Alzheimer Hastalığında Ketojenik Diyet Tedavisi

Alzheimer, bellek kaybı ve bilişsel fonksiyonlardaki azalma ile karakterize progresif bir nörodejeneratif hastalıktır. Patogenezinde yer alan glikoz hipometabolizmasının yıkıcı sonuçlarını engellemek, artmış oksidatif stresi ve inflamatuar yanıtı azaltmak ve mitokondriyal işlevleri geliştirmek amacıyla çeşitli diyet müdahaleleri kullanılmıştır. Bunlardan biri ketojenik diyet olmuştur. Ketojenik diyet, yüksek yağlı, düşük karbonhidratlı bir diyettir ve vücut enerjisinin yağlardan karşılanmasını sağlamaktadır. Alzheimer gibi nörodejeneratif hastalıklarda tedavi yöntemi olarak kullanılabileceği öne sürülmüştür. Bunun en önemli nedenlerinden birisi beyinin glikoza bağımlılığını azaltacak alternatif bir enerji kaynağı oluşturabilmesidir. Yağların mitokondride β-oksidasyonu sonucu keton cisimcikleri oluşmaktadır. Bu keton cisimcikleri beynin temel enerji kaynağı olan glikozun yokluğunda alternatif enerji kaynağı olarak kullanılmaktadır. Sonuç olarak glikoz metabolizması düzeltmekte, mitokondriyal fonksiyonlar gelişmekte, oksidatif stres azalarak sistemik inflamatuar azalmaktadır. Ketojenik diyetin β-Amiloid plak birikimi ve nörofibril yumak oluşumuna etkisi ise hala tartışmalıdır. Yapılan bazı hayvan modelli çalışmalarda β-Amiloid plak birikimini azalttığı sonucuna varılmıştır. Ancak bunun tersi sonuçlara sahip araştırmalar da mevcuttur. Dolayısıyla diyetin etkisini açıklayabilmek için daha çok çalışmalara ihtiyaç duyulmaktadır. Bu derlemede ketojenik diyetin Alzheimer üzerine etkisini değerlendirmek amaçlanmıştır.

Anahtar Kelimeler:

Alzheimer, beslenme, ketojenik diyet

Ketogenic Diet Treatment in Alzheimer’s Disease

Alzheimer's is a progressive neurodegenerative disease characterized by memory loss and decreased cognitive function. Various dietary interventions have been used to prevent the devastating consequences of glucose hypometabolism in its pathogenesis, to reduce increased oxidative stress and inflammatory response, and to improve mitochondrial functions. One of them has been the ketogenic diet. The ketogenic diet is a high-fat, low-carb diet that provides the body's energy from fat. It has been suggested that it can be used as a treatment method in neurodegenerative diseases such as Alzheimer's. One of the most important reasons for this is that it can create an alternative energy source that will reduce the brain's dependence on glucose. Ketone bodies are formed as a result of β-oxidation of fats in mitochondria. These ketone bodies are used as an alternative energy source in the absence of glucose, the main energy source of the brain. As a result, glucose metabolism is corrected, mitochondrial functions develop, oxidative stress decreases and systemic inflammation decreases. The effect of the ketogenic diet on β-Amyloid plaque accumulation and neurofibrillary tangle formation is still controversial. In some animal model studies, it has been concluded that it reduces the accumulation of β-Amyloid plaque. However, there are also studies with opposite results. Therefore, more studies are needed to explain the effect of diet. In this review, it was aimed to evaluate the effect of the ketogenic diet on Alzheimer's.

Keywords:

Alzheimer's, nutrition, ketogenic diet,

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