in this paper that I thought readers of this blog would find amusing.
The article starts out:
Doctors have for nearly a century prescribed a low-carbohydrate diet to help prevent seizures in people with epilepsy, but they had no idea why it works—until now.
Harvard University researchers in April reported that the strict diet—dubbed the ketogenic diet because it induces a state of ketosis, in which the body is forced to use fat for energy—may enhance the function of electrical switches in an area of the brain that controls seizures (J. Neurosci. 27, 3618–3625; 2007). With further testing, the mechanism could reveal potential drug targets, experts say.
Yep, that’s science for you. We’ve got a perfectly safe and acceptable solution to the problem in the form of the ketogenic diet, so let’s try to find a drug that will do the same thing. And cost a zillion dollars. And cause side effects. And… But, friends and neighbors, that’s how science – funded by Big Pharma – works these days.
The article continues:
The diet enhances the protective role of energy-, or ATP-, dependent potassium channels in the brain, which control the electrical firing of neurons that release the neurotransmitter gamma-aminobutyric acid (GABA) in a region of the brain called substantia nigra pars reticulata, the researchers found. Those neurons are known to be associated with seizure control, says lead investigator Gary Yellen, professor of neurobiology at Harvard.
“The diet affects multiple metabolic features,” notes Philip Schwartzkroin, a neuroscientist at the University of California, Davis. “Some are related to antiepileptic effects of the diet and some are irrelevant.”
Schwartzkroin says there are many other cells in the brain that have energy-sensitive potassium channels that might be affected by the diet. “How that might be integrated is not even discussed,” he says.
So, if we’ve got such a good tool for managing brain energetics with the ketogenic diet, tell me again why we need drugs?
Developing a drug that could replace the diet is key because the eating regimen is arduous. The diet consists entirely of fats and protein in portions that are precisely weighed and timed, and dieters must be monitored by a doctor. Cheating on the diet—such as eating a candy bar—can bring on a seizure in minutes.
The eating regimen is arduous?!?!?! Ah, tell that to the many people who have been on low-carb diets for years and feel better than they’ve ever felt. I sometimes wish that I would have a seizure within moments of cheating on my low-carb diet. It would certainly go a long way in preventing my cheating.
And, not only does the ketogenic diet work for epilepsy, but other disorders as well.
The diet is so complex, in fact, that doctors have seen benefits in people with other neurological diseases, such as Alzheimer’s and Parkinson’s diseases.
How does it work for Alzheimer’s and Parkinsons and a multitude of other disorders? You can find out this coming September when our partner’s book comes out. Dr. Larry McCleary, a noted neurosurgeon, has written a terrific book about all this that explains how a low-carb diet works to improve brain performance. By reading this book, you will be far ahead of most researchers working in the field in terms of your understanding of brain energetics and how a ketogenic diet works to help the brain function better cognitively while warding off Alzheimer’s and a host of other brain disorders.
My maternal grandfather was what is now known as a compounding pharmacist, one of the few educated people in my mother’s tiny town of 500 or so. There wasn’t always a doctor available, so people would go to him for medical help expecting some kind of chemical miracle from him. He would listen to their complaints, giving them the attention they would otherwise not get, both emotional and medical. Often, when the person was expecting to be given some medication, my grandfather would tell them, “The best medication is the one never taken,” and send them home. No placebos, no bromides.
He took the obligations of his job seriously and ethically. What a change from what happens nowadays.
Hi LC–
Your grandfather was a wise man. It’s a pity there aren’t more like him.
Cheers–
MRE
Hi Doc,
Been away for a while and finally caught up with the blog reading. My new wife and I just got married in Iceland with the honeymoon in Wales the following week and a half. Thought I’d share a few funny tales. I have to admit we both were hard core low carbers but have somewhat fallen off the wagon. I blame Wales. We and two friends booked a biking (as in cycling…with our legs) trip around the southwest coast of Wales. Sounds great, right? The trip was marketed as flat terrain with rolling hills. I think the only flat terrain in Wales are the landing strips at the airports! We biked about 30 miles a day and I swear it was all uphill. It was literally like being at the gym for 6 hours a day doing slow burn on the legs. After the first day, with each pedal we were questioning our sanity. So, what does this have to do with low carbing? Well since none of us were Lance Armstrong we were having to output twice the effort to get anywhere so when we sat down to eat it was like watching ravenous vultures. I’ve never been so hungry or drained in all my life. Now, low carbing in Wales is about as practical as a screen door on a submarine. For God’s sake, they serve “chips” with EVERYTHING! And if you’d rather not have chips you have your choice of new potatoes, mashed potatoes, garlic potatoes, string potatoes, and my new favorite term “jacket potato” (baked) or you can get a small pathetic assortment of vegetables; read carrots, peas, broccoli…always in that order. After a while the waitresses started sounding like Bubba from Forrest Gump rattling on about shrimp, except with potatoes. Now, I could have just said bring me a plate of meat, but with everything being twice as expensive as it is here we would have been broke by the end of the trip. So needless to say in order to keep the caloric intake up I’ve probably eaten a sack and a half of potatoes in the last two weeks and I’ll have to admit quit a few desserts but hey, it’s vacation right? Another thing I thought was funny was that with dessert you have your choice of another dessert. They serve nearly every dessert with your choice of sweetened cream, ice cream or custard, for free. Couldn’t turn that down either. All in all it was great fun. Now I have to break my sugar habit again!
Thanks for the great blog,
Ned
Hi Ned–
Glad to have you back. Funny story indeed. Sounds like a great honeymoon: pedaling 30 miles per day uphill while eating potatoes and double desserts. I can’t help but wonder if the 30 miles per day of uphill pedaling had any untoward effects on newlywed marital activities.
Cheers–
MRE
Dr. Eades, Thank you for keeping your eyes peeled for things like this. This supports my concept of people who low carb have a higher knowledge of what is substantially healthy for our bodies. Look at all the diseases that we avoid ( good thing cuz doctors give meds for everything ). I can get some pretty tasty low carb selections at many fast food places here. But, hey, this is CA and everyone has some kind of dietary agenda.That’s what keeps these places in business.;-) Again, thanks for the news.
Mary Titus
Hey Doc,
Few things:
1- By public good, I’m talking in economic terms, as in “consumption of the good by one individual does not reduce the amount of the good available for consumption by others; and no one can be effectively excluded from using that good.” I’m actually talking an extended definition that covers that the cost of the good is too great for any single provider to reap a reward. Like rural electrification, national defense, environmental clean up and firemen and cops. Almost by definition, government is better suited to deliver public goods than the market (I love trotting out the example of privatized fire departments of the 19th century). The debate is really whether public health is a public good or not. I’m in the camp that thinks it is. There’s a lot of room for debate, however.
2- Recently read Beppe Severgnini’s Ciao America. He’s a Italian journalist who lived in DC for a year (he’s done it in other countries as well). He sums up the “American obsessions” thusly: Control, Comfort, Competition, community and Choreography. As far as a chemical/surgery interventive health system (rather than a cheaper preventive holistic system), it appeals to Control and Comfort (and competition too). Take two pills every day for the rest of your life and continue doing everything else the way you were doing it is all about control and comfort. Making changes (even simple ones like carb restriction) is not about comfort. It’s a little about control, but it’s about self control rather than control of the universe.
Happy to be back. Catching up on the blog.
Hi Max–
As your catching up, don’t take all my rantings on gov’t employees to seriously. I was in a state over the angst I was thrust into with my daughter-in-law’s passport misadventure and the gov’t incompetence that created the situation.
Cheers–
MRE
Marital activities?! Believe me there was no energy left- mental, physical or otherwise- at the end of the day. Besides, did I mention that sitting on a bike seat for 6 grueling hours a day makes one quite sore in the “marital activity” area?! We still wouldn’t have traded it for the world though.
Cheers!
I suppose planning a honeymoon biking in Wales is a good rationale for plenty of pre-marital activities.
Cheers–
MRE
Hey Doc!
Great post as always. Ketones are also highly protective in cases of ischemic re-perfusion and hypoxia. For our Soldiers if a ketone ringer solution was used instead of a lactated ringers solution many of the fatal brain injuries could be avoided. More work from Veech and Seyfried.
Thanks, Robb–
And, according to Seyfreid, they work to treat brain cancer.
Cheers–
MRE
How about a Black Box warning on carbs?
Not a bad idea.
Doc,
No worries.
Pareto Curve is well in effect here at DOL with 80% sitting about and waiting for the great retirements. The weird thing is that just like the top 1% of earners (where 15-20% of people believe they’re in the top 1%), probably 60% of government workers think they are in the 20% that does 80% of the work. If you troll sites that appeal to government workers (GovExec.com or Fed-something-I-can’t-remember), you read a lot of comments from people who left government, tried their hand in the private sector and apparently couldn’t hack so they came back. I’m guessing they were in the 40% who are actually lousy but don’t know it.
Any rate, I have my own passport story from 2004. Sent app in with 9 weeks to go before a trip to Asia, paid the expediting fee. In three weeks (not two), I got a form asking for 10 years of personal history. That took me two-three days to put together (it was twice as difficult as my background check for a public trust position, and 50% longer than my enhanced public trust). They took 4-5 weeks turning that around. I got my passport six days before leaving for Asia, and I still had to get a visa to go to Vietnam. Remarkably, the Vietnamese embassy was able to take a passport fed exed to them on Monday and Visa it and return it from New York to St. Louis by Thursday. Remarkable thing about communist countries… when the government wants something to get done, it seems to get done (I was in Vietnam during the Bird Flu thing… you couldn’t find a chicken ANYWHERE in Ho Chi Minh city… no restaurant, no street vendor, nothing).
Any rate, you keep on knocking em, just remember there’s a useful 10% of us.
Hey Max–
I’m sure you’re in the useful 10% even though you wouldn’t have stopped for Jonathan Bell. Thanks for not being offended by my government rants.
Cheers–
MRE
Great post, Dr. Mike! Loved it!
As for Bi-polar disorder, I suffered from this horrific, torturous disorder for 13 years, on some dozen or more different medications, never being stable for more than 3 weeks at a stretch. I never stopped questioning my doctors as to WHY this couldn’t be controlled through non-drug means, always believing that I didn’t really suffer from a drug deficiency!
Very long story short, I turned my nightmare around in less than a year, on my own, when I switched from a high carb vegetarian diet to a low carb, basically PPLP diet, adding a tablespoon of cod liver oil per day, and got off every single medication. I have taken NO medications, and had NO episodes in over 9 years now, despite having dealt with a difficult menopause, as well as some very trying personal life crises.
I thank you and MD from the bottom of my heart, for showing me the path to save my health, and maybe even my life. My biggest sadness about all this is how frustrating it’s been trying to get friends and family to listen to me.
Best,
Madeline Mason
Thanks for the kind words, Madeline.
I’m glad you’ve done so well.
MRE
Ugh, just reading these posts here makes me want to shout! Wake-up people. Stop consuming poison. To quote a famous speech, “I have a dream, today”, I will not go through any disease,ache, pain or even a hangnail without low carb.
Mary
If you should drop by this blog again, I have been pondering something and I wonder what you think about my pondering? My pondering is, is it at all possible that a ketogenic diet can benfit someone with dystonia. I just can’t stop thinking about this and I have yet to find any speculating on this. I am getting Dr. McCleary’s book. I might get 2 of them because I know someone who might benefit greatly from it. But I can’t help but to wonder how this would work for dystonia. I am hoping to attend a dystonia convention I would feel more comfortable if there were something there about the healing ability fo our ketogenic diet. Dr. Eades, you’d make a great speaker at this event. I’m just sayin’.
I think you ought to write Dr. McCleary through his blog. He’s a really nice guy and would be the one who would know.
Thanks, I did write Dr. McCleary and he was very nice. He took the time to dig deep into my theory but could not any documentation on this subject. Thankfully he did suggest that this information should be taken to the acting physican or neurospecialist. I got some very positive feedback from him and I ordered his book. I received the wrong book, however ( The Brain That Changes Itself ) and will be exchanging it. Take care
Mary