Brain Energy & Neurological Health
Based on the work of Nick Norwitz, a physician, researcher, and science educator
This article explores how the brain uses energy and why researchers are investigating ketones in brain aging, Alzheimer’s disease, and Parkinson’s disease. It draws on the work of Dr. Nick Norwitz, whose research interests include ketone metabolism and neurodegenerative disease.
The focus here is cognition and neurological function. A companion article, “The Metabolic Theory of Mental Illness,” examines research on metabolic approaches to psychiatric conditions.
The Brain’s Alternative Fuel
The brain normally relies heavily on glucose for energy. In aging and particularly in Alzheimer’s disease, glucose metabolism in parts of the brain can become impaired.
Ketones provide an alternative fuel. They are produced naturally during fasting or carbohydrate restriction and their availability can also be increased through medium-chain triglycerides (MCTs) or ketone supplements.
Research suggests that the brain can retain its ability to use ketones even when glucose utilization is impaired. Researchers are investigating whether increasing ketone availability can help compensate for this energy deficit—and whether doing so produces meaningful improvements in cognition or neurological function.
Alzheimer’s and Cognitive Decline
Dr. Norwitz has coauthored scientific work examining ketogenic therapies for neurodegenerative diseases, including Alzheimer’s.
Clinical studies using ketogenic diets, MCTs, and other methods of increasing ketones have produced encouraging results. Some studies have reported improvements in particular measures of cognition, especially in people with mild cognitive impairment or mild-to-moderate Alzheimer’s.
The research provides a scientific basis for continuing to investigate therapeutic ketosis as a way to support brain energy and cognitive function.
Parkinson’s Disease & Exercise Endurance
Dr. Norwitz has also studied ketogenic interventions in Parkinson’s disease.
In a randomized crossover study involving 14 people with Parkinson’s, Norwitz and colleagues compared a ketone ester drink with a calorie-matched control drink. Participants were able to sustain exercise 24% longer after consuming the ketone ester.
This was a small study of exercise endurance. It does not establish that ketone-based therapies improve Parkinson’s symptoms generally or alter the course of the disease.
A Science Communicator
Norwitz also explains nutrition and metabolic research to a general audience. His videos explore brain health, ketogenic diets, cholesterol, obesity, and other topics, drawing on published studies and, at times, his own experiments. .
I find his willingness to question assumptions and examine emerging research particularly interesting. His work is particularly useful for people interested in emerging areas of metabolic research.
Learn More
Website and Scientific Reviews
His website includes information about his work, publications, and educational resources.
International Review of Neurobiology, 2020
A scientific review examining how ketogenic diets and ketone-based therapies might affect brain energy metabolism, with discussion of their potential applications in Alzheimer’s, Parkinson’s, and other neurodegenerative diseases.
A scientific review examining how nutrition and metabolic health may influence Alzheimer’s risk in people who carry ApoE4 and discusses the potential for personalized dietary strategies to reduce that risk.
Newsletter
Norwitz’s newsletter on metabolic health and emerging research.
Videos
Dr. Norwitz explains intriguing research suggesting that ketones may help the brain identify and clear damaged, misfolded proteins associated with neurodegenerative disease.
Norwitz explains why ketogenic diets and ketones are being studied in Parkinson’s disease and discusses proposed mechanisms and early human research.
Dr. Norwitz discusses how personalized medicine, metabolic health research, continuous glucose monitoring, and emerging technologies may change the way health and disease are understood and treated.
Dr. Bikman explains how ketones, particularly beta-hydroxybutyrate (BHB), act not only as an alternative fuel but also as signaling molecules that may influence inflammation, gene expression, mitochondrial function, and cellular resilience.