Ketosis for the body means fat-burning. For the brain, it means a lower seizure risk and a better environment for neuronal recovery and repair.
Ketogenic diets have been prescribed for seizures for a long time. The actual research diets used in the past were pretty dismal and seemed to involve drinking a lot of cream and eating a lot of mayonnaise. At Johns Hopkins, pediatric patients were admitted to the hospital for a 48 hour fast and then given eggnog (minus the rum and sugar, I'm guessing) until ketosis was achieved (usually took about 4 days). In addition, ketogenic diets were calorie restricted to just 75-90% of what would be considered a child's usual calorie intake, and often they were fluid-restricted too (
1)! If we're talking soybean oil mayonnaise, you could see how someone could get into trouble with mineral deficiencies and liver problems pretty quickly
To understand "dismal," some of the latest research showed that a "modified Atkins protocol" was just as good as the classic ketogenic diet, and so much more liberating, as the patients were allowed up to 10 grams of carbohydrates daily, and they didn't begin with the fast, and they weren't calorie restricted (
2)(
3). While the classic ketogenic diet was 4:1:1 fat to carbs to protein. If you use MCT oil for 50% of your calories (have to add it in slowly though to prevent vomiting, diarrhea, and cramping!), you could increase the carbohydrates and proteins to a 1.2:1:1 fat:carb:protein and still get the same numbers of magical ketones circulating. And while "MCT oil" sounds nice and yummy when it is gorgeous coconut milk, this
MCT Oil 100% Pure 32 fl.oz doesn't look quite as appetizing, especially when that is going the be half of what you eat for the foreseeable future (
4). You can see why researchers consider ketogenic diets (especially the original versions) to be extremely difficult and unappetizing (they were), whereas seasoned low-carbers (who have a bit of a different idea what a ketogenic diet is) will find that attitude ridiculous, especially when you compare a ketogenic diet to the side effects of some anti-epileptic medications.
So it looks like modified Atkins (very very low carb, but not zero carb) and a preponderance of MCT is the same, ketone-wise, for the brain as the classic cream-heavy ketogenic diet. And what does it mean to have a ketogenic brain? Before, we talked about protons, but now I'm going to examine neurotransmitters and brain energy more closely. Specifically, glutamate and GABA (
5).
If you recall, GABA is the major inhibitory neurotransmitter in the mammalian nervous system. Turns out, GABA is made from glutamate, which just happens to be the major excitatory neurotransmitter. You need them both, but we seem to get into trouble when have too much glutamate. Too much excitement in the brain means neurotoxicity, the extreme manifestation of which is seizures. But
neurological diseases as varied as depression, bipolar disorder, migraines, ALS, and dementia have all been linked in some way to neurotoxicity.
Comment: For more information on the ketogenic diet, check out our threads "Life Without Bread" and "Ketogenic Diet".