Your Brain Loves Ketones

One of the hottest discoveries in brain health is the positive effect of switching the fuel for your brain from sugar to ketones, derived from fat. High-fat, low-carb diets designed to put you in ‘ketosis’, with measurable levels of ketones flowing in your bloodstream and consequently brain, have been shown to help memory loss, mood, concentration and more serious disorders, from Alzheimer’s to schizophrenia, and also epilepsy and Parkinson’s.

Body Cells Burn Sugar and Fat

All cells in the body can burn either sugar or fatty acids, derived from fat. That fat can come from fat you’ve eaten or your own fat if you go on a low-calorie diet or fast. However, brain cells cannot.

Why Brain Cells are Different

There are so many of neurons – some 100 billion of them – packed into such a small area that there isn’t any free space, so they have to use the cleanest, fastest, most efficient fuel, rather than inefficient fat.

Usually this is glucose, but when the glucose ‘engine’ starts to malfunction, as often happens with diabetics and those with memory decline, ketones – manufactured in the liver from fat – are a terrific alternative source of energy for the brain.

Under these circumstances, the brain often derives a fifth of its energy from ketones. ‘Fuelling cells’ called astrocytes, which help prep the ketones, are even positioned next to the neurons. Ketones may even be a preferred fuel, especially for those with age-related memory decline.

How Ketones work for Babies

At the other end of the spectrum, ketones are essential to build babies’ brains. Babies are born with 50 trillion brain connections and need to make millions a minute in the first few months, with the brain consuming 75 per cent of all energy from food! There’s a limit to how much glucose it can use and the only way it can get all the energy it needs for rapid building is from ketones. That’s why human breastmilk is relatively high in medium-chain triglycerides (MCTs). Body fat, or fat we eat, is then turned into ketones in the liver. This is also why babies are born plump, unlike the young of most mammals.

Babies can survive on the ketones that their livers produce from their own fat reserves for as long as 60 days, and interestingly, even a high-carb diet doesn’t push them out of ketosis.

Ketones

You don’t have to generate ketones for the brain to work optimally, even though it might help. Normally, the brain uses about a quarter (22 per cent) of the total energy we take in from food. We can get all that from glucose. However, if there are ketones in our system, the brain will use them in preference.

C8 MCT oil

Ketones are only made in the liver from MCTs. The backbone of a fat molecule is a chain of carbon atoms. A MCT is between 6 and 12 carbon atoms long. In contrast, olive oil is a long-chain fat, with 14 carbon atoms. Coconut, palm and olive oil are sources of MCTs. However, recent research has proven that almost all ketones are made from a sub-fraction of these fats called C8 (short for carbon 8, or caprylic acid triglyceride, an 8-carbon-chain fat).[1] Coconut oil is only 7 per cent C8, while most MCT oil, which you can buy in a health-food store, is 12 per cent C8. You’re better off getting pure C8 oil, which is also available in health-food stores and online (see Resources), if you want to supply your brain with ketones. C10 is the next best, but it’s not nearly so good for making ketones.

The Research

Two breakthrough studies in Canada, by Dr Melanie Fortier and Professor Stephen Cunnane from Sherbrooke University, have established that C8 oil can be extremely helpful as an energy source for those with cognitive decline.

Cunnane’s research team gave people with either Alzheimer’s[2] or pre-dementia[3] two tablespoons of MCT oil (30g of C8 and C10) or a placebo and measured their cognitive abilities, as well as how much energy their brains made. They kept making the same amount of energy from glucose, but had a 230 per cent increase in energy made from ketones. As they started making more energy, certain areas in their brains lit up. These related to functions such as memory and language, and on tests, these improved.

‘Measures of episodic memory, language, executive function, and processing speed improved on the C8 versus baseline. Increased brain ketone uptake was positively related to several cognitive measures,’ reported Cunnane.

Professor Cunnane is a member of our Scientific Advisory Board at Food for the Brain and holds the chair in ketotherapeutics at the university. His research has shown that Alzheimer’s patients start to suffer glucose deficiency in certain regions of the brain even before they start to experience any symptoms. There may be various reasons for this, but the most likely candidate is insulin resistance, which makes it more difficult for the fuel to make its way into the neurons. This makes sense, as diabetics are three times more likely to develop Alzheimer’s than non-diabetics.

‘We know from our scanning research that the glucose deficit is not due to damage to the neurons, but to insufficient amounts being available as fuel,’ explains Cunnane. ‘It’s safe to treat this deficiency with ketones.’

On the other hand, if the condition remains untreated, the fuel-deprived neurons suffer the sort of damage that ultimately leads to Alzheimer’s.

Meanwhile, in New Zealand neurologists decided to test the effects on 26 people diagnosed with Alzheimer’s by putting them onto a low-carb ketogenic diet for 12 weeks or a healthy low-fat but not ketogenic diet as the ‘control’, with each participant following both diets.[4] On the ketogenic diet, there were improvements in their daily function and quality of life measures, which is quite remarkable at this late stage of the disease process.

Mind the Brain Energy Gap with Ketones

‘People with cognitive decline have an energy gap,’ says Cunnane. ‘Probably due to insulin resistance, they are not able to make use of glucose. Providing a food source, C8 oil, from which the body can readily make ketones, fills that energy gap, brain cells come back to life and memory and brain function improve as a result. It reminds me of those announcements on the London Underground: “Mind the gap.”’

Practically, as in his studies, that means having a couple of tablespoons of C8 oil. The energy effect lasts for a few hours, so this might be best administered by taking a teaspoon two or three times a day, then building up to 2 teaspoons three times a day. It’s a pleasant, creamy taste. A few people get gastrointestinal upset from these oils, which is mitigated by emulsifying, for example having the oil in a smoothie, or having it with a meal, or building up the dose slowly over time.

Some people have C8 oil with their coffee, as advocated by llow-carb enthusiast David Asprey, apparently inspired by the Tibetans’ yak-butter tea. He invented bullet-proof coffee, adding grass-fed butter and two tablespoons of MCT oil to coffee.

My hybrid latte combines carb-free almond milk, almond butter and two tablespoons of C8 oil (I use my Ketofast), plus a teaspoon of unsweetened cacao and half a teaspoon of cinnamon.

Further Information

Read more on ketogenic dieting in The Hybrid Diet and The 5 Day Diet available from HOLFORDIRECT.

Listen to my podcast with Dr Georgia Ede – Can a Keto Diet Transform Your Mind?

References

1.. Vandenberghe C, St-Pierre V, Pierotti T, Fortier M, Castellano CA, Cunnane SC. Tricaprylin Alone Increases Plasma Ketone Response More Than Coconut Oil or Other Medium-Chain Triglycerides: An Acute Crossover Study in Healthy Adults. Curr Dev Nutr. 2017 Mar 22;1(4):e000257. doi: 10.3945/cdn.116.000257. PMID: 29955698; PMCID: PMC5998344.

2.. Croteau E, Castellano CA, Richard MA, Fortier M, Nugent S, Lepage M, Duchesne S, Whittingstall K, Turcotte ÉE, Bocti C, Fülöp T, Cunnane SC. Ketogenic Medium Chain Triglycerides Increase Brain Energy Metabolism in Alzheimer’s Disease. J Alzheimers Dis. 2018;64(2):551-561. doi: 10.3233/JAD-180202. PMID: 29914035.

3. Fortier M, Castellano CA, St-Pierre V, Myette-Côté É, Langlois F, Roy M, Morin MC, Bocti C, Fulop T, Godin JP, Delannoy C, Cuenoud B, Cunnane SC. A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT. Alzheimers Dement. 2021 Mar;17(3):543-552. doi: 10.1002/alz.12206. Epub 2020 Oct 26. PMID: 33103819; PMCID: PMC8048678.

4.. Danan A, Westman EC, Saslow LR, Ede G. The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients. Front Psychiatry. 2022 Jul 6;13:951376. doi: 10.3389/fpsyt.2022.951376. PMID: 35873236; PMCID: PMC9299263.