Refuelling the Post-COVID Brain: The Role of Ketogenic Nutrition

Five years after COVID-19 became a public health emergency, the spotlight seems to be increasingly falling on “long COVID,” a condition marked by lingering symptoms that persist well beyond the acute phase of the infection. Among these, cognitive dysfunction – commonly referred to as “brain fog” – is one of the most debilitating. There seems to be potential for ketogenic nutrition in addressing the cognitive challenges of long COVID.

Understanding Long COVID and Brain Fog

Long COVID encompasses a spectrum of symptoms, including fatigue, memory lapses, difficulty concentrating, and mood disturbances. A growing body of evidence points to cerebral glucose hypometabolism as a potential underlying cause of these cognitive deficits. This condition, observed in other neurodegenerative diseases like Alzheimer’s, reflects the brain’s impaired ability to utilize glucose for energy, leading to widespread dysfunction in brain regions responsible for attention, memory, and executive function.

Key contributors to this energy crisis in the brain include:

• Oxidative Stress: An imbalance between reactive oxygen species (ROS) and antioxidant defenses, exacerbated by inflammation and mitochondrial dysfunction.
• Neuroinflammation: Triggered by systemic cytokines crossing the blood-brain barrier (BBB), causing prolonged inflammation and damage.
• Mitochondrial Impairment: SARS-CoV-2’s interference with mitochondrial function, leading to reduced ATP production and increased ROS.

Ketogenic Metabolic Therapies: Fuelling the Brain with Ketones

Ketogenic metabolic therapies encompass a range of dietary and supplemental strategies designed to induce a state of therapeutic ketosis. This state is achieved by significantly reducing carbohydrate intake while increasing dietary fats, prompting the body to produce ketones as an alternative energy source. These therapies are utilized not only for managing chronic metabolic conditions like type 2 diabetes and obesity but also for neurological disorders, cancer, and emerging applications like long COVID. By providing a steady and efficient energy supply to the brain, ketones bypass the brain’s reliance on glucose and provide several additional benefits:

1. Energy Production with Reduced ROS: Ketones generate energy more efficiently than glucose, resulting in lower oxidative stress.
2. Enhanced Antioxidant Activity: Ketones upregulate antioxidant enzymes like glutathione peroxidase and superoxide dismutase, neutralizing ROS.
3. Neuroinflammation Reduction: By modulating inflammation pathways, ketones help control excessive cytokine activity.
4. Epigenetic Modulation: Beta-hydroxybutyrate (BHB), a primary ketone, activates protective genes that enhance stress resistance and reduce inflammation.
5. Mitochondrial Support: Ketones promote mitochondrial biogenesis and repair, ensuring sustained energy production and cellular health.
6. Cognitive Enhancement: Ketones improve synaptic plasticity, memory, and processing speed, making them particularly effective in addressing cognitive decline.

Practical Guidance for Implementing Ketogenic Strategies

For those considering Ketogenic Metabolic Therapies, here are key steps:

• Consult a Professional: Work with a nutrition specialist or healthcare provider to tailor strategies to your individual needs and health conditions. Different individuals require different ratios of fat to carb + protein to get into therapeutic ketosis.
• Start Slow: It is best to build up from 1 keto meal per week to 3 keto meals per week over a 2-3 week period.  This helps the body adjust at a sustainable rate.
• Monitor Ketone Levels: Use finger-prick tests to track beta-hydroxybutyrate levels and blood sugar once you’re on 3 keto meals per day. This is the best way to assess your levels of therapeutic ketosis.
• Ensure your diet is well formulated: Even within the restrictions of Ketogenic Metabolic Therapies, it is essential to ensure that your diet is well formulated to support optimal nutrition status.

If you’d like to investigate whether Ketogenic Metabolic Therapies may be an option for you please get in touch with me: hannah@hannahkaye.co.za