Illuminating the Adherence Gap
Lessons from the TruNeura Mastermind: KetoFlex Implementation Training with Kia Sanford, MS
This week’s TruNeura Mastermind expanded upon the theme of our recent blog: The Adherence Gap. While we previously explored why identifying root causes is only the first step, this session focused on practical steps to help patients actually restore their brain networks.
To help our clinicians navigate the most difficult pieces of the protocol, we invited an expert in implementation: Kia Sanford, MS.
Introducing Kia Sanford
Kia is a clinical nutritionist and counselor who served as the lead nutrition specialist in the randomized controlled trial that successfully treated Alzheimer’s using the KetoFLEX protocol. Her role was to translate the science into practical lifestyle changes the patients could sustainably follow daily for the duration of the study.
Why the Mastermind Brings in Experts
Clinicians learn fastest from those who have executed the work at scale. Protocols look clean on paper, but real life involves travel, family habits, and executive dysfunction. Bringing in experts like Kia allows our practitioners to bypass textbooks and learn the practical lessons that actually bridge the adherence gap.
The Adherence Gap Begins with Diet
In cognitive care, diet is the foundation. Shifting the brain’s fuel source to ketones is a powerful lever, but the science of ketosis isn’t the challenge. Adherence is. Patients must learn new ways of cooking, tracking, and testing while navigating brain fog and overwhelm.
Start with the Clinician
Kia’s most direct advice to the group was simple: Experience it yourself first. Clinicians who have personally attempted ketosis understand the “keto flu,” the hidden carbohydrates, and the psychological pull of sugar. When you have lived the process, your guidance becomes more credible and compassionate.
Phased Implementation: High-Level Success
Rather than introducing the entire framework at once, Kia highlighted the success of moving through structured stages:
Initial Entry: Focusing on simplifying choices to help patients reliably reach therapeutic levels.
Personalized Testing: Slowly reintroducing specific foods to find individual metabolic thresholds.
Long-Term Sustainability: Creating a personalized template based on what supports the patient’s unique biology.
Exercise as a Metabolic Lever
We also explored how to navigate special cases, such as insulin-resistant or diabetic patients who struggle to make the metabolic shift. In these scenarios, strength training becomes an essential tool. By utilizing movement to deplete glucose stores, clinicians can accelerate the transition toward fat oxidation and brain-saving ketosis.
Stories Solve Shame
One of the most profound takeaways was the role of storytelling in clinical care. Cognitive decline often brings a heavy burden of embarrassment. Kia explained that stories can solve the shame around losing brain function.
By reframing “slips” as data-gathering experiments rather than failures, we remove the emotional weight of memory loss. If a patient eats something off-protocol, we don’t judge; we look at the story the data tells. How did your brain feel 24 hours later? This shifts the patient from a place of shame to a place of empowered observation.
Join the Mastermind: A Cutting-Edge Community
Protocols do not reverse cognitive decline; implementation does. Patients need structure, and clinicians need a community that shares real-world frameworks for success.
