Enhance autophagy, ketogenesis

Goal: Enhance autophagy, ketogenesis

Approach: Fast 12 hours each night and stop eating 3 hours prior to bedtime.

Rationale: Reduce insulin levels, reduce Aß (amyloid beta).

Autophagy means "self-eating." When you don't eat for longer periods, your body turns to itself for fuel by recycling the old bits and pieces that result from every day cellular functions. Here is an interesting discussion of autophagy.

Ketogenesis means making ketone molecules. When you sleep, after your last meal is digested and the resulting blood glucose used, your brain still needs energy. If you fast long enough, the body produces energy from turning your fat stores into ketones, which the brain can use in place of blood glucose. Medium chain triglycerides (MCT) can be used to help promote ketosis and improve insulin resistance. Coconut oil contains MCTs, but for some, coconut oil can raise lipid markers quite a bit. Dr. Bredesen suggests that E4s use MCT and coconut only as short-term crutches to ease into ketosis.

In the long term, a low-carbohydrate diet, along with fasting (minimum 12 hours overnight, Dr Bredesen recommends 14 to 16 hours of overnight fasting for ApoEε4s) and exercise will help sustain mild ketosis. Visit our page about ketosis and a ketogenic diet for more details.

Insulin is the hormone produced when you eat carbohydrates, telling your body to take glucose out of the bloodstream. If you eat more carbohydrates than your body can process, you can become insulin resistant. This can lead to diabetes, which doubles your Alzheimer's risk. For strategies to improve your insulin resistance, see our page on Insulin Resistance.

Aß (Amyloid Beta) makes up most of the plaque found in autopsies of Alzheimer's brains. A ketogenic diet has been shown to reduce the plaques in mice.

References

• Overnight fasting/autophagy as a neuroprotective strategy: Neuroprotective effects of dietary restriction: Evidence and Mechanisms
• Ketone as an alternate form of neural fuel in ApoE4 carriers: Brain fuel metabolism, aging, and Alzheimer's disease
• Using MCT oil to achieve ketosis and improve glucose metabolism: Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in NIDDM subjects. (1992)
• Using MCT oil to achieve ketosis: Pilot feasibility and safety study examining the effect of medium chain triglyceride supplementation in subjects with mild cognitive impairment: A randomized controlled trial. (2015)
• Fasting and impact on health: Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease (2017)
• Restricting hours of eating for better health: Time-restricted feeding is a preventative and therapeutic intervention against diverse nutritional challenges (2014)
• Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial
• Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer's disease. (2016)
• Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in NIDDM subjects. (1992)

For Additional Reading

ApoE4.info wiki article: Ketosis and Ketogenic Diet

ApoE4.info wiki article: Coconut Oil, MCT oil, and other Ketone/Cognition Boosters (salts, esters)

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