Ketogenic diet as a treatment for brain and spinal cord injury

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Infographic by Justin Yap

Edited by Crystal Han and Rona Herzog.

This is an infographic based on a review article by ICORD researches Dr. Wolfram Tetzlaff, Oscar Seira, Kathleen Kolehmainen, Ward Plunet, and Nima Alaeiikhchi and their colleagues. Read the original article here.

Following a traumatic brain or spinal cord injury, there are many pharmaceutical methods which can be used to help treat the symptoms associated with brain or spinal cord injury. Additionally, evidence has also been found supporting the ability of ketogenic diets to reduce reliance on pharmaceutical treatments following a traumatic brain or spinal cord injury.

In this article by Dr. Tetzlaff and his colleagues, the authors review the most recent publications showing the beneficial role of ketogenic regimes following spinal cord injuries or traumatic brain injuries. Additionally, they summarize the main mechanisms which the ketogenic regimes are acting upon to provide the benefits.

The following infographic summarizes the most recent evidences of the beneficial role of Ketogenic regimes, and the most likely mechanisms that are playing a role on its.  All of the images below were created using Biorender.

Initial Injury: TBI or SCI
After a TBI (traumatic brain injury) and a SCI (spinal cord injury) there is an initial damage that is followed by inflammation and metabolic dysregulation, resulting, amongst other things, in damage to building blocks which are essential to our cells, as well as damaging other energy producing molecules.
Ketogenic Diets and Ketone Ester Supplements: a therapeutic diet
Keto ester supplements or a ketogenic (keto) diet were found to be promising therapies to combat symptoms associated with initial TBI (traumatic brain injury) and SCI (spinal cord injury). A keto diet is a diet composed of high fats and proteins, with a very small amount of carbohydrates. Foods which make up a keto diet are shown above.
How does it work?
A keto diet provides the body with energy from high levels of fat found in the foods. The body is able to convert the fat into energy by breaking down the fat molecules into ketones. The liver is responsible for this conversion. After fat is converted into ketones, the ketones can be used as a source of energy in the body.
The 3 main effects of ketone bodies in the body after trauma, as well as the mechanisms of how they function to provide benefits following spinal cord injury, are listed below.


Role 1: Prevention of Reactive Oxygen Species (ROS)
Neurotrauma, such as TBI and SCI, causes the formation of reactive oxygen species (ROS). Reactive oxygen species are molecules which are harmful to proteins used by our cells, and even cause damage to the DNA in the cell. This will result in a “stressed”, or damaged neuron, as shown above. Ketones can reduce the formation of ROS production.
Role 2: Decrease inflammation in the body
Pain could be one of the consequences following neurotrauma, but inflammation can also contribute to secondary damage which could involve tissue loss. A keto diet was found to reduce overall inflammation, which subsequently results in a decreased level of pain in those with neurotrauma.
Role 3: Alternative energy source and improved mitochondrial function
Neurotrauma can impair mitochondrial function, which is concerning as the mitochondria is the organelle which is responsible for producing energy for our cells. Without proper mitochondrial function, our cells will be deprived of energy. Ketones were found as an alternative energy source which can be used to improve mitochondrial function, in addition to being a more efficient energy source for the brain.
Why is this important?
Recent research and data from Dr. Tetzlaff’s lab demonstrates that ketones can improve mitochondrial function by being used as an alternative energy source, and also by acting as molecules able to alter functionality at a cellular level. Up to date, these recent discoveries, along with the others summarized in this review article, support the potential of ketogenic regimes in the treatment of neurotraumatic events.

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One thought on “Ketogenic diet as a treatment for brain and spinal cord injury

  1. Yes the Keto diet makes all the difference in the world. I just keep getting better! Not that I am back to the person that I was before my car accident. But I am not not screeming out of control any more due to stress and frustration.

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