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KetoNutrition: From Science to Emerging Applications and Practical Implementation

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I had the pleasure of hearing Dominic D’Agostino, NASA crew member, researcher and Associate Professor at the University of South Florida present on “KetoNutrition: From Science to Emerging Applications and Practical Implementation” at the 6th BioCeuticals Research Symposium in Melbourne last weekend. His presentation was based on decades of evidence that supports the anticonvulsant and neuroprotective properties of nutritional ketosis. It was one of my favorite presentations and I’m thrilled to share some of the highlights with you here.

Ketones are alternative fuels and neuroprotective signaling metabolites – increasing longevity, lowering inflammation, dampening oxidative stress, lowering glutamate and raising GABA.

In this slide he shared how the proven applications of nutritional ketosis are extensive – including epilepsy, type 2 diabetes, weight loss, NAFLD, mitochondrial disease and inflammation, GLUTID Syndrome, PDH Deficiency, Lennox-Gastaut Syndrome, Dravet Syndrome and Rett Syndrome.

There is emerging evidence for acne, PCOS, exercise performance, wound healing, longevity, cancer, CNS Oxygen Toxicity, autism, Angelman’s Syndrome, ALS, MS, Neuropathies, Alzheimer’s disease, brain injury, neurodegeneration, anxiety, depression, bipolar and schizoaffective disorder.

Seizures, cancer and the ketogenic diet

 

In his TEDx talk from 2013 Dr. D’Agostino shares the benefits of a ketogenic diet for seizures and how while studying the effects of gasses on the brains of Navy Seal divers, he developed an approach for metabolically starving cancer cells through diet and compressed oxygen, replacing chemotherapy, surgery, or radiation.

He ends by saying this:

Future treatments and prevention of many diseases may fall back on the ancient wisdom of Hippocrates when he said “let food be thy medicine”

As you can see from the applications slide above, much more research has been done on the therapeutic benefits of a ketogenic diet since this 2013 TEDx talk.  And food truly is medicine!

In one of his studies, the first paper above, ketone supplementation was found to have an anti-anxiety effect – Exogenous Ketone Supplements Reduce Anxiety-Related Behavior in Sprague-Dawley and Wistar Albino Glaxo/Rijswijk Rats:

We conclude that ketone supplementation may represent a promising anxiolytic strategy through a novel means of inducing nutritional ketosis.

Adenosine and the adenosinergic mechanism

He shared a number of studies that describe how the anti-anxiety and anti-convulsant effects of ketone supplementation are mediated, in part, through the adenosinergic mechanism. This was one of his papers – Anxiolytic Effect of Exogenous Ketone Supplementation Is Abolished by Adenosine A1 Receptor Inhibition in Wistar Albino Glaxo/Rijswijk Rats.

Adenosine is a neurochemical which many coffee-drinkers may be familiar with since: “Caffeine increases wakefulness [and often anxiety] by antagonizing adenosine receptors, and adenosine itself promotes sleepiness” and a feeling of calm.

Older research finds that there is the “involvement of adenosinergic receptor system in anxiety related behaviours.” More recent research describes adenosine as “a mediator with multisystemic effects”, and it is produced by almost all cells, playing a role in heart function, sleep, bone health, activation of the immune system and mediating the effect of various hormones. I expect we’ll be hearing a great deal more about adenosine in relation to ketogenic diets in the near future.

The microbiomes of astronauts sync up and so do their serotonin levels

This was one of my favorite presentations at the BioCeuticals Symposium and it was really great to meet Dominic afterwards and learn more about future anxiety research. He shared that his lab has planned research on the benefits of ketosis for both anxiety and improved cognitive function.

It was also fascinating learning from someone who has been in space and hearing how the microbiomes of the astronauts sync up when they are all in space together. And so do their serotonin levels.

If the ketogenic diet is new for you or you want to see the latest research, check out Dominic’s work at Keto Nutrition. And if you want to learn more from Dominic and other keto experts, the Keto Edge Summit runs all of next week.

I also write about two schizoaffective case studies here and share questions and concerns I have about the ketogenic diet. It’s not a panacea for everyone in all instances. But the therapeutic benefits are profound when someone needs to adopt this dietary approach.

Feel free to ask questions and share you experiences with a ketogenic diet – in the comments below.

The ketogenic diet for mental health, weight loss, inflammation and disease prevention

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I wasn’t aware until recently that “KETO”, “Ketones” “Keto diet”, “Ketogenic lifestyle”, “Ketosis” and “Ketogenic diet” are some of the MOST SEARCHED terms on the internet today.

But there is a good reason for this and host of  The Keto Edge Summit (which runs from May 7-13, 2018), Dr. David Jockers shares this:

The goal of the ketogenic lifestyle is to adapt the body to utilize FAT as its primary fuel source instead of SUGAR.

For our ancestors, eating three meals a day just wasn’t a thing. Instead, they’d hunt and forage for the foods they could find. When there wasn’t food, they wouldn’t eat.

Sometimes they’d go for days without food. To sustain life during times of scarcity, the body is thought to have developed the ability to utilize fat as an alternative fuel source.

Today, there’s an abundance of food available to most of us at all times. We regularly eat three meals per day with intermittent snacking between them.

This kind of frequent eating, along with an overemphasis on carb-rich and sugary foods, causes a REDUCED ability to burn fat. Because we don’t have to hunt or forage for food; we’ve become “sugar burners.”

As these sugar-laden foods damage our bodies, we rely MORE on sugar and lose the ability to produce ketones – as a result, massive blood sugar spikes, inflammation, hormone imbalance and ultimately many of the chronic diseases that plague us today.

In a traditional nutrition course, you’d learn that sugar is the body’s PRIMARY fuel source, while fat is secondary. What we’ve learned now (and so much research is supporting this) fat can be a healthier and more sustainable source of energy.

Ketones help you burn fat for energy, powerfully reduce inflammation and show promise in preventing and eradicating diabetes, cancer, autoimmune and neurodegenerative diseases like Alzheimer’s and Parkinson’s, and they can even play a role in alleviating symptoms in mental health conditions like anxiety, depression and schizoaffective disorder.

One of the amazing speakers on the summit is Dominic D’Agostino, researcher and Associate Professor at the University of South Florida. I attended the Bioceuticals conference in Melbourne this past weekend and had the pleasure of hearing him present on this topic live and all I can say is wow! I don’t want you to miss out and now you don’t have to when you tune in via the Keto Edge Summit.

Here is one of the slides where he shares the many proven and emerging applications of nutritional ketosis:

The applications of nutritional ketosis are extensive – including epilepsy, type 2 diabetes, weight loss, NAFLD, mitochondrial disease and inflammation, with emerging evidence for acne, PCOS, wound healing, cancer, autism, ALS, MS, Alzheimer’s, the brain and anxiety.

(anxiety and depression fall under brain on the right and also under inflammatory disorders on the left)

I shared these case studies a few weeks ago in a blog post – Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss. Two schizoaffective patients working with Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss:

  • After four weeks on the ketogenic diet, the female patient had resolution of her delusions and lost ten pounds.
  • The male patient experienced similar results with “dramatic” reductions in auditory hallucinations and delusions, as well as better mood and energy. He also lost weight, losing 104 pounds over the course of a year.

There is also research reporting the following results:

the patient’s behavior and intellect improved in regard to hyperactivity, attention span, abnormal reactions to visual and auditory stimuli, usage of objects, adaptability to changes, communication skills, fear, anxiety, and emotional reactions

ketone supplementation may represent a promising anxiolytic strategy through a novel means of inducing nutritional ketosis.

As Dr. Jockers states:

The GREATEST health discovery of this century may ALREADY be inside your body!

During this health summit, you’ll discover:

  • What is ketosis (and how does it work)?
  • Myths, and how to separate fact from fiction!
  • How to overcome the challenges of being “keto adapted.”
  • Whether you should start a keto diet (or not!).
  • How to shop, live and eat on a ketogenic lifestyle.

The Keto Edge Summit is online and available at no-cost from May 7-13, 2018! Register here

I will be in learning mode with you for the Keto Edge Summit. I’ve been following Dr. David Jockers for awhile and I’m very excited about the applications of a ketogenic diet for anxiety and depression, given what we’ve learned so far. It’s going to be a great educational opportunity for all of us.

Have you experienced benefits from a ketogenic diet? If yes please do share what benefits?

If you’ve had challenges being on a ketogenic diet please share those challenges too, so we can all learn.

Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss

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Two schizoaffective patients of Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss. As well as losing weight, they experienced reductions in auditory hallucinations and delusions, had a better mood and had more energy.

Here is additional information about these remarkable results, published late last year in this letter to the editor – Ketogenic diet in the treatment of schizoaffective disorder: Two case studies.

The male patient: lost weight, reductions in auditory hallucinations and delusions, better mood and energy

The male patient, diagnosed with schizoaffective disorder, with a prior psychiatric history of attention deficit hyperactivity disorder and major depression, experienced “dramatic” reductions in auditory hallucinations and delusions, as well as better mood and energy on the ketogenic diet. He also lost weight, losing 104 pounds over the course of a year.

He weighed 322 lb and wanted to lose weight by following a ketogenic diet, typically consisting of coffee with medium chain triglyceride (MCT) oil and butter (“bulletproof coffee”), eggs, meat, fish, poultry, spinach, kale, and olive oil. Within 3 weeks, he had lost 15 lb, but also noted a dramatic reduction in his auditory hallucinations and delusions, and improvement in his mood, energy, and ability to concentrate. For the past year, he has largely remained on this ketogenic diet and has lost 104 lb.

His functioning has improved and he has become more independent:

He completed a certification course, successfully participates in an online college program, has friends, began dating, and moved from his father’s home into an independent apartment.

The female patient: lost weight, resolution of her delusions

After four weeks on the ketogenic diet, the female patient, also diagnosed with schizoaffective disorder, and with a prior psychiatric history of major depression and anorexia nervosa, had resolution of her delusions and lost ten pounds:

she wanted to lose weight, and went on a ketogenic diet, consisting mostly of coffee, eggs, poultry, and lettuce. Within 4 weeks, she lost 10 lb and noted that her delusions were no longer present, and that her mood and energy were much better. After 4 months, she lost a total of 30 lb and her PANSS score decreased to 70 [down from 107]

In both instances their symptoms returned when they stopped the diet, but then improved again when back on the ketogenic diet.

In case you’re not familiar with the ketogenic diet here is a quick summary:

The ketogenic diet is a high-fat / low carbohydrate [and low protein] diet that has been used since the 1920’s to treat childhood epilepsy, with some studies suggesting that over 50% of patients experience significant reductions in seizure frequency. The ketogenic diet results in ketone bodies, instead of glucose, being used as the primary energy source in the brain.

There simply is no psychiatric medication available with the power to accomplish these results

I had the pleasure of meeting Dr. Georgia Ede, MD  last year at the ISNPR conference. She is a Harvard-trained psychiatrist and nutrition consultant practicing at Smith College, and writes about these two schizoaffective cases in her article – Low-Carbohydrate Diet Superior to Antipsychotic Medications:

These outcomes are truly remarkable: improvement by dozens of points on the PANSS, significant weight loss, and better quality of life. There simply is no psychiatric medication available with the power to accomplish these results.

I agree with Dr. Ede especially when we look at the medications these patients had trialed. These medication trials for the male patient: methylphenidate, amphetamine salts, dextroamphetamine, bupropion, sertraline, paroxetine, buspirone, lamotrigine, lorazepam, clonazepam, gabapentin, haloperidol, perphenazine, aripiprazole, olanzapine, quetiapine, and clozapine. The female patient had a similarly long list of medication trials and she also received 23 electroconvulsive therapy treatments. For both of them, positive and negative symptoms persisted.

I do still have questions about the ketogenic diet

The research in epilepsy is extensive and the research in mental health is growing. I am really impressed with the results, but I do still have questions about the ketogenic diet. Perhaps you have some similar questions and concerns. Here goes…

  1. If this particular nutritional psychiatry approach works so well for severe mental health disorders such as schizophrenia and psychosis, how will it work for less severe conditions like anxiety and panic attacks? Are these severe cases like the “canaries in the coal-mine” paving the way and teaching us about the benefits of this way of eating?
  2. Should you use a ketogenic dietary approach as the first approach or consider it as a last resort once the other dietary approaches have been implemented and you’re not seeing full symptom resolution? In other words, should you start with a real whole foods diet, then implement a gluten-free diet, then a grain-free diet, then remove dairy (if it’s an issue), then incorporate low FODMAPs if needed and only then implement a ketogenic diet? (low oxalate, low salicylate and low histamine would be incorporated as needed earlier in the process, based on each person’s unique needs).  If we look only at schizoaffective disorder,  there is growing evidence of the role of gluten  in some individuals with this paper “suggesting that an antigliadin IgG positive population of schizophrenia could be a distinct subgroup.” This 2 person pilot study reports the benefits of a gluten-free diet: “this potential mechanism is exciting and may provide improvement for up to one-fourth of patients (antibody-positive) who suffer from this devastating disorder.”
  3. How do we clearly define a ketogenic diet and communicate this definition to practitioners and to those who choose to implement this way of eating on their own? I’ve had feedback from many people who tell me they have been on a ketogenic diet (and it’s worked well for them or maybe it hasn’t worked so well for them), only to discover they are not really eating a true ketogenic diet. How do we simplify this way of eating and make it easy for individuals to understand and then stay in ketosis?
  4. How do we create a ketogenic diet that is nutrient dense and also offers the benefits seen in this research. I have major concerns about long-term nutritional deficiencies with a diet of coffee, eggs, poultry, and lettuce (as eaten by the female patient in this case study). It should ideally include plenty of leafy greens, non-starchy vegetables like broccoli, cauliflower, asparagus etc. and healthy fats like avocado, grass-fed butter and coconut oil, together with fermented vegetables and bone broths. I’m also not convinced that coffee should be part of the ketogenic diet, especially if coffee increases your anxiety and affects your sleep.

  1. How do we help individuals make the switch to this way of low carb eating and help them maintain so they don’t feel deprived and are not relying on willpower alone? As you can see from these 2 cases, the diet can be challenging to sustain and slip ups are common. If you are eating enough health fats (and it’s a lot more than you’re used to eating), this typically helps with cravings. If you still have cravings and feel you are deprived and missing out on treats, the targeted individual amino acids offer powerful results: tryptophan (for afternoon cravings), GABA (for stress eating), DPA (for comfort eating), tyrosine (when there is low motivation) and glutamine (for low blood sugar cravings).
  2. Is the ketogenic diet the next big fad or weight-loss trend as we’re hearing in the media? Based on the above research it truly does have impressive therapeutic benefits beyond only weight-loss. So can we see similar benefits with a modified ketogenic diet, using intermittent fasting and/or cycling in and out of ketosis, and even adding in a ‘feasting day’ of carbs?
  3. Who shouldn’t adopt a ketogenic diet? For example: those with the APOE4 gene, women with adrenal and hormone issues, and individuals with thyroid issues and no gallbladder? The question then becomes this: of those suffering with anxiety and depression or another mental health disorder, who doesn’t have one of these issues? And how do we address the keto rash, constipation, fat malabsorption, fatigue, mineral deficiencies and other issues some people experience on a ketogenic diet?

Right now, this is my thinking: as with any nutritional or functional medicine approach, I would say there is no one-size-fits all for who should implement a ketogenic diet (we need to consider the unique biochemistry of each person) and there is no one set ketogenic diet (it will need to be customized for each person).

I’m hoping to get answers to many of these questions on the upcoming Keto Edge Summit (May 7-13, 2018), hosted by ketogenic diet expert, Dr. David Jockers. If you have similar questions, be sure to tune in too.  I’m going to reach out to Dr. Jockers for an interview too.

I’m also hoping to do my own interview with Dr. Palmer to discuss his interest in the ketogenic diet for mental health, to learn more about these cases and other patients he’s seen success with. Feel free to post your questions for Dr. Palmer (and Dr. Jockers) here and I’ll be sure to get them addressed.  We certainly appreciate Dr. Palmer for sharing these results so we can all learn, and also appreciate his patients for being willing to share their stories.

Please do share if you’ve adopted a ketogenic diet and the benefits you have experienced, and if you experienced any issues. Be sure to share what a typical day’s diet looks like for you.