Does the Brain Need Carbs?

Bret: 
Does the brain need carbohydrates? Ketogenic therapy can be a life-changing treatment for multiple brain-based disorders, including severe depression, bipolar disorder, dementia, and more. But some claim the brain needs carbohydrates. And therefore, we shouldn’t eat a ketogenic diet. Turns out this is completely false.

So let’s see why.

Welcome to the Metabolic Mind Podcast. I’m your host, Dr. Bret Scher. Metabolic Mind is a nonprofit initiative of Baszucki Group where we’re providing information about the intersection of metabolic health and mental health and metabolic therapies, such as nutritional ketosis as therapies for mental illness.

Thank you for joining us. Although our podcast is for informational purposes only and we aren’t giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

At Metabolic Mind, we get comments almost weekly that people should avoid a ketogenic diet because the brain needs carbs. And therefore, it would be unhealthy to remove carbs from the diet. First, a keto diet does not have to be a no-carb diet, right? Keto diets can consist of an array of high-fiber veggies, such as broccoli and cauliflower, zucchini, spinach, bell peppers, and more.

But perhaps, more importantly, the idea that the brain needs carbs is just simply wrong. But I can understand why some doctors or dieticians or others may believe that. But before we go further and get into the details, please remember our channel is for informational purposes only. We’re not providing individual or group medical or healthcare advice or establishing a provider patient relationship.

Many of the interventions we discuss can have potentially dangerous effects if done without proper clinical supervision. So, consult your healthcare provider before changing your lifestyle or medications. In addition, please recognize that people may respond differently to ketosis, and there isn’t one recognized universal response.

So, let’s get into it. Why would some healthcare providers mistakenly believe that the brain needs carbs? It turns out the brain needs some glucose, but that doesn’t mean we need to eat carbs to get the glucose. So, remember, when it comes to energy metabolism, we can either burn glucose for energy or we can burn fat, and in the process create ketones, which the brain can use for energy.

But studies indicate that the brain can shift from using a 100% glucose to using up to 70% ketones and 30% glucose for energy. Now, only requiring 30% of your energy demands from glucose is a dramatic improvement for an insulin-resistant brain that has trouble metabolizing glucose. But the brain won’t run 100% on ketones. So, it’s accurate to say the brain still needs some glucose. But the body’s pretty smart, and it has its own way of making glucose from fat and protein, if needed.

This process is called gluconeogenesis, literally, making new glucose. So, even on sustained no-carb diets, the body and brain get plenty of glucose. That’s why you can fast for days or weeks or eat no carbs for days or weeks, and your blood glucose remains the same, and your brain will still run on that 30% of glucose that it needs.

But that’s why some people believe we need carbs, because our brains need glucose, but we don’t need carbs. So, now that our brains don’t require us to eat carbohydrates, could ketogenic therapy be a potential treatment for you? Please go back and watch some of our prior videos so you can have a more informed discussion with your healthcare team about this.

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