What to do to reduce 'chemo-brain'?
Often patients ask us why we recommend a ketogenic diet after the completion of chemotherapy or radiation therapy.
Both treatments cause 'brain fog' or 'chemo-brain'.
The dietary component of our approach promotes a combination of ketogenic and Mediterranean food patterns, which replaces saturated fats from animal sources with coconut products, and encourages a high diversity of plant foods rich in phytonutrients and vitamins.
Mediterranean diet (Mediet) the Mediet has been studied extensively for its anti-inflammatory and nutrient density and has been found to effectively support a reduction in chronic disease risks and mortality.
This dietary and lifestyle approach:
Emphasizes a high fruit and vegetable intake
Focuses on whole grains and legumes over refined grains
Maintains a focus on nuts, fish and olive oil as sources of unsaturated fats
Recommends moderation in the consumption of red wine, red meat and poultry
Encourages regular physical activity as part of the overall lifestyle
Ketogenic diet (keto diet) the keto diet has garnered considerable attention recently. Following the keto diet results in the production of ketone bodies, which can be utilized by the brain for energy, in place of glucose.
The macronutrient distribution of the keto diet typically involves the following ranges:60-80% of calories from fats
5-15% of calories from carbohydrates
15-30% of calories from protein
A case for a Keto-Mediet with coconut
Coconut oil, Cocos nucifera, is a mostly saturated, medium-chain fatty acid (MCFA). MCFAs are an important SFA source of energy in the body as they bypass the carnitine shuttle pathway and enter the mitochondria directly. MCFAs from coconut may play a significant role in the aging adult population's diet, particularly for those who have difficulty breaking down and utilizing dietary fats. Coconut MCFAs can also be used in place of long-chain SFA, such as those found in red meat, dairy and various types of processed foods, as needed when adhering to a keto diet approach.Following a Keto-Mediet with coconut encourages a combination of components from both the Mediterranean and ketogenic diets, including a high-phytonutrient, anti-inflammatory, high-fiber, low-carbohydrate, high medium chain SFA approach which focuses on 7 key food categories including: fruits, vegetables, proteins, fats and nuts, dairy, grains, and beverages. Coconut is recommended to replace some or all sources of saturated animal fats, and the limited carbohydrates are mainly sourced from whole grains. Additional details of this modified Keto-Mediet with coconut adult food pyramid include:
Pyramid base consists of fruits (2-3 serving per day), vegetables (2-3 cups per day) and beverages such as water, broth soup, green tea, other forms of teas (ashwagandha and almond), black coffee, juice with pulp, and coconut water
Second level of pyramid consists of fats (from plants and fish including olive oil, fatty fish, coconut oil, avocados, walnut oil, camellia oil, and vegetable oil) and nuts, protein (lean meats, tofu, fish, poultry, eggs) and dairy (1-2 cups of low-fat milk or yogurt per day) with coconut and soy milk substituting for butter and milk from animals as desired
Third level of pyramid consists of grains (bread, cereal, rice, pasta, etc.) at < 50 grams per day or 1-2 cups per day with at least half of the total coming from whole grains
Top of pyramid consists of "snack" or "junk" food and should be avoided all together or consumed infrequently
In summary, this review article recommends following a Keto-Mediet with coconut substitution along with regular physical exercise to improve brain function in those with risk factors, to improve weight management, and to prevent cardiovascular disease.
A combination of Mediterranean and ketogenic diet approaches help combat dysfunctional brain insulin signaling and brain glucose metabolism
The Keto-Mediet is also supportive of weight management and cardiovascular health
Replacing long-chain SFA with coconut products, which mainly consists medium chain SFA may be beneficial in individuals requiring greater energy sources or those who have difficulty metabolizing and utilizing long-chain SFAs
Alzheimer's Association. 2018 Facts and Figures. https://www.alz.org/facts/overview.asp. Accessed May 7, 2018.
Sanabria-Castro A, Alvarado-Echeverria I, Monge-Bonilla C. Molecular pathogenesis of Alzheimer's disease. Ann Neurosci. 2017;24(1):4654.
Perng BC, Chen M, Perng JC, Jambazian P. A Keto-mediet approach with coconut substitution and exercise may delay the onset of Alzheimer's disease among middle aged. J Prev Alzheimers Dis. 2017;4(1):51-57.
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