Exercise is a hot favourite recently with gyms sprouting in every locality and every lane. Today on our website we are going to talk about exercise and keto diet, but not for weight loss or muscle building purposes, but as an adjuvant therapy for medical disorders. Yes you heard it right!! – for medical disorders. How does exercise act as an adjuvant with the ketogenic diet in medical disorders? As you all know we use the ketogenic diet at our center exclusively for epilepsy and other medical disorders. So we will present some scientific data to our patients and website viewers keen to know the benefits of exercise while on the ketogenic diet. Though it is technical but we will try and make it simple for all.
First we have to understand the connection between exercise, diet and brain-derived neurotrophic factor (BDNF) and medical disorders. Let us first explain what BDNF is.
BDNF stands for brain-derived neurotrophic factor. Its main function is to regulate the growth of neural connections in the brain.
Fernando Gomez-Pinilla states that exercise and selected dietary factors have the ability to impact molecules related to cellular energy control and neural repair through agents such as BDNF, and are important for the function and maintenance of neuronal circuits. The action of BDNF is crucial for supporting cognitive and motor abilities. Thus, proper BDNF function is necessary for maintaining learning and memory capacities in humans (Egan et al., 2003; Hariri et al., 2003)
Low levels of BDNF have been correlated with mental disorders such as Alzheimer’s, depression, schizophrenia, and Huntington’s disease.
Also epilepsy has been linked with polymorphisms in BDNF. Levels of both BDNF mRNA and BDNF protein are known to be up-regulated in epilepsy (Gall C et al., 1991) BDNF modulates excitatory and inhibitory synaptic transmission by inhibiting GABAA-receptor-mediated post-synaptic currents (Tanaka T et al., 1997). This provides a potential mechanism for the observed up-regulation and consequent control of epilepsy.
BDNF is one of many neurotrophins in the brain that helps stimulate and manage the process of neurogenesis..
How can we increase BDNF (Brain-Derived Neutrophic Factor)
- Aerobic exercise, also known as cardio exercise, is any exercise that lasts over three minutes. Lower intensity, steady-state cardio is fat burning, making it very friendly for the keto dieter.
- Anaerobic exerciseis characterized by shorter bursts of energy, such as from weight training or high-intensity interval training. Carbohydrates are the primary fuel for anaerobic exercise, so fat alone cannot provide enough energy for this type of workout.
- Flexibility exercisesare helpful for stretching your muscles, supporting joints, and improving muscle range of motion. Increasing your flexibility can help prevent injuries caused by shortening of the muscles over time. Yoga and simple after-workout stretches are good examples of this.
- Stability exercises include balance exercises and core training. They help improve your alignment, strength muscles, and control of movement.
- Intermittent Fasting or Caloric Restriction
Mattson MP et al observed in his study that the mechanism by which a reduction in calories or intermittent fasting elevates BDNF is probably similar to that of intense aerobic exercise.
- Dietary modifications
- Cutting refined sugar and saturated fat:
Molteni R et al. investigated a potential mechanism by which a diet, similar in composition to the typical diet of most industrialized western societies rich in saturated fat and refined sugar (HFS), can influence brain structure and function via regulation of neurotrophins. These were sufficient to reduce hippocampal level of BDNF and spatial learning performance.
- Use of Curcumin:
Liu D et al and Nam SM et al., both observed that curcumin elevated BDNF production in the hippocampal region, which created antidepressant effects and improved cognitive function.
- Green tea:
Gundimeda U et al showed that green tea polyphenol resulted in an increase in BDNF.
- Omega-3 fatty acids:
- The omega-3 fatty acids in fish oil include DHA and EPA, but DHA (docosahexaenoic acid) alone is responsible for increasing levels of BDNF.
- Wu A et al study’s results imply that omega-3 enriched dietary supplements can provide protection against reduced plasticity and impaired learning ability after traumatic brain injury.
- Balanzá-Martínez V et al. article summarizes the molecular pathways related to the role of n-3 as a neuroprotective and neurogenic agent, with a specific focus on BDNF.
There are few studies showing contradicting results of Ketogenic diet on exercise.
Chen-Kang Chang et al observed that while KD improves endurance and repeated high-intensity exercise and but on the other hand it also shows effects on central fatigue and perceptual-motor performance in athletes. High protein content of LCHF (Ketogenic diets) leads to elevated ammonia production during exercise. Ammonia is another factor that could induce central fatigue by altering the cerebral energy metabolism and neurotransmission, and affect signaling pathways within the neural circuits. But this study which focuses on sports concludes that long-term LCHF diets appear to be safe and may even improve several metabolic risk factors for chronic diseases in the general population. The protein used in these sports related KDs are much higher in proteins than the WHO recommendations.
The ketogenic diet used for epilepsy control and other medical therapies does not use high protein but as per WHO recommended dietary allowances.
So we conclude that Ketogenic diet and exercise is safe in any neurological disorder but this article has taken into consideration only one factor namely BDNF. Apart from BDNF, there are many other aspects which we would like to explore.
So stay tuned with us for our next update on KD: exercise – a myriad effects.
1. Fernando Gomez-Pinilla. The combined effects of exercise and foods in preventing neurological and cognitive disorders. Prev Med. 2011 June 1; 52(Suppl 1): S75–S80.
2. Gall C, Lauterborn J, Bundman M, Murray K, Isackson P (1991). “Seizures and the regulation of neurotrophic factor and neuropeptide gene expression in brain”. Epilepsy Research. Supplement. 4: 225–45. PMID 1815605.
3. Tanaka T, Saito H, Matsuki N (May 1997). “Inhibition of GABAA synaptic responses by brain-derived neurotrophic factor (BDNF) in rat hippocampus”. The Journal of Neuroscience. 17 (9): 2959–66. PMID 9096132.
4. Mattson MP. Energy intake, meal frequency, and health: a neurobiological perspective. Annu Rev Nutr. 2005;25:237-60
5. Mattson MP et al. Beneficial effects of intermittent fasting and caloric restriction on the cardiovascular and cerebrovascular systems. J Nutr Biochem. 2005 Mar;16(3):129-37.
6. Molteni R et al. A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience. 2002;112(4):803-14.
7. Liu D et al. Effects of curcumin on learning and memory deficits, BDNF, and ERK protein expression in rats exposed to chronic unpredictable stress. Behav Brain Res. 2014 Sep 1;271:116-21.
8. Nam SM et al. Effects of curcumin (Curcuma longa) on learning and spatial memory as well as cell proliferation and neuroblast differentiation in adult and aged mice by upregulating brain-derived neurotrophic factor and CREB signaling. J Med Food. 2014 Jun;17(6):641-9
9. Gundimeda U et al. Green tea catechins potentiate the neuritogenic action of brain-derived neurotrophic factor: role of 67-kDa laminin receptor and hydrogen peroxide. Biochem Biophys Res Commun. 2014 Feb 28;445(1):218-24.
10. Wu A et al. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma. 2004 Oct;21(10):1457-67.
11. Balanzá-Martínez V et al. Therapeutic use of omega-3 fatty acids in bipolar disorder. Expert Rev Neurother. 2011 Jul;11(7):1029-47
12. Chen-Kang Chang et al. Low‐Carbohydrate‐High‐Fat Diet: Can it Help Exercise Performance? Journal of Human Kinetics volume 56/2017, 81-92.