The Ketogenic Diet for Traumatic Brain Injury

We keep hearing so much about the Ketogenic Diet, and there’s good reason for that! Being in a state of ketosis (where the body is burning ketones) can have many benefits, from healing chronic illness to improving overall performance. The keto diet, as it’s called, was originally studied and used to treat epilepsy. It was proven extremely effective but still not that commonly used until further researched. The keto diet is primarily comprised of fat, moderate amounts of protein, and very little carbohydrate. The diet is called “ketogenic” because it shifts the body’s primary fuel source from burning glucose to burning ketones, which the liver makes as it converts fat into this new fuel source. Ketones are unique because they are one of the only molecules that can cross the blood-brain barrier. This allows ketones to be an alternative fuel source for the brain. 

The ketogenic diet seems to enhance the ability of mitochondria (the power plants of our cells) to deliver our bodies’ energy needs in a manner that reduces inflammation and oxidative stress. To do this, the body must shift from primarily burning glucose/sugar to burning ketones produced by the liver as it uses fat for fuel. Cutting off the primary source of glucose (sugar) is key and this is no easy feat, as carbohydrates make up most of the Standard American Diet, as well as many other diets around the world. Additionally, our bodies are used to using glucose/carbohydrate and typically crave this fuel source. On the flip side, having a diet that is fat-based with substantial protein and very little carbohydrate is more satiating, helping one feel full after a keto-style meal and keeping them full longer with more stable blood sugar. Stable blood sugar levels prevent the fat-storage hormone insulin from spiking, making this diet a recent hot topic as it pertains to weight loss (but that’s a discussion for another day).

When it comes to overall brain health and healing, the keto diet especially shines. As mentioned, ketones can cross the blood-brain barrier and fuel the brain for functioning and healing. Additional research shows that ketones decrease oxidative stress, increase antioxidants, and fight free radicals, all of which promote healing of the brain. About 1.7 million people in the US sustain a TBI (traumatic brain injury) each year, making it a major health concern. Current research shows the effectiveness of ketones in reducing brain edema, improving cortical ATP levels, and decreasing the size of contusion. The ketogenic diet could easily become part of standard treatment of care for any intracranial pressure as well as functional recovery. 

As previously mentioned, achieving ketosis isn’t easy, as it requires not only a very different approach to food and fueling one’s body but also might now physically “feel good” initially. The body can have difficulty shifting its fuel source (called metabolic flexibility) and it’s common to feel what’s called the “keto flu.” Symptoms can include brain fog, dizziness, fatigue, nausea, difficulty sleeping, and irritability. Not everyone experiences these transitional symptoms and they typically only last a couple days before noticeable improvements. It is recommended that anyone wishing to transition to a ketogenic diet consult a registered dietitian, especially individuals with diabetes, as they are at increased risk for ketoacidosis, a dangerous state caused by the body storing up too many ketones, making the blood too acidic. Please check with an experienced practitioner who is knowledgeable about the diet and can make recommendations based on your individual medical history. 

Sources:

https://www.ncbi.nlm.nih.gov/books/NBK209323/

https://www.amenclinics.com/blog/3-ways-the-keto-diet-can-help-heal-a-concussion/

https://clinicaltrials.gov/ct2/show/NCT03982602

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012517/

https://charliefoundation.org/am-i-a-candidate/keto-for-tbi/

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