Ketones and brain development: Implications for correcting deteriorating brain glucose metabolism during aging (Nugent et al., 2016)
A pretty good review article. Here are some quotes and my opinions.
"Brain energy metabolism in Alzheimer's disease (AD) is characterized mainly by glucose hypometabolism" in specific regions of the brain... "The importance of ketones in meeting the high energy and anabolic requirements of the infant brain suggest they may be able to contribute in the same was in the aging brain." But you already knew about that from this excellent blog post.
They then go on about the unsure cause-effect of lower glucose uptake causing AD or mild cognitive impairment (MCI) or AD/MCI causing impaired glucose uptake. They present a fairly strong case supporting the former. For example, people with certain polymorphisms that drastically increase the risk of AD/MCI exhibit reduced brain glucose uptake YEARS before cognitive decline.
The crux of the paper is that glucose uptake is impaired, but ketone uptake is not. And ketone uptake is directly proportional to blood ketones.
All images are from here.
When the brain is "activated," it "pulls" in glucose. In AD/MCI, this is impaired. By increasing ketones in the blood, they can be "pushed" into the brain to compensate for the reduced glucose availability. The authors really like coconut oil for this, but I think some of the new ketone supps like D-b-hydroxybutyrate-R 1,2-Butanediol Monoester would really be promising here.
Normally, with ketones < 0.5 mM, they contribute only roughly 3% of brain fuel; with coconut oil this can be increased to 15%.
Type 2 diabetes drastically increases risk of AD/MCI. It is known. It's also a double whammy: 1) brain glucose uptake is impaired; and 2) elevated insulin decreases lipolysis and thus ketogenesis. These people need coconut oil, refined MCTs, or ketone supps.
Ketones and baby brains: baby brains love ketones! They're used as fuel and provide the building blocks for brain cholesterol and fatty acids.
That's all for now!
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