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Cited by 169Diet and metabolism studiesDietary Effects on HealthDiabetes Management and Research

Inverse relationship between brain glucose and ketone metabolism in adults during short-term moderate dietary ketosis: A dual tracer quantitative positron emission tomography study

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Courchesne-Loyer, Alexandre, Croteau, Etienne, Castellano, Christian-Alexandre, St-Pierre, Valérie, Hennebelle, Marie, Cunnane, Stephen C·2017·Journal of Cerebral Blood Flow & Metabolism
DOI 10.1177/0271678x16669366PMC PMC5531346
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Abstract

Ketones (principally β-hydroxybutyrate and acetoacetate (AcAc)) are an important alternative fuel to glucose for the human brain, but their utilisation by the brain remains poorly understood. Our objective was to use positron emission tomography (PET) to assess the impact of diet-induced moderate ketosis on cerebral metabolic rate of acetoacetate (CMRa) and glucose (CMRglc) in healthy adults. Ten participants (35 ± 15 y) received a very high fat ketogenic diet (KD) (4.5:1; lipid:protein plus carbohydrates) for four days. CMRa and CMRglc were quantified by PET before and after the KD with the tracers, 11 C-AcAc and 18 F-fluorodeoxyglucose ( 18 F-FDG), respectively. During the KD, plasma ketones increased 8-fold ( p = 0.005) while plasma glucose decreased by 24% ( p = 0.005). CMRa increased 6-fold ( p = 0.005), whereas CMRglc decreased by 20% ( p = 0.014) on the KD. Plasma ketones were positively correlated with CMRa (r = 0.93; p < 0.0001). After four days on the KD, CMRa represented 17% of whole brain energy requirements in healthy adults with a 2-fold difference across brain regions (12–24%). The CMR of ketones (AcAc and β-hydroxybutyrate combined) while on the KD was estimated to represent about 33% of brain energy requirements or approximately double the CMRa. Whether increased ketone availability raises CMR of ketones to the same extent in older people as observed here or in conditions in which chronic brain glucose hypometabolism is present remains to be determined.

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  • Intermittent fasting (IF) is a diet with salutary effects on cognitive aging, Alzheimer's disease (AD), and stroke.

    “Intermittent fasting (IF) is a diet with salutary effects on cognitive aging, Alzheimer’s disease (AD), and stroke.”

    From 2-Deoxyglucose drives plasticity via an adaptive ER stress-ATF4 pathway and elicits stroke recovery and Alzheimer’s resilience (2023) · cites this paper as [5]

    The Introduction discusses a ketogenic diet and compares its ketone levels with those reached during fasting; it does not discuss intermittent fasting as an intervention. The Discussion proposes a possible metabolic benefit of ketogenic intervention in Alzheimer’s disease, while the Conclusion says effects in aging and Alzheimer’s disease remain to be assessed. Neither passage establishes benefits of intermittent fasting for cognitive aging, Alzheimer’s disease, or stroke (section pages not provided). (LLM, conf=0.76)

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Authors
Courchesne-Loyer, A., Croteau, E., Castellano, C.-A., St-Pierre, V., Hennebelle, M., & Cunnane, S. C.
Affiliations
  • Research Center on Aging, Sherbrooke, Université de Sherbrooke, Québec, Canada
  • Université de Sherbrooke (CA)
Corresponding author
Cunnane, Stephen C
ORCID
Venue
Journal of Cerebral Blood Flow & Metabolism
Publisher
SAGE Publications
Published
2016-10-01
Volume
37
Issue
7
Pages
2485-2493
ISSN
  • 0271-678X (ISSN-L)
  • 1559-7016
DOI
10.1177/0271678x16669366
PMC
PMC5531346
OpenAlex
W2518997301
Cited by
169
References
51
Citations by year
2026: 14 · 2025: 11 · 2024: 18 · 2023: 15 · 2022: 30 · 2021: 21 · 2020: 17 · 2019: 12 · 2018: 14 · 2017: 13 · 2016: 3 · 2015: 1
FWCI
11.26
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Cerebral Blood Flow & Metabolism (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
dietary ketosis, ketogenic diet, brain glucose metabolism, acetoacetate, beta-hydroxybutyrate, cerebral metabolic rate, brain energy metabolism, plasma ketones, plasma glucose, regional brain differences
MeSH terms
Adult, Brain, Female, Glucose, Humans, Ketones, Ketosis, Male, Middle Aged, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography, Diet, Ketogenic, Young Adult

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