Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Radiology, Columbia University, New York, NY, USA.
Neurobiol Aging. 2020 Feb;86:54-63. doi: 10.1016/j.neurobiolaging.2019.09.015. Epub 2019 Sep 26.
There is currently no established therapy to treat or prevent Alzheimer's disease. The ketogenic diet supplies an alternative cerebral metabolic fuel, with potential neuroprotective effects. Our goal was to compare the effects of a modified Mediterranean-ketogenic diet (MMKD) and an American Heart Association Diet (AHAD) on cerebrospinal fluid Alzheimer's biomarkers, neuroimaging measures, peripheral metabolism, and cognition in older adults at risk for Alzheimer's. Twenty participants with subjective memory complaints (n = 11) or mild cognitive impairment (n = 9) completed both diets, with 3 participants discontinuing early. Mean compliance rates were 90% for MMKD and 95% for AHAD. All participants had improved metabolic indices following MMKD. MMKD was associated with increased cerebrospinal fluid Aβ42 and decreased tau. There was increased cerebral perfusion and increased cerebral ketone body uptake (C-acetoacetate PET, in subsample) following MMKD. Memory performance improved after both diets, which may be due to practice effects. Our results suggest that a ketogenic intervention targeted toward adults at risk for Alzheimer's may prove beneficial in the prevention of cognitive decline.
目前尚无治疗或预防阿尔茨海默病的既定疗法。生酮饮食提供了一种替代大脑代谢燃料的方法，具有潜在的神经保护作用。我们的目标是比较改良地中海生酮饮食（MMKD）和美国心脏协会饮食（AHAD）对有患阿尔茨海默病风险的老年人的脑脊液阿尔茨海默病生物标志物、神经影像学测量、外周代谢和认知的影响。20 名有主观记忆主诉（n=11）或轻度认知障碍（n=9）的参与者完成了这两种饮食，其中 3 名参与者提前中断。MMKD 的平均依从率为 90%，AHAD 的平均依从率为 95%。所有参与者在接受 MMKD 后代谢指数均有所改善。MMKD 与脑脊液 Aβ42 增加和 tau 减少有关。接受 MMKD 后，脑灌注增加，脑酮体摄取增加（亚组的 C-乙酰乙酸 PET）。两种饮食后记忆力均有提高，这可能是由于练习效应。我们的结果表明，针对有患阿尔茨海默病风险的成年人的生酮干预可能有助于预防认知能力下降。
