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TBI THERAPY WEBINAR:
KETOGENIC DIET FOR TBI
By Dr. John Hughes
February 13th, 2018
DR. JOHN HUGHES, DO
Doctor of Osteopathy Arizona College of Osteopathic
Medicine
From Georgia
LEARNING OBJECTIVE
• What is a Traumatic Brain Injury (TBI)?
• What are Ketones?
• What is the Ketogenic Diet?
• How Does the Ketogenic Diet Help
TBI?
WHAT IS A TBI?
• A sudden, violent blow or jolt to the
head
• Brain collides with the inside of the
skull
• Bruising of the brain
• Tearing of nerve fibers and
bleeding
WHAT HAPPENS AFTER A TBI?
• During brain swelling, glucose uptake that
surges to the injured area to provide
energy for healing and repair is blocked
• The brain is flooded with disproportional
responses
TBI = METABOLIC CRISIS
“The brain is in a metabolic crisis in a concussion,
potassium ion from inside the cell going
extracellular, calcium ions going intracellular,
neurotransmitters widely released in a chaotic
manner. It takes energy to pump that potassium
back, put the neurotransmitters back on so the
cell can function.”
BIOCHEMICAL AND
PHYSIOLOGICAL
RESPONSES AFTER TBI
• Disproportional proinflammatory
cytokine production and release
→ Small proteins that are important
in cell signaling
• Increased counterregulatory
hormones
→ Work against the action of insulin
• Hypermetabolic and catabolic
states
• Severely impairing nitrogen
homeostasis
OXIDATIVE STRESS FROM TBI
A disturbance in the balance
between the production of
reactive oxygen species (free
radicals) and antioxidant
defenses
OXIDATIVE STRESS FROM TBI
• Impairs cerebral vascular function
• Impairs circulation
• Impairs the energy metabolism
• Damages mitochondria and DNA
• Fatigue
• Disturbances in sleep
• Memory loss and/or brain fog
• Decreased eye sight
• Headaches and sensitivity to noise
• Cognitive impairment
• Changes in mood
• Insulin resistance
• Hormone abnormalities
SYMPTOMS FROM OXIDATIVE STRESS
HOW TO DECREASE OXIDATIVE STRESS?
“Ketones decrease oxidative stress,
increase antioxidants and scavenge free
radicals.”
(Greco, Glenn, Hovda, & Prins, 2016)
WHAT ARE KETONES?
The result of breaking down fat for
energy when carbohydrate intake is low
HOW DOES THIS WORK?
HOW DOES THE BODY
CREATE ENERGY?
Glucose
Glycogen/Blood Sugar/Insulin Decreases
Body uses fat for energy
If we cut out carbohydrates and sugar
=Beta-oxidation / Ketosis / Decrease Oxidative Stress
Glucose/Carbohydrates
= Kindling
Ketones/Fats
= Logs
Which burns
more even?
KETONES BURN EVENLY
• Stabilizes the nervous system
• Reduces seizure threshold
• Enhances brain organization
• Corrects the metabolic crisis
• Balances hormones
KETONES ARE LIKE DIESEL FUEL
(GLUCOSE IS LIKE GASOLINE)
• Diesel fuel has a high flash point than
gasoline
• Harder to oxidize – Less flammable (excitable)
• The brain works like a diesel engine
• Burns more efficiently – lasts longer
Video
WHAT ELSE DO KETONES DO?
Increases GABA
Decreases Depression, Fear,
Anxiety
Decreases Glutamate
Decreases Oxidative Stress
Increases Neuroprotection
Increases Calming
NEUROPROTECTIVE ACTIONS OF THE
KETOGENIC DIET
• Increases resistance to metabolic stress
• Increases resilience to neuronal loss
• Upregulates energy metabolism genes
• Stimulates of mitochondrial biogenesis
• Enhances alternative energy substrates
• Promotes synthesis of adenosine triphosphate (ATP)
• Interferes with glutamate toxicity
• Bypasses the inhibition of complex I in the
mitochondrial respiratory chain
(Pillsbury, Oria, & Erdman, 2011)
THE KETOGENIC
DIET
• High-fat
• Adequate-protein
• Low-carbohydrate
DOEAT
Meats – fish, beef, lamb, poultry, eggs, etc.
Leafy Greens – spinach, kale, etc.
Above ground vegetables – broccoli, cauliflower, etc.
High Fat Dairy – hard cheeses, high fat cream, butter, etc.
Nuts and seeds – macadamias, walnuts, sunflower seeds, etc.
Avocado and berries – raspberries, blackberries, and other
low glycemic impact berries
Sweeteners – stevia, erythritol, monk fruit, and other low-carb
sweeteners
Other fats – avocado oil, coconut oil, grass-fed ghee, high-fat
salad dressing, saturated fats, etc.
DONOTEAT
Grains – wheat, corn, rice, cereal,
etc.
Sugar – honey, agave, maple
syrup, etc.
Fruit – apples, bananas, oranges,
etc.
Tubers – potato, yams, etc.
TBI THERAPY PROTOCOL
3 MONTHS
1. Begin ketogenic diet at beginning of
TBI Therapy treatments
2. Read Fat for Fuel by Dr. Joseph
Mercola
3. Consider intermittent fasting
4. Brain Octane (MCT Oils) =
16x more ketones than coconut oil
• Reduces oxidative stress
• Decreases neuroexcitatory glutamate
• Increases GABA – the calming neurotransmitter
• Overall improvements in cognitive and motor
functioning
• Proven treatment for patients suffering from
epileptic seizures – since 1921
KETOGENIC DIET AND TBI
Q&A
Learn more at tbitherapy.com
or call 303-447-1257
Video

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Ketogenic for TBI

  • 1. TBI THERAPY WEBINAR: KETOGENIC DIET FOR TBI By Dr. John Hughes February 13th, 2018
  • 2. DR. JOHN HUGHES, DO Doctor of Osteopathy Arizona College of Osteopathic Medicine From Georgia
  • 3. LEARNING OBJECTIVE • What is a Traumatic Brain Injury (TBI)? • What are Ketones? • What is the Ketogenic Diet? • How Does the Ketogenic Diet Help TBI?
  • 4. WHAT IS A TBI? • A sudden, violent blow or jolt to the head • Brain collides with the inside of the skull • Bruising of the brain • Tearing of nerve fibers and bleeding
  • 5. WHAT HAPPENS AFTER A TBI? • During brain swelling, glucose uptake that surges to the injured area to provide energy for healing and repair is blocked • The brain is flooded with disproportional responses
  • 6. TBI = METABOLIC CRISIS “The brain is in a metabolic crisis in a concussion, potassium ion from inside the cell going extracellular, calcium ions going intracellular, neurotransmitters widely released in a chaotic manner. It takes energy to pump that potassium back, put the neurotransmitters back on so the cell can function.”
  • 7. BIOCHEMICAL AND PHYSIOLOGICAL RESPONSES AFTER TBI • Disproportional proinflammatory cytokine production and release → Small proteins that are important in cell signaling • Increased counterregulatory hormones → Work against the action of insulin • Hypermetabolic and catabolic states • Severely impairing nitrogen homeostasis
  • 8. OXIDATIVE STRESS FROM TBI A disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses
  • 9. OXIDATIVE STRESS FROM TBI • Impairs cerebral vascular function • Impairs circulation • Impairs the energy metabolism • Damages mitochondria and DNA
  • 10. • Fatigue • Disturbances in sleep • Memory loss and/or brain fog • Decreased eye sight • Headaches and sensitivity to noise • Cognitive impairment • Changes in mood • Insulin resistance • Hormone abnormalities SYMPTOMS FROM OXIDATIVE STRESS
  • 11. HOW TO DECREASE OXIDATIVE STRESS? “Ketones decrease oxidative stress, increase antioxidants and scavenge free radicals.” (Greco, Glenn, Hovda, & Prins, 2016)
  • 12. WHAT ARE KETONES? The result of breaking down fat for energy when carbohydrate intake is low HOW DOES THIS WORK?
  • 13. HOW DOES THE BODY CREATE ENERGY? Glucose Glycogen/Blood Sugar/Insulin Decreases Body uses fat for energy If we cut out carbohydrates and sugar =Beta-oxidation / Ketosis / Decrease Oxidative Stress
  • 15. KETONES BURN EVENLY • Stabilizes the nervous system • Reduces seizure threshold • Enhances brain organization • Corrects the metabolic crisis • Balances hormones
  • 16. KETONES ARE LIKE DIESEL FUEL (GLUCOSE IS LIKE GASOLINE) • Diesel fuel has a high flash point than gasoline • Harder to oxidize – Less flammable (excitable) • The brain works like a diesel engine • Burns more efficiently – lasts longer Video
  • 17. WHAT ELSE DO KETONES DO? Increases GABA Decreases Depression, Fear, Anxiety Decreases Glutamate Decreases Oxidative Stress Increases Neuroprotection Increases Calming
  • 18. NEUROPROTECTIVE ACTIONS OF THE KETOGENIC DIET • Increases resistance to metabolic stress • Increases resilience to neuronal loss • Upregulates energy metabolism genes • Stimulates of mitochondrial biogenesis • Enhances alternative energy substrates • Promotes synthesis of adenosine triphosphate (ATP) • Interferes with glutamate toxicity • Bypasses the inhibition of complex I in the mitochondrial respiratory chain (Pillsbury, Oria, & Erdman, 2011)
  • 19. THE KETOGENIC DIET • High-fat • Adequate-protein • Low-carbohydrate
  • 20. DOEAT Meats – fish, beef, lamb, poultry, eggs, etc. Leafy Greens – spinach, kale, etc. Above ground vegetables – broccoli, cauliflower, etc. High Fat Dairy – hard cheeses, high fat cream, butter, etc. Nuts and seeds – macadamias, walnuts, sunflower seeds, etc. Avocado and berries – raspberries, blackberries, and other low glycemic impact berries Sweeteners – stevia, erythritol, monk fruit, and other low-carb sweeteners Other fats – avocado oil, coconut oil, grass-fed ghee, high-fat salad dressing, saturated fats, etc. DONOTEAT Grains – wheat, corn, rice, cereal, etc. Sugar – honey, agave, maple syrup, etc. Fruit – apples, bananas, oranges, etc. Tubers – potato, yams, etc.
  • 21. TBI THERAPY PROTOCOL 3 MONTHS 1. Begin ketogenic diet at beginning of TBI Therapy treatments 2. Read Fat for Fuel by Dr. Joseph Mercola 3. Consider intermittent fasting 4. Brain Octane (MCT Oils) = 16x more ketones than coconut oil
  • 22. • Reduces oxidative stress • Decreases neuroexcitatory glutamate • Increases GABA – the calming neurotransmitter • Overall improvements in cognitive and motor functioning • Proven treatment for patients suffering from epileptic seizures – since 1921 KETOGENIC DIET AND TBI
  • 23. Q&A Learn more at tbitherapy.com or call 303-447-1257 Video