Dementia and Diet: Why Dr. Paul Mason Says the Brain Runs Better on Ketones
Is dementia simply an illness of old age that we cannot prevent? That is the common belief. Many people are told it is a natural part of aging and that nothing can be done. For decades, the medical explanation has focused on plaques and tangles in the brain. Treatments have centered on drugs designed to target these features, but the results have been disappointing. Families continue to watch loved ones decline with little hope for improvement.
Dr. Paul Mason offers a different perspective. He explains dementia as a metabolic disease rather than an inevitable result of aging. At the center of his view is insulin resistance, the same process that drives type 2 diabetes and other chronic illnesses. When the body and brain become resistant to insulin, energy flow breaks down. Brain cells are starved of fuel even when blood sugar levels are high. This makes dementia a condition not only of the brain but also of metabolism.
This shift in understanding changes everything. If dementia is linked to metabolic health, then lifestyle choices such as diet, activity, and sleep may play a powerful role in prevention and treatment. Instead of accepting dementia as fate, Dr. Mason points to strategies that can reduce risk and support brain health throughout life.
Dementia as a Metabolic Condition
Insulin resistance is at the center of Dr. Mason’s explanation. Insulin is the hormone that helps move glucose from the blood into cells to be used for energy. When the body becomes resistant to insulin, this process breaks down. Blood sugar remains high, but cells cannot access the energy they need. Over time, this leads to widespread damage throughout the body.
The same problem occurs in the brain. Brain cells begin to struggle with energy uptake, leaving them starved even when blood sugar is elevated. This energy crisis is a major driver of cognitive decline. People with type 2 diabetes, where insulin resistance is already present, have a much higher risk of developing dementia. The connection is so strong that some researchers now refer to Alzheimer’s as “type 3 diabetes.”
This idea reframes how we think about dementia. Instead of seeing it only as a buildup of plaques and tangles, it can also be understood as a failure of energy metabolism. When brain cells cannot access fuel, their function declines, networks break down, and memory and thinking are impaired. The good news is that if metabolic dysfunction is central to dementia, then supporting metabolism through diet and lifestyle becomes a powerful tool for prevention.
The Brain Performs Better on Ketones
The brain can use glucose, but Dr. Paul Mason explains that it performs much better on ketones. Ketones are a cleaner, more efficient fuel. They deliver more energy per unit of oxygen than glucose and create fewer free radicals in the process. This means less oxidative stress and less damage to brain cells.
Another advantage is that ketones bypass the need for insulin. In dementia, one of the main problems is insulin resistance in the brain. Glucose struggles to enter the cells, leaving them starved of energy even when blood sugar levels are high. Ketones do not rely on insulin, so they can enter brain cells freely and restore energy balance.
This is why people with mild cognitive impairment or early Alzheimer’s often show improvement when ketones are made available, either through a ketogenic diet, fasting, or supplementation. Studies have shown better memory, clearer thinking, and improved daily function when the brain has access to ketones.
Dr. Mason emphasizes that these improvements are not the result of medication but of lifestyle changes. A low-carb diet lowers insulin spikes, keeps blood sugar stable, and increases ketone availability. This steady fuel supply reduces metabolic stress and supports brain performance. Evidence suggests that adopting this approach early may slow progression and help preserve cognitive function.
Beyond Nutrition
Diet is only part of the picture. Poor sleep, chronic stress, and inactivity also raise insulin resistance and increase dementia risk. Addressing these habits alongside nutrition gives you the best chance to protect long-term brain health.
Changing your lifestyle now is essential. Daily choices make a difference. Moving your body, managing stress, and getting quality sleep are not extras but core practices for protecting your brain. These habits directly affect insulin sensitivity, the issue Dr. Mason identifies as central.
Regulating insulin and keeping it stable is critical. Constant high spikes that stay elevated for long periods cause damage over time. A low-carb diet, regular movement, stress control, and consistent sleep all work together to keep insulin steady. This combination supports both body and brain. It is the foundation of prevention and the most practical way to lower your risk of dementia.
Why This Matters
For many years dementia has been seen as unavoidable, something that comes with age and cannot be stopped. This belief has left people feeling powerless. Dr. Mason’s explanation challenges that view. If dementia is strongly linked to metabolic health, then it is not simply a disease of old age. It is influenced by choices we make every day.
Knowing that dementia can be prevented should encourage you to be proactive. Supporting metabolic health is not about waiting until symptoms appear. It is about taking steps now to protect the brain for the future. Eating in a way that keeps insulin stable, getting enough sleep, staying active, and reducing inflammation all make a difference.
This perspective offers hope. Dementia may not be inevitable. By making changes in daily habits, you have the ability to lower your risk and support long-term brain health. Drugs have not provided answers, but lifestyle and nutrition give us a path forward that is within reach.
References
Kandimalla R, Thirumala V, Reddy PH. "Is Alzheimer's disease a Type 3 Diabetes? A critical appraisal." Biochim Biophys Acta. 2017;1863(5):1078-1089.
Cunnane SC, Courchesne-Loyer A, Vandenberghe C, et al. "Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer’s disease." Ann N Y Acad Sci. 2016;1367(1):12-20.
Phillips MCL, Deprez LM, Mortimer GMN, et al. "Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease." Alzheimers Res Ther. 2021;13(1):51.
Krikorian R, Shidler MD, Dangelo K, Couch SC, Benoit SC, Clegg DJ. "Dietary ketosis enhances memory in mild cognitive impairment." Neurobiol Aging. 2012;33(2):425.e19-425.e27.
Taylor MK, Sullivan DK, Mahnken JD, Burns JM, Swerdlow RH. "Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer’s disease." Alzheimers Dement. 2018;4:28-36.
Mason P. Lectures and resources on nutrition and metabolic health. drpaulmason.com.au
Disclaimer: The content shared here is for informational and educational purposes only and should never be taken as medical advice.
In writing this blog post, my goal is to distill research findings into a clear, approachable format that encourages critical thinking and empowers you to make informed decisions about your health.
