There is unequivocal evidence that a disturbed glucose metabolism underpins all stages of metabolically induced dementia. In ALL cases of metabolically induced dementia, the brain becomes insulin resistant and cannot take up sufficient glucose to support normal activities. This results in impaired brain-function and brain-shrinkage.
Many in the scientific community are now calling this metabolically-induced dementia “Type 3 Diabetes” and I call it T3D.
Most people will tell you that there is nothing that can be done – although many sufferers are given false hope by the promise of magical pharmaceutical drugs. However, they don’t work on you – they work for the drug company’s bottom line.
What can you do?
Stop the dementia getting worse
Metabolically induced dementia is caused by decades of consuming foods that raise insulin levels and cause insulin resistance. Thus, reducing your body’s insulin level is your highest priority if you have T3D. You do this by eating foods that reduce insulin. See our “what to eat” page. If you read this page, you will see that the key to reducing insulin is to limit carbohydrate intake. As carbohydrate intake goes down, insulin comes down and the body starts to make both glucose and ketones. The production of ketones is what gives the ‘ketogenic diet’ its name.
If you already have T3D symptoms, you should aim towards a fully ketogenic diet (zero carbohydrate).
Eating a ketogenic diet may also help the brain to become better at using available glucose because it can reverse insulin resistance. Read more about regaining insulin sensitivity on our losing weight page. You don’t have to be overweight to be insulin resistant and the dietary treatment is the same.
Start feeding your brain
Most people, including most doctors, will tell you that the brain can only be fueled by glucose. This is totally false and fosters an environment of misery for people with T3D. Your brain can be provided with energy from another source other than glucose.
Your brain can get around 75% of its energy requirements from an alternative fuel – called ketones. Even better, the brain’s ability to use ketones is not affected by insulin resistance.
When you stop your brain getting worse – by following a ketogenic diet – you are also providing your brain with the alternative fuel source – ketones. Your body can make ketones when insulin is kept low. It is only when carbohydrate consumption approaches zero that your body produces enough ketones to start fueling the brain. Ketones can fill the brain’s energy shortfall that results from insulin resistance.
Where there is a significant decline in brain function, it may not be enough to just turn to a ketogenic diet to provide enough fuel for the brain. As ketogenic diets are gaining so much popularity, there are now ketone supplements that you can buy off the shelf. By supplementing your body’s own production of ketones with ketone supplements, you are then providing your brain with a much greater energy source.
If you are significantly insulin resistant or diabetic, then you should consult your doctor before radically altering your diet, especially if you are on diabetic medications. If your doctor does not understand the importance of a ketogenic diet for treating diabetes and insulin resistance then find a better doctor.
Your symptoms could initially get worse when you switch to a ketogenic diet. This is because the body needs to make glucose if it isn’t getting any from the diet. The brain still needs to get around 25% of its energy from glucose. The problem is that the high insulin levels also prevent the body making glucose, so there may be a time before insulin starts to come down where the body cannot supply enough glucose. These two strategies can help:
- Don’t immediately drop to zero carbohydrate intake – instead, start cutting it down over a period of a few weeks.
- Use off-the-shelf ketones to supplement the brain during the transition period.
The important message is:
If you eat carbohydrates then your body won’t make ketones and you will be stuck with a brain that is not getting enough fuel to function properly.
Consume more salt
The body needs a significant amount of extra salt on a low carbohydrate diet as low insulin levels allow greater excretion of sodium via the kidneys.
There is no scientifically credible evidence that salt is bad for you – despite the messages that have bombarded you. There is strong evidence that insufficient salt is bad – you will get sick and die from lack of salt. One of the signs of insufficient salt intake is delirium – this alone will give you an idea of the importance of salt for cognitive function.
Not consuming enough salt can actually promote insulin resistance. This is because the body tries to hang onto sodium by raising insulin to prevent its excretion via the kidneys.
What results to expect?
Well, it depends on you. Will you follow a strict ketogenic diet? If you do, you may see a significant improvement in symptoms because the brain is now getting much more of the fuel it needs to function properly. Any further decline could be slowed or halted because you have addressed the root cause of the problem.
Will the damage be reversed? Probably not. My opinion is that the dietary approach is about (a) stopping T3D symptoms getting worse, and (b) making the best of the remaining brain capacity. That said, this approach can make a huge difference to the life of anyone with T3D and their carers.
Update – 6th Dec’19
I came across an interesting lecture on an ongoing trial using ketones to improve Alzheimer’s outcomes. The lecture is here:
While a very interesting lecture, I believe the speaker misses and misrepresents a couple of points which I will discuss below:
- Elevated insulin levels do not impede the brain’s uptake of ketones. The speaker confuses the role of insulin on the uptake of ketones into the brain. He does try to correct the issue but I suspect that he leaves the audience confused. Elevated insulin levels do impede the body’s own ability to make ketones as we discussed above. This is the point that he made badly.
- Focus on supplements. The speaker focused his discussion on the use of ketone supplements rather than the use of a ketogenic diet with or without additional ketone supplementation.
In this case, no effort is made to reduce insulin levels and thus (a) prevent the condition getting worse, and (b) potentially also improve glucose uptake by reducing insulin resistance.
- Wrong normal. The speaker represented the condition where the brain predominantly uses glucose for fuel as ‘normal’. He even presents evidence that ‘normal’ might be a brain fueled by ketones when he discusses the infant brain.
A brain fuelled primarily by glucose may be normal for a high-carb, western diet, but not for traditional hunter-gathers whose brains would have been constantly fuelled by ketones.
- Prevention. The speaker did not discuss the potential to prevent the onset of dementia/alzheimer’s through diet.
Having identified these points, it is still worth viewing to get another angle on how to feed the T3D brain.
Update 12 Dec’19
Just a brief update on supplementing ketones. A readily accessible method of supplementing with ketones is by consuming MCT oil. “MCT” stands for Medium Chain Triglyceride”. If you buy MCT oil off-the-shelf, it will generally be extracted from coconut oil.
MCT oils are quickly absorbed and the body converts them to ketones rather than storing them. Reports suggest that ketone levels are increased for around 3-4 hours.
If you cannot find MCT oil in the health food section, then try the cooking oil section.
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|1.||⇧||If your doctor does not understand the importance of a ketogenic diet for treating diabetes and insulin resistance then find a better doctor.|