Impact of Eating a Carbohydrate-Restricted Diet on Cortical Atrophy in a Cross-Section of Amyloid Positive Patients with Alzheimer's Disease: A Small Sample Study.

Jennifer Bramen, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USA; Providence Saint John's Cancer Institute Department of Translational Neurosciences and Neurotherapeutics Santa Monica California USAFollow
Prabha Siddarth, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA.Follow
Emily S Popa, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA.Follow
Gavin T Kress, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
Molly Rapozo, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USAFollow
John F Hodes, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USAFollow
Aarthi Ganapathi, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USA; Providence Saint John's Cancer Institute Department of Translational Neurosciences and Neurotherapeutics Santa Monica California USAFollow
Colby B Slyapich, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA.Follow
Ryan M. Glatt, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USAFollow
Kyron P Pierce, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA.Follow
Verna R Porter, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA; Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA; Providence Saint John's Health Center, Santa Monica, CA, USAFollow
Claudia L Wong, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA., Providence Saint John's Health Center, Santa Monica, CA, USA.Follow
Mihae Kim, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA., Providence Saint John's Health Center, Santa Monica, CA, USA.Follow
Richelin V Dye, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA; Institute for Systems Biology, Seattle, WA, USA
Stella Panos, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USA; Providence Saint John's Cancer Institute Department of Translational Neurosciences and Neurotherapeutics Santa Monica California USAFollow
Tess Bookheimer, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USAFollow
Tori Togashi, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA; Institute for Systems Biology, Seattle, WA, USA
Spencer Loong, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA; Institute for Systems Biology, Seattle, WA, USA
Cyrus A Raji, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
Susan Y Bookheimer, Pacific Brain Health Center, Pacific Neuroscience Institute and Foundation, Santa Monica, CA, USA
Jared C Roach, Institute for Systems Biology, Seattle, WA, 98109, USA.Follow
David A Merrill, Pacific Neuroscience Institute Pacific Brain Health Center Santa Monica California USA; Providence Saint John's Cancer Institute Department of Translational Neurosciences and Neurotherapeutics Santa Monica California USAFollow

Document Type

Article

Publication Date

1-1-2023

Publication Title

Journal of Alzheimer's disease : JAD

Keywords

california; sjci; pni; washington; isb; Alzheimer’s disease; amyloid; atrophy; carbohydrate-restricted; carbohydrates; cerebral cortical thinning; cognitive dysfunction; diet; magnetic resonance imaging

Abstract

BACKGROUND: A carbohydrate-restricted diet aimed at lowering insulin levels has the potential to slow Alzheimer's disease (AD). Restricting carbohydrate consumption reduces insulin resistance, which could improve glucose uptake and neural health. A hallmark feature of AD is widespread cortical thinning; however, no study has demonstrated that lower net carbohydrate (nCHO) intake is linked to attenuated cortical atrophy in patients with AD and confirmed amyloidosis.

OBJECTIVE: We tested the hypothesis that individuals with AD and confirmed amyloid burden eating a carbohydrate-restricted diet have thicker cortex than those eating a moderate-to-high carbohydrate diet.

METHODS: A total of 31 patients (mean age 71.4±7.0 years) with AD and confirmed amyloid burden were divided into two groups based on a 130 g/day nCHO cutoff. Cortical thickness was estimated from T1-weighted MRI using FreeSurfer. Cortical surface analyses were corrected for multiple comparisons using cluster-wise probability. We assessed group differences using a two-tailed two-independent sample t-test. Linear regression analyses using nCHO as a continuous variable, accounting for confounders, were also conducted.

RESULTS: The lower nCHO group had significantly thicker cortex within somatomotor and visual networks. Linear regression analysis revealed that lower nCHO intake levels had a significant association with cortical thickness within the frontoparietal, cingulo-opercular, and visual networks.

CONCLUSIONS: Restricting carbohydrates may be associated with reduced atrophy in patients with AD. Lowering nCHO to under 130 g/day would allow patients to follow the well-validated MIND diet while benefiting from lower insulin levels.

Clinical Institute

Mental Health

Clinical Institute

Neurosciences (Brain & Spine)

Clinical Institute

Digestive Health

Department

Neurosciences

Department

Nutrition

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