Alzheimer's Disease: Metabolic strategies to slow and reverse progression

Dr Matthew Phillips discusses metabolic strategies for the treatment of Alzheimer’s disease, including both fasting and the ketogenic diet. He also discusses results from his Waikato trials.

Topics

Intro
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impaired brain energy metabolism
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prevalence in NZ
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What is meant by the phrase “type 3 diabetes”
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new randomized crossover trial in the Waikato
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A modified keto diet
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How difficult was adherence
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Prescribing keto or Low Carbohydrate Diet may be a bit scary
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Can we measure LDL subfractions in NZ, and should we be doing this?
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Trial results
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Can we, and should we, be telling our patients w AD to go keto full time?
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How fasting differs from Keto diets
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What does the fast involve?
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Has Alzheimer's and fasting been studied.
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Take-home messages
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Take home messages

People with Alzheimers display a brain-specific form of insulin resistance, resulting in deficient glucose metabolism.
Alzheimers neurons also show significant mitochondria dysfunction, which precedes the appearance of plaques or tangles.
Metabolic strategies, such as fasting and ketogenic diets, create ketones that can bypass the insulin resistance, and they stimulate multiple mechanisms focused on mitochondria renewal.
In the first-ever randomized crossover trial of a ketogenic diet in Alzheimer’s, people showed statistically (and clinically) meaningful improvements in daily function and quality of life.
Given the efficacy and safety data to date, it is reasonable to offer a modified ketogenic diet to people with Alzheimer’s disease.

Resources

Metabolic Neurologist Resources from Matthew Phillips
Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease Alzheimer's Research & Therapy (2021)
NZ Dementia Foundation
Alzheimers New Zealand
New Zealand Framework for Dementia Care MZ MOH (2013)
Alzheimer’s disease Health Navigator NZ patient resources

Presenter

Matthew Phillips

Clinical and Research Neurologist

Dr Matthew Phillips is a full-time clinical and research neurologist at Waikato Hospital, Hamilton. His foremost passion is to explore the potential feasibility, safety, and efficacy of metabolic strategies, particularly fasting and ketogenic diets, in creating alternate metabolic states that may improve not only the symptoms, but also function and quality of life, for people with a variety of difficult disorders. In 2021, Matt and his dedicated team published the world’s first randomized trial of a ketogenic diet in Alzheimer’s Disease.