Inhaling pleasant Scents during sleep and boost in Cognition

 

Inhaling Pleasant Scents During Sleep Tied to a Dramatic Boost in Cognition

Batya Swift Yasgur MA, LSW

August 08, 2023

Inhaling a pleasant aroma during sleep has been linked to a "dramatic" improvement in memory, early research suggests.

In a small, randomized control trial researchers found that when cognitively normal individuals were exposed to the scent of an essential oil for 2 hours every night over 6 months, they experienced a 226% improvement in memory compared with a control group who received only a trace amount of the diffused scent.

In addition, functional magnetic resonance imaging (fMRI) showed that those in the enriched group had improved functioning of the left uncinate fasciculus, an area of the brain linked to memory and cognition, which typically declines with age.

"To my knowledge, that level of [memory] improvement is far greater than anything that has been reported for healthy older adults and we also found a critical memory pathway in their brains improved to a similar extent relative to unenriched older adults," senior investigator Michael Leon, PhD, professor emeritus, University of California, Irvine, told Medscape Medical News.

The study was published online July 24,2023 in Frontiers of Neuroscience.

The Brain's "Superhighway"

Olfactory enrichment "involves the daily exposure of individuals to multiple odorants" and has been shown in mouse models to improve memory and neurogenesis, the investigators note.

A previous study showed that exposure to individual essential oils for 30 minutes a day over 3 months induced neurogenesis in the olfactory bulb and the hippocampus.

"The olfactory system is the only sense that has a direct 'superhighway' input to the memory centers areas of the brain; all the other senses have to reach those brain areas through what you might call the 'side streets' of the brain, and so consequently, they have much less impact on maintaining the health of those memory centers."

When olfaction is compromised, "the memory centers of the brain start to deteriorate and, conversely, when people are given olfactory enrichment, their memory areas become larger and more functional," he added.

Olfactory dysfunction is the first symptom of Alzheimer's disease (AD) and is also found in virtually all neurological and psychiatric disorders.

"I've counted 68 of them — including anorexia, anxiety, [attention-deficit/hyperactivity disorder], depression, epilepsy and stroke. In fact, by mid-life, your all-cause mortality can be predicted by your ability to smell things," Leon said.

Leon and colleagues previously developed an effective treatment for autismusing environmental enrichment that focused on odor stimulation, along with stimulating other senses. "We then considered the possibility that olfactory enrichment alone might improve brain function.”

Rose, Orange, Eucalyptus…

For the study, the researchers randomly assigned 43 older adults, aged 60 - 85 years, to receive either nightly exposure to essential oil scents delivered via a diffuser (n = 20; mean [SD] age, 70.1 [6.6] years) or to a sham control with only trace amounts of odorants (n = 23; mean age, 69.2 [7.1] years) for a period of 6 months.

The intervention group was exposed to a single odorant, delivered through a diffuser, for 2 hours nightly, rotating through seven pleasant aromas each week. They included rose, orange, eucalyptus, lemon, peppermint, rosemary, and lavender scents.

All participants completed a battery of tests at baseline, including the Mini-Mental State Examination (MMSE), which confirmed normal cognitive functioning. At baseline and after a 6-month follow-up, participants completed the Rey Auditory Verbal Learning Test (RAVLT) as well as three subsets of the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III).

Olfactory system function was assessed using "Sniffin Sticks," allowing the researchers to determine if olfactory enrichment enhanced olfactory performance.

Participants underwent fMRI at baseline and again at 6 months.

Brain imaging results showed a "clear, statistically significant 226% difference between enriched and control older adults in performance on the RAVLT, which evaluates learning and memory (timepoint × group interaction; F = 6.63; P = .02; Cohen's d = 1.08; a "large effect size").

They also found a significant change in the mean diffusivity of the left uncinate fasciculus in the enriched group compared with the controls (timepoint × group interaction; F = 4.39; P = .043; h ² p = .101; a "medium-size effect").

The uncinate fasciculus is a "major pathway" connecting the basolateral amygdala and the entorhinal cortex to the prefrontal cortex. This pathway deteriorates in aging and in AD and "has been suggested to play a role in mediating episodic memory, language, socio-emotional processing, and selecting among competing memories during retrieval."

No significant differences were found between the groups in olfactory ability.

Limitations of the study include its small sample size. The investigators hope the findings will "stimulate larger scale clinical trials systematically testing the therapeutic efficacy of olfactory enrichment in treating memory loss in older adults."

Exciting but Preliminary 

Commenting for Medscape Medical News, Donald Wilson, PhD, professor of child and adolescent psychiatry and of neuroscience and physiology, the Child Study Center, NYU Langone Medical Center, New York, said that multiple studies have "demonstrated that problems with sense of smell are associated with and sometimes can precede other symptoms for many disorders, including AD, Parkinson's disease, and depression."

Recent work has suggested that this relationship can be "bidirectional" — for example, losing one's sense of smell might promote depression, while depressive disorder might lead to impaired smell, according to Wilson, also director and senior research scientist, the Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, who wasn't involved with the study.

This "two-way interaction" may raise the possibility that "improving olfaction could impact non-olfactory disorders."

This paper "brings together" previous research findings to show that odors during bedtime can improve some aspects of cognitive function and circuits that are known to be important for memory and cognition — which Wilson called "a very exciting, though relatively preliminary, finding."

A caveat is that several measures of cognitive function were assessed and only one (verbal memory) showed clear improvement.

Nevertheless, there's "very strong interest now in the olfactory and nonolfactory aspects of odor training and this training expands the training possibilities to sleep. This could be a powerful tool for cognitive improvement and/or rescue if follow-up studies support these findings," Wilson said.

Front Neurosci. Published online July 24, 2023. Full text

Dental care and health could protect against Dementia

Brushing, Flossing Could Help Protect Against Dementia

Analysis by Dr. Joseph Mercola - July 20, 2023

STORY AT-A-GLANCE

• Dental health is associated with hippocampal atrophy — shrinkage of the hippocampus brain region that serves as a marker for Alzheimer’s disease
• People with mild gum disease and fewer teeth had a faster rate of shrinkage in the left hippocampus; having one less tooth increased brain shrinkage at a rate equivalent to nearly one year of brain aging
• For those with severe gum disease, having more teeth was linked to a faster rate of brain shrinkage, with one more tooth akin to 1.3 years of brain aging
• Porphyromonas gingivalis (P. gingivalis), a pathogen involved in chronic periodontitis, has been identified in the brains of patients with Alzheimer’s disease
• Even in young, otherwise healthy, adults, episodic memory and learning rate is improved among those without good oral health compared to those with aggressive periodontal disease

Dementia has been added to the long list of health problems potentially associated with poor oral health. The finding, published in Neurology,1 suggests dental health is associated with hippocampal atrophy — shrinkage of the hippocampus brain region that serves as a marker for Alzheimer’s disease.2

In short, “Retaining more healthy teeth without periodontal disease may help to protect brain health,” study author Satoshi Yamaguchi, an associate professor at Tohoku University Graduate School of Dentistry in Sendai, Japan, explains.3

Since periodontal disease is also linked with systemic inflammation and bacteria in the bloodstream, leading to chronic disease, keeping your teeth, mouth and gums healthy is a key way to boost your overall health, as well.

Brain Shrinkage Linked to an Unhealthy Mouth

Without proper oral hygiene, gingivitis can develop. This is an inflammatory disease caused by an accumulation of plaque, or bacteria, on your teeth that often leads to bleeding gums. If left untreated, it can lead to periodontitis, which is a more serious infection that can lead to teeth loss.

Periodontitis, or gum disease, has been suggested as a potential risk factor for Alzheimer’s since at least 2015, when researchers with the University of Bristol noted “periodontal pathogens are possible contributors to neural inflammation and SLOAD [sporadic late onset Alzheimer's disease].”4

The Neurology study involved 172 people aged 55 years and over who had no cognitive decline at the start of the study. The participants had dental exams and took memory tests, while brain scans were used to measure hippocampus volume at the start of the study and four years later.

Both gum disease and number of teeth were linked to brain changes. Those with mild gum disease and fewer teeth had a faster rate of shrinkage in the left hippocampus. Among this group, having one less tooth increased brain shrinkage at a rate equivalent to nearly one year of brain aging.5

For those with severe gum disease, having more teeth was linked to a faster rate of brain shrinkage, with one more tooth akin to 1.3 years of brain aging.6 Yamaguchi said in a news release:

“Tooth loss and gum disease, which is inflammation of the tissue around the teeth that can cause shrinkage of the gums and loosening of the teeth, are very common, so evaluating a potential link with dementia is incredibly important. Our study found that these conditions may play a role in the health of the brain area that controls thinking and memory, giving people another reason to take better care of their teeth.”

Gum Disease Bacteria Travel to Your Brain

In 2019, researchers with the University of Louisville identified Porphyromonas gingivalis (P. gingivalis), a pathogen involved in chronic periodontitis, in the brains of patients with Alzheimer’s disease.7 Gingipains — toxic proteases from P. gingivalis — were also found in the brains of Alzheimer’s patients. Levels of gingipains were associated with two markers of the disease, tau protein and another protein called ubiquitin.8

Further, in mice, oral infection with P. gingivalis resulted in brain colonization of the pathogen, along with increased production of Aβ1–42, which is found in amyloid plaques.9 In vivo and invitro studies also showed gingipains were neurotoxic and damaging to tau, which is needed for normal neuronal function.

Gingipain antigens were detected in the brains of people with Alzheimer’s disease as well as in those with Alzheimer’s pathology who had not yet been diagnosed. This “argues that brain infection with P. gingivalis is not a result of poor dental care following the onset of dementia or a consequence of late-stage disease, but is an early event that can explain the pathology found in middle-aged individuals before cognitive decline,” the researchers explained.10

It's suggested the bacteria may access the brain from an infected oral cavity via infection of endothelial cells protecting the blood-brain barrier, spreading through cranial nerves or infection of monocytes — white blood cells — that travel to the brain.

“After entering the brain, we suggest that P. gingivalis may spread slowly over many years from neuron to neuron along anatomically connected pathways, similar to what has been demonstrated for vascular cell-to-cell transmission of P. gingivalis,” the team added.11

Periodontal Disease Linked to Alzheimer’s

Patients with Alzheimer’s disease often have poor oral health, which has commonly been attributed to declining self-care or neglect for oral health by caregivers. Past research has also revealed that periodontal disease may be a contributory factor in the disease’s development.12

For instance, a systematic review and meta-analysis that included 13 studies showed the risk of Alzheimer’s disease and mild cognitive impairment in patients with periodontal disease was significantly higher than in those without periodontal disease.13 This was especially true in people with severe periodontal disease.

A separate study, published in the Journal of Alzheimer’s disease, found that among people aged 65 and older, Alzheimer’s disease incidence and mortality were consistently associated with probing pocket depth, a measure of periodontal health, as well as Prevotella melaninogenica (P. melaninogenica) and Campylobacter rectus (C. rectus), bacterial markers of periodontitis.14

New Bacteria Linked to Cavities

Streptococcus mutans (S. mutans) bacteria are usually blamed for causing cavities, but another species may also be involved, highlighting how much remains to be learned about the microbes in our mouths and how they influence disease processes. The bacteria, Selenomonas sputigena (S. sputigena), have previously been linked to gum disease.

Research published in Nature Communications15 revealed they also partner with S. mutans, enhancing their ability to cause cavities.16 Using plaque samples from 300 children aged 3 to 5 years, the researchers found that S. sputigena don’t cause cavities on their own.

However, they may become trapped by sticky deposits on the teeth called glucans, which are built by S. mutans. According to a University of Pennsylvania School of Dental Medicine news release:17

“Once trapped, S. sputigena proliferates rapidly, using its own cells to make honeycomb-shaped “superstructures” that encapsulate and protect S. mutans. The result of this unexpected partnership, as the researchers showed using animal models, is a greatly increased and concentrated production of acid, which significantly worsens caries severity.”

It's possible that using specific enzymes or tooth-brushing methods could better target S. sputigena superstructures to reduce cavity incidence. “This phenomenon in which a bacterium from one type of environment moves into a new environment and interacts with the bacteria living there, building these remarkable superstructures, should be of broad interest to microbiologists,” study author Hyun Koo noted.18

‘Gum Disease Is Often Silent’

Among adults aged 30 or over, 46% have signs of gum disease, while 9% of adults have severe gum disease.19 However, many aren’t aware they have it, as gum disease is often a “silent” condition, not showing signs and symptoms until more advanced stages.20

In the initial stage of gingivitis, you may notice that your gums bleed when you brush your teeth, floss or eat hard food. Your gums may also be red or swollen. As the disease progresses, your gums may pull away from your teeth, making your teeth appear longer. Your teeth may also become loose, and there may sores in your mouth, bad breath and pus between your gums and teeth.21

In addition to cognitive decline, periodontitis has been linked to a number of systemic diseases, including:22

Diabetes	Heart disease
Respiratory disease	Adverse pregnancy outcomes
Cancer	Nervous system diseases

Protecting Oral Health Early on Is Best

Since deposits of amyloid beta in the brain may start one to two decades before cognitive decline and diagnosis of Alzheimer’s disease, and periodontal disease may also be persistent for about 10 years to initiate Alzheimer’s, positive oral health early on may help prevent the disease.23

This is important not just for older adults, but also middle-aged and younger adults, who may be able to protect their brain health by maintaining good oral health. Even in young, otherwise healthy, adults, episodic memory and learning rate is improved among those without good oral health compared to those with aggressive periodontal disease24 — suggesting damage to brain health may start early on.

Proper oral hygiene, including regular brushing, flossing and tongue scraping, and getting regular cleanings with a mercury-free biological dentist, will go a long way toward keeping your teeth and gums healthy. A lifestyle that includes a diet based on fresh, whole foods is also essential to a naturally clean mouth and good oral health.

Oil Pulling Works Wonders for Healthy Teeth and Gums

For extra care, try oil pulling using coconut oil. I’ve previously detailed how simple it is to incorporate oil pulling into your dental hygiene routine. Coconut oil is antibacterial and antiviral, and oil pulling has been found to reduce gingivitis and plaque, significantly lowering plaque index scores compared to a control group, while also reducing bacterial colony counts in saliva.25

Notably, researchers also found that coconut oil pulling worked as well as chemical (chlorhexidine) mouthwash for plaque score, gingival index score and bleeding-on-probing.26 The oil may also be effective against gingivitis. In a pilot study of 20 people with plaque-induced gingivitis, coconut oil was used as a mouthwash daily for 30 days.

A control group carried out normal daily oral health procedures but without coconut oil. Both plaque and bleeding decreased in the groups, but the coconut oil group had a more significant decline, showing promise for reducing plaque formation and gingivitis.27

To try it, take a small amount of the oil and swish it around your mouth, “pulling” it between your teeth and ensuring it moves around your entire mouth. After about 20 minutes, spit the oil out into the garbage. You can use oil pulling daily along with regular brushing and flossing.

More Ways to Protect Your Brain Health 

Shortly after the draft of this article was written I serendipitously discovered Dr. Ellie Phillips, a dentist trained in the U.K., from a recommended YouTube video on how to regrow receding gums. I purchased her book "Kiss Your Dentist Goodbye" which outlines her complete program to eliminate tooth decay by removing the bacteria from your mouth. Her program is very inexpensive and highly counterintuitive, and, among other strategies, uses 10 grams of xylitol per day to alkalinize the saliva and kill dental bacteria..

I have been doing her program for the past week and notice a radical decrease in dental plaque which I have been plagued with my entire life. I hope to interview her later this year and give you an update at that time but thought it was important to give you a sneak preview now.

Beyond oral health, nourishing brain health is best done with a comprehensively healthy lifestyle, including healthy diet, which will also work to reduce your risk of gum disease. Your risk of cavities increases the more sugar you eat, for instance. One study found that, in order to minimize your risk of cavities, processed sugars should make up no more than 3% of your total energy intake (with 5% noted as a “pragmatic” or more realistic goal).28

Mineral deficiencies, like magnesium, can weaken bones and teeth,29 while B vitamins are also important. Research published in PLOS One compared brain atrophy in participants taking folic acid (0.8 milligrams (mg) per day), vitamin B12 (0.5 mg per day) and vitamin B6 (20 mg per day) for 24 months with that in patients taking a placebo.30

Those taking B vitamins had a lower rate of brain atrophy per year — 0.76% — than those not taking them, who had an atrophy rate of 1.08%. According to the researchers, “The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.”31

Vitamin B3 is found in grass fed beef, mushrooms and avocados,32 while vitamin B6 is plentiful in grass fed beef, potatoes, bananas and avocados.33 You can find folate, or vitamin B9, spinach, broccoli, avocado and asparagus.34

Vitamin B12-rich foods include grass fed beef liver, wild rainbow trout and wild sockeye salmon. Other important strategies to boost your brain health include exercise, ketogenic diet, time-restricted eating, optimizing vitamin D and other hormones, increasing sleep, meditation and detoxification and eliminating processed food.

 Sources and References

• 1 Neurology July 5, 2023
• 2 Neurology January 24, 2006; 66 (2)
• 3 Drugs.com July 6, 2023
• 4 Br Dent J. 2015 Jan;218(1):29-34. doi: 10.1038/sj.bdj.2014.1137
• 5, 6 Science Daily July 5, 2023
• 7, 11 Science Advances January 23, 2019
• 8 Science Alert November 22, 2022
• 9 Alzheimer’s Research UK January 23, 2019
• 10 Science Advances January 23, 2019, Discussion
• 12, 24 Front Cell Infect Microbiol. 2021; 11: 766944, Alzheimer’s Disease and Cognitive Dysfunction
• 13 Psychogeriatrics. 2021 Sep;21(5):813-825. doi: 10.1111/psyg.12743. Epub 2021 Jul 11
• 14 J Alzheimers Dis. 2020;75(1):157-172. doi: 10.3233/JAD-200064
• 15 Nature Communications volume 14, Article number: 2919 (2023)
• 16, 17, 18 Penn Today June 9, 2023
• 19 U.S. CDC, Gum Disease
• 20, 21 American Academy of Periodontology, Gum Disease Information
• 22 Front. Aging Neurosci., 23 June 2022
• 23 Expert Rev Anti Infect Ther. 2020 Nov;18(11):1063-1066. doi: 10.1080/14787210.2020.1792292. Epub 2020 Jul 14
• 25, 26 Heliyon August 2020, Volume 6, Issue 8, e04789, Into
• 27 Eur J Dent. 2020 Oct; 14(4): 558–565
• 28 BMC Public Health September 16, 2014
• 29 Weston Price Foundation September 23, 2010
• 30, 31 PLOS One September 8, 2010
• 32 My Food Data, Vitamin B3 September 26, 2022
• 33 My Food Data, Vitamin B6 September 26, 2022
• 34 My Food Data, Vitamin B9 September 26, 2022

Neurodegenerative disease and the benefits of a Ketogenic diet..

This is another amazing article by the Institute of Functional Medicine on the neurological benefits of the Ketogenic diet.

<https://www.ifm.org/news-insights/neuro-ketogenic-diet-neurodegenerative-diseases/?utm_campaign=Newsletter&utm_medium=email&_hsmi=245039362&_hsenc=p2ANqtz-8OFVUJFm64w8oLXsNBwWC13kWixc75y6fmv7OzIW694J8o1guI_560SS45-MBc6h8ym503er9ecv9dlL-kBy8SOo2pug&utm_content=245039362&utm_source=hs_email>

Ketogenic diet in Neurodegenerative disease... 

 Ketosis. It has become one of the most popular words of the 21st century. Often connected to weight loss plans, “ketosis” is also strongly associated with epilepsy: the ketogenic diet was first introduced by clinicians as a treatment for epilepsy in the 1920s. Over the last decade, researchers have been studying the effect of ketosis on other neurological and mitochondrial disorders, with promising results.

In ketosis, the mitochondria burn fat instead of glucose for energy metabolism. Ketosis can be achieved through periods of fasting or by restricting the intake of carbohydrates in the diet, leading the body to break down fatty acids to produce higher-than-normal levels of the so-called ketone bodies—acetoacetate, ?-hydroxybutyric acid, and acetone—through a process called ketogenesis, which occurs principally in the mitochondrial matrix in the liver.1 The “state of ketosis” has been shown to exert a protective action against neurological diseases like Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and more.2-4 In AD and PD, human studies have shown a reduction of disease symptoms in participants following a ketogenic diet.5A therapeutic ketogenic diet has been studied by IFM educator Terry Wahls, MD, IFMCP with the specific aim of reversing the symptoms of multiple sclerosis (MS). Such diets have been shown to stimulate mitochondrial biogenesis, improve mitochondrial function, and reduce oxidative stress.2,3,6,7 Dr. Wahls has used ketogenic diets in her clinical practice for a wide variety of health issues that result from mitochondrial disease. In the following IFM video, Dr. Wahls talks about the importance of diet for patients with neurological disease symptoms like fatigue.

(Video Time: 2 minutes) Terry Wahls, MD, is a clinical professor of medicine at the University of Iowa, where she teaches internal medicine residents, sees patients in a therapeutic lifestyle clinic, and conducts clinical trials. Dr. Wahls is a patient with secondary progressive multiple sclerosis. She restored her health using a diet and lifestyle program she designed specifically for her brain. 

Neuroprotection & Ketogenic Therapies

In 2004, the first randomized controlled trial of the ketogenic diet with medium-chain triglycerides in humans with AD or mild cognitive impairment (MCI) showed that higher ketone values were associated with greater improvement in paragraph recall.8 Subsequent studies have demonstrated that ketone bodies act as neuroprotective agents by raising ATP levels and reducing the production of reactive oxygen species in neurological tissues, together with mitochondrial biogenesis, which may help to enhance the regulation of synaptic function.1,6 Caloric restriction, in and of itself, has also been suggested to exert neuroprotective effects, including improved mitochondrial function, decreased oxidative stress and apoptosis, and inhibition of pro-inflammatory mediators such as the cytokines tumor necrosis factor-? and inflammatory interleukins.1

In a 2017 Ketogenic Diet Retention and Feasibility Trial, 15 patients with AD were put on a medium-chain triglyceride–supplemented ketogenic diet: approximately 70% of energy as fat, including the MCT, 20% of energy as protein, and less than 10% of energy as carbohydrates. Researchers observed that in a state of ketosis, the mean score on the Alzheimer’s Disease Assessment Scale cognitive subscale improved significantly during the diet and reverted to baseline after the washout.9

Results from a 2020 systematic review of 10 randomized controlled trials indicated that among adults with MCI and/or AD, adherence to an acute or long-term (45-180 days) ketogenic therapy (ketogenic diet, MCT-based, or ketogenic formulas/meals) improved both acute and long-term cognition.10 Specifically, one of the reviewed studies from 2019 examined the effect of an MCT–based ketogenic diet on the cognitive function of 20 Japanese patients with mild-to-moderate AD.11 At eight weeks, the patients showed significant improvement in their immediate and delayed logical memory tests, and at 12 weeks, they showed significant improvements in a digit-symbol coding test and immediate logical memory test, tests which evaluate verbal memory and cognitive processing speed.11

A study of 150 migraine patients found that the ketogenic diet may be a rapid-onset effective prophylaxis for both episodic and chronic migraine.12 Researchers speculate that the ketogenic diet restores brain excitability and metabolism to counteract neuroinflammation in migraine patients.2 Although the ketogenic diet is seen by many as a promising therapy for diverse neurological diseases, the long-term effects of this kind of diet in humans remains uncertain.2

To this end, some researchers have begun to study the effects of intermittent metabolic switching (IMS).13,14 This entails repeating cycles of a metabolic challenge that induces ketosis (fasting and/or exercise) followed by a recovery period (eating, resting, and sleeping), which may optimize brain function and resilience throughout the lifespan.13This metabolic switching may impact multiple signaling pathways that promote neuroplasticity and resistance of the brain to injury and disease.13 Although IMS may enhance brain function and stress resistance, the research is still new and seen mainly in animal models. The question of what specific IMS regimen(s) is ideal for brain health throughout the life course is also unknown.13

Future research should help us better understand how ketogenic therapies work and what effects they have on mitochondrial function and neurological disorders. Ketogenic diets may prove to be another tool functional medicine clinicians can use to help improve outcomes for patients with neurodegenerative disorders. To learn more, visit IFM’s Bioenergetics Advanced Practice Module (APM).

Related Articles

NEURODEGENERATIVE DISEASE: IMPROVING OUTCOMES THROUGH NUTRITION

EMERGING CONCEPTS: TYPE 2 DIABETES AND THE KETOGENIC DIET

ALZHEIMER’S RISKS, INFLAMMATION, AND LIFESTYLE INTERVENTIONS: AN INTERVIEW BETWEEN NEUROLOGIST DAVID PERLMUTTER, MD, AND IFM EDUCATOR KRISTI HUGHES, ND, IFMCP

FASTING AND MITOCHONDRIAL HEALTH

References

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2. Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic diet in neuromuscular and neurodegenerative diseases. Biomed Res Int. 2014;2014:474296. doi:10.1155/2014/474296
3. Branco AF, Ferreria A, Simões RF, et al. Ketogenic diets: from cancer to mitochondrial diseases and beyond. Eur J Clin Invest. 2016;46(3):285-298. doi:10.1111/eci.12591
4. Pavón S, Lázaro E, Martínez O, et al. Ketogenic diet and cognition in neurological diseases: a systematic review. Nutr Rev. 2021;79(7):802-813. doi:10.1093/nutrit/nuaa113
5. Wlodarek D. Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease and Parkinson’s disease). Nutrients. 2019;11(1):E169. doi:10.3390/nu11010169
6. Yang H, Shan W, Zhu F, Wu J, Wang Q. Ketone bodies in neurological diseases: focus on neuroprotection and underlying mechanisms. Front Neurol. 2019;10:585. doi:10.3389/fneur.2019.00585
7. Brocchi A, Rebelos E, Dardano A, Mantuano M, Daniele G. Effects of intermittent fasting on brain metabolism. Nutrients. 2022;14(6):1275. doi:10.3390/nu14061275
8. Reger MA, Henderson ST, Hale C, et al. Effects of beta-hydroxybutyrate on cognition in memory-impaired adults. Neurobiol Aging. 2004;25(3):311-314. doi:10.1016/S0197-4580(03)00087-3
9. Taylor MK, Sullivan DK, Mahnken JD, Burns JM, Swerdlow RH. Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer’s disease. Alzheimer’s Dement. 2017;4:28-36. doi:10.1016/j.trci.2017.11.002
10.  Grammatikopoulou MG, Goulis DG, Gkiouras K, et al. To keto or not to keto? A systematic review of randomized controlled trials assessing the effects of ketogenic therapy on Alzheimer disease. Adv Nutr. 2020;11(6):1583-1602. doi:10.1093/advances/nmaa073
11.  Ota M, Matsuo J, Ishida I, et al. Effects of a medium-chain triglyceride-based ketogenic formula on cognitive function in patients with mild-to-moderate Alzheimer’s disease. Neurosci Lett. 2019;690:232-236. doi:10.1016/j.neulet.2018.10.048
12.  Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M. Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci. 2017;38(Suppl 1):111-115. doi:10.1007/s10072-017-2889-6
13.  Mattson MP, Moehl K, Ghena N, Schmaedick M, Cheng A. Intermittent metabolic switching, neuroplasticity, and brain health. Nat Rev Neurosci. 2018;19(2):63-80. doi:10.1038/nrn.2017.156
14.  Mishra S, Singh B. Intermittent fasting and metabolic switching: a brief overview. Biomed Pharmacol J. 2020;13(3). doi:10.13005/bpj/2030