Coconut Oil and Alzheimers Ketones as Fuel for Neurons by SupremeLord

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									   COCONUT OIL &
     Ketones as Fuel
      for Neurons
Steve Newport 2009
            Steve Newport
   BSBA in Accounting from Xavier University,
    Cincinnati, Ohio
   Worked for 9 years as accountant/office
    manager for mental health centers until 1980
   1980’s to 2003 - Worked from home for medical
    practice – accounting, management, billing,
    while caring for our children
   Computer wiz
   Loves landscaping, cooking, reading novels,
   Can fix anything, invents tools
    Onset Of Alzheimer’s Disease
Early clues (retrospective):
 Grade School:
       Couldn’t remember rules of football
       “Fired” as altar boy – couldn’t remember flow of the
   Early adult:
       Couldn’t catch on to card games
       Did not feel he was functioning as well in accounting/
        office manager position by late 20’s
   30’s and 40’s
       Hoarding – amasses garage full of “stuff”
Onset Of Alzheimer’s Disease
   Age 50-51:
       Frequently forgets appointments even with 30 minute
       Often loses wallet and keys
   Age 51-52:
       Payroll errors
       Procrastinates with tax reports
       Misses deadlines
       Can’t remember going to bank and post office
       Misplaces important mail
       Psychiatrist believes it is depression rather than
        dementia - starts anti-depressants and counseling
                  Mild to Moderate
                Alzheimer’s Disease
   Age 56:
       Can no longer follow map – gets lost in New Port
       Misses turn and ends up in Jacksonville
       Can’t remember how to turn on windshield wiper
       Confusion at tollbooth
       Gives up driving
       Stops reading – can’t explain why
       Often walks around house and yard with one shoe
         • No matching pairs of shoes in the house!
    Moderate Alzheimer’s Disease
   Age 57:
       Doesn’t recognize some relatives at family reunion –
        lost and confused
       Loses 10 pounds in 3 weeks – no longer preparing
        meals for himself
       Develops intention tremor and problem with keeping
        food on fork
       Develops jaw tremor when talking
       Gait becomes slow, can no longer run
       Forgets that he “sired” older daughter
       Personality and sense of humor fading
       Takes lawn tractor and vacuum cleaner apart
       difficulty spelling simple written words, such as “out”
        and “put,” and trouble recalling many common words
        when speaking
                  Clinical Trials
 Age    58 (May 2008):
     Participates in ADRC annual evaluation and
      screens for vaccine trial at Johnnie Byrd
       • MRI: “Diffuse involutional change of frontal and
         parietal lobes and moderate left-sided and severe
         right-sided amygdala and hippocampal atrophy
         with no ischemic change, which would support a
         clinical diagnosis of Alzheimer’s disease.”
       • Scores only 12 of 30 on MMSE
            Doesn’t qualify for study – told to try again in a

             couple of weeks
                    Clinical Trials
 Scheduled for screenings for 2 different clinical
  trials May 20 and 21, 2008
 Late night internet research “risks and benefits”
 Learn about Accera product, Ketasyn, now
  called Axona – read patent application
       Active ingredient is medium chain triglyceride oil –
        derived from coconut oil
       47% in pilot study had significant improvement in
        memory (ADAS-COG,) the rest declined minimally
      Glucose as Energy

 Glucoseis the usual source of energy
       for neurons (brain cells).
         Glucose as Energy
 In certain diseases, neurons and/or other
  brain and nerve cells have a problem with
  transporting glucose into the cell and
  essentially starve and die.
“Diabetes of the Brain”

Medium chain triglycerides converted in liver
               to Ketones
Ketone Bodies
 Ketones: Metabolism’s Ugly
 Theodore B. VanItallie, M.D.,
 and Thomas H. Nufert, B.A.
Nutrition Reviews , Vol. 61, No.

Ketones can be taken up by neurons that
          cannot use glucose

       +             =
Neuron Can Function
  And Stay Alive
Diagram from: Parkinson disease: primacy of age as a risk factor for mitochondrial dysfunction
               Theodore B. VanItallie, Metabolism Clinical and Experimental
                              57 (Suppl 2) (2008) S50–S55
Normal neurons can use glucose or ketones
    but usually use glucose if available
 For neurons that cannot use glucose,
Ketones can serve as an “alternate fuel.”
   Steve screens for clinical
    trial in St. Pete
       Scores only 14 of 30 on
        MMSE, needs 16 to qualify
       Doctor asks him to draw a
        clock – consistent with
        moderately severe
       We pick up coconut oil on
        the way home
       More internet research,
        learn about medium chain
        triglycerides, ketones
             HOW MUCH?

         Coconut Oil is 60% MCT oil
4 teaspoons MCT Oil or 7 teaspoons Coconut oil
           provide same amount of
          medium chain triglycerides

 Receives at least 35 grams coconut oil
 with breakfast

 Screens at Johnnie Byrd Center for
 vaccine clinical trial
     Scores 18 of 30 on MMSE
     Qualifies for study
      First Days after Coconut Oil
 Begins   daily consumption of coconut oil
     Measured dose at breakfast, cooking and
      other coconut containing foods for dinner
 More  alert - Personality and sense of
  humor resurface
 Steve says the “light switch came back on”
  and the “fog lifted”
 Facial tremor disappears
 Intention tremor infrequent
14 Days After Starting Coconut Oil
37 Days After Starting Coconut Oil
              Steve’s Clocks

DAY BEFORE        14 DAYS ON    37 DAYS ON
              More Research

 Ketones, medium chain triglycerides, fatty
 acids, coconut oil

 Dr.   Richard Veech/NIH – Ketone expert
     Ketone ester (beta-hydroxybutyrate)
     Suggested ketone levels
                 Ketone Ester
Dr. Richard Veech – NIH-Rockville, MD
   Became interested in studying ketones in
    early 1990’s
   Developed an ester of ketone body beta-
    hydroxybutyrate – oral or IV
   Can achieve levels comparable to starvation
    – 10 x coconut oil or MCT oil levels
   No adverse effects in recent human toxicity
   Needs funding to mass produce for testing
    in AD and other diseases
                                    Plasma ketones & glucose vs time
                        0.3                                                          6

                       0.25                                                           5
Plasma [ketone] (mM)

                                                                                          [Glucose] (mM)
                        0.2                                                           4

                       0.15                                                           3

                        0.1                                                           2

                       0.05                                                           1

                         0                                                            0
                              0     2        4         6         8          10   12
                                           time (hr after breakfast)

                                  35 grams (7 teaspoons) coconut oil
                                    with breakfast and with dinner
                                           Plasma [bHB] & [AcAc] after C-8 breakfast
                                                                                        1 bHB
                                0.45                                                    1 AcAc
                                 0.4                                                    2 bHB
   Plasma [bHB] & [AcAc] (mM)

                                0.35                                                    2 AcAc







                                       0      0.5      1        1.5       2       2.5     3
                                                             time (hr)

20 grams (4 teaspoons) medium chain triglyceride oil (C:8)
  Expanded Coconut Oil Intake
 As a result of levels with coconut oil also
  used measured amounts at lunch and
 Mixing coconut oil and MCT oil
 Substituting foods with MCTs for others:
     Goat’s milk and cheese for cow’s milk and
     Coconut milk for other liquids in cooking
           Between 2 - 4 months
             after Intervention
   Visual disturbance resolves
   Normalization of gait – able to run again
   Completes household and gardening tasks with
    minimal to no supervision and without distraction
   Wears both shoes and keeps pairs together
   His ability to initiate and continue a course of
    conversation improves
   Recognizes family members that he couldn’t
    recall one year earlier
   Family says he no longer looks lost,
    conversation makes sense
           Between 4 -10 Months
             After Intervention
   Conversational skills continue to improve
   Reading comprehension improves
   Short term and recent memory improves
   Stops having episodes of near syncope
   No longer depressed – Says, “I have my life
   Wants to do more with his life - volunteers in
    hospital warehouse
   Vacuums, cuts grass and weeds gardens again
    (instead of taking equipment apart!)
       Getting the Message Out
 Family     confirms Steve has improved

         “What If There Was a Cure for
 Article:
  Alzheimer’s Disease and No One Knew?”
  July 2008
     Sent letters to high profile persons to investigate MCT
      oil studies and make public aware
     Chicago ICAD conference
     Grass roots method/internet
     St Petersburg Times article October 2008
     Website:
     Legislators March 2009
Diseases With Decreased Glucose
  Uptake into Brain/Nerve Cells

   Alzheimer’s disease      Some forms of autism
   Parkinson’s disease      Down’s syndrome –
   Multiple sclerosis        develop Alzheimer’s
   Huntington’s chorea       disease by ages 30-40
   ALS/Lou Gehrig’s         Acute brain injury,
    disease                   accompanied by lack
                              of oxygen
   Duchenne muscular
    dystrophy                Type I and Type II
                                            N = 47
 80                                                                                  Percent
 70                             66

 40                                             36
 30                                                             21
                        10.5                                            8.5                    8.5
 10              2                                                               4        4

47 individuals there were 25 males, 20 females, 1 unknown
30 of 47 reported age with range of 55 to 94 years old (average 76.8.)
29 used coconut oil only, 3 MCT oil only and16 a combination of coconut oil and MCT oil
 Other Reported Improvements
 Parkinson’s  disease
 Multiple sclerosis
 Improved blood sugars in type II diabetes
 Down’s syndrome
 Bipolar disorder
 Glaucoma
 Macular degeneration
 Cognition in elderly dog
 Foods with Short and Medium
      Chain Fatty Acids
 Fats/Oils:
     Coconut oil       59%
     Palm Kernel Oil   54%
     Babassu Oil       55% (Amazon palm)
     Ucuhuba butter    13% (Amazon tree seed)
     Butter            11.5%
     Nutmeg Butter     3.1%
     Sheanut Oil       1.7%
 Foods with Short and Medium
      Chain Fatty Acids
 Per   8 ounces:
     Goat Milk           1.7 grams
     Whole Cow Milk      0.9 grams
     Human breast milk   0.78 grams
     Infant formula      1.0 grams
     Cottage Cheese      0.64 grams
 Foods with Short and Medium
      Chain Fatty Acids
 Per   ounce:

     Goat cheese       2.0 grams
     Feta cheese       1.4 grams
     Cream cheese      0.96 grams
     American cheese   0.85 grams
     Mozarella         0.78 grams
      Newborns and Ketones
 Newborn   develops “ketosis” at onset of
 Ketones provide 25% of energy
  requirements during first weeks of life
 Even with equivalent amount MCTs in
  formula, same degree of “ketosis” doesn’t
  occur – missing factor?
            Newborn MCFAs
           Equivalent in Adult
 10pound breastfeeding baby gets about
 3.12 grams MCFAs per quart breast milk =

 47   grams MCFAs for 150 pound adult =

 5.5   tablespoons of coconut oil
       Coconut Oil Equivalents

 Coconut    oil - 1 tablespoon =
     Coconut Milk (undiluted) – 4 ½ tablespoons
     Coconut meat – 2” x 2” x ½” piece
     Coconut grated – 1/3 cup
     Coconut oil capsules (1 gm) – 14 capsules
          Coconut Oil
             START SLOW
 Common effect – Diarrhea
   Begin with 1 teaspoon and increase slowly

   Start on a day when you don’t have to go

    somewhere immediately!
   Take with other food

   Can take it slowly during meal over 20-30

   Some foods may help retain oil – cottage

   Try grated coconut or coconut milk as

    alternative for part of “dose”
                    Food Ideas
 Use coconut oil instead of butter on toast, English
  muffins, bagels, grits, corn on the cob, potatoes or
  sweet potatoes.
 Add coconut oil or coconut milk to your favorite
  smoothie recipe.
 Mix coconut oil into:
       Oatmeal or other hot cereal.
       Rice, vegetables, noodles, pasta.
       Half and half with salad dressings.
       Soup, chili or spaghetti sauce.
                   Food Ideas
   Use a measured amount of coconut oil to stir fry or
    sauté any of your favorite dishes.
   Purchase or make coconut macaroons made from
    all natural products.
   Make Coconut oil “fudge”
   Eat a 2” x 2” square of raw coconut for a snack to
    provide 15 grams of oil.
   Add flaked or grated coconut to hot or cold cereal,
    yogurt, fruit or vegetable salads
  Mixing MCT and Coconut Oil
 Reason:   to achieve higher and continuous
  levels of ketones
 One combination:
     MCT Oil 16 ounces + Coconut oil 12 ounces
     Can emulsify with soy lethicin (about ½
     Start low and increase as tolerated
     Take with each meal
  Mixing MCT and Coconut Oil

 Advantages:
     Stays liquid when mixed
     Mixes more easily into many foods
     Takes advantage of properties of each oil
     More portable for eating away from home
 Do Eat Foods with
Omega-3 Fatty Acids
Eat Whole Foods
Don’t Eat Foods with Transfats
and Hydrogenated or Partially
      Hydrogenated Oils
      Why not use just MCT oil?
 Many other fatty acids of all chain lengths
 in coconut oil that may serve special
     Supports thyroid
     Anti-microbial properties – kills certain viruses
      and bacteria that some research implicates in
      Alzheimer’s and Parkinson’s
       • Herpes viruses
       • Helicobacter pylori
     May be other factors in the “whole” oil that
      benefit Alzheimer’s and other diseases
            Why not use just
             Coconut Oil?

 Ketone   levels higher with MCT oil

 Recent evidence that medium chains
 cross blood brain barrier and appear to
 also be used by neurons as fuel
          Cholesterol Issue
 Proponents   of each side of issue can find
  studies to support their beliefs
 Large scale study with men and women of
  all ages needs be done to lay the issue to
 Consider risks vs. benefits in making
  decision to try this intervention in
  Alzheimer’s and other diseases
     people will not have immediate or
 Most
 dramatic response and some “stabilize”
     Keep a journal
 Mustbe consistent and persistent
 Cannot miss a day
     If no fuel in the tank the car won’t run
 Strongly    suggest at least three month trial
     Monitor closely if stopping this intervention
     Some don’t realize how much it was helping
      until they stop it
 Is there a relationship between
 lack of MCFAs AND AUTISM?
A Mother’s Observation: Child developed
 neurologic symptoms of autism after
 discontinuing infant formula at 18 months
     Lack of MCFAs the culprit?
     Do MCFAs delay onset of neuro symptoms?
     Onset of autism often during second year
 Parental    Survey:
     Most autistic children not breastfed
 Website    for information only
     Copies of article, “What If…?
     Diet guidelines and FAQs
     Complete articles - scientific references
      related to ketones that can be printed out
     Interviews
     Can email me with questions
     Updates
     Blog
Drs. George Cahill, Mary Newport & Richard Veech
         in Capitol Building – March 2009
            KETOGENIC DIET
 History
     Fasting used as treatment for seizures and
      epilepsy in biblical times and middle ages
     Early 1900’s - NY Pediatrician Rawle Geyelin
      successfully fasted children to control
      seizures (15 day fast) – 18% were helped
     1921 – Wilder proposed that benefits of
      fasting (increase in ketone bodies) could be
      produced by diet rich in fats and low in
      carbohydrates - - “ketogenic diet”
              KETOGENIC DIET
 History      (continued):
     1924 – Peterman reports effectiveness of diet
      from Mayo Clinic – 51% seizure free after 2 ½
      years on diet
       •   1 gram protein per kg body weight
       •   10-15 grams/day carbohydrate
       •   Remainder of calories as fat
       •   Total calories Basal Metabolic Rate + 50%
     Identical to ketogenic diet used today – some
      variations exist – including MCT oil version –
      half of calories are MCT oil
 Reported    positive effects of ketogenic diet:
     Epilepsy
     Alzheimer’s disease
     Parkinson’s disease
     Lou Gehrig’s disease (ALS)
     Traumatic brain injury and stroke
     Oxygen toxicity
     Glioblastoma and other cancerous tumors
     Weight loss
  Brain Metabolism during Fasting
0. E. OWEN, A. P. MORGAN, H. G. KEMP, J. M.
              G. F. CAHILL, JR.

     The Journal of Clinical Investigation
           Vol. 46, No. 10, 1967

 First report of ability of brain to use
             ketones as fuel
                    Overnight in normal          Starvation:
                     people: glucose            Ketones about
                       100% of fuel               2/3 of fuel
Diagram from: Ketone Bodies as a Fuel for the Brain during Starvation - Oliver E. Owen‡
                          Vol. 33, No. 4, pp. 246–251, 2005
                               FIG. 3. Concentrations of ketone bodies
                               and free fatty acids during starvation in
                               humans. Values are shown as the
                               S.E. Ketone bodies undergo the
                               greatest changes of all fuels during
                               total starvation.
Diagram from: Ketone Bodies as a Fuel for the Brain during Starvation
                           Oliver E. Owen‡
          Printed in U.S.A. Vol. 33, No. 4, pp. 246–251, 2005
                Ketone Effects
   Presence of ketone in circulation, even at low levels
    increases cerebral blood flow by as much as 40%

   Ketones used within mitochondria to drive the chain
    reaction that produces ATP

   Reduces generation of free radicals and at same time
    increases the scavengers of free radicals linked to the
    NADP system, such as glutathione.

   Activates anti-inflammatory mechanisms
            Ketone Effects
   Presence of ketone in circulation, even at
    low levels increases cerebral blood flow by
    as much as 40%
   Rectify cerebral energy metabolism
    (provide alternative fuel)
   Protect cerebral function
   Suppress cerebral edema and reduce
    extent of cerebral infarction in brain injury
   Treat diseases involving free radical
    damage such as occurs in coronary
    reperfusion, diabetic angiopathy,
    inflammatory bowel disease, pancreatitis
                  Ketone Effects
   “Utilizing the nerve growth/ stimulatory effects of
    the ketone bodies…cells that are still viable can
    be caused to improve beyond the state to which
    they have degenerated and accordingly some
    improvement of function will be seen in patients.”

       Veech has shown in mice receiving 30% ketone ester
        diet, significant increase in brain peptides BDNF and
        NGF, compared to high CHO or high fat diet.
Potential Effects of Ketones
   Would allow diabetics to maintain better
    control of blood sugars without fear of
    hypoglycemic consequences and thereby
    prevent the vascular changes in eye and

   May treat refractory epilepsy and other
    seizure related disorders currently treatable
    with ketogenic diet
               D,L-3-hydroxybutyrate treatment of multiple acyl-CoA dehydrogenase
                 deficiency (MADD,) Johan L K Van Hove,, Lancet 2003; 361: 1433–35

                                                                            After a 150 mg/kg dose
                                                                            of D,L-3-
                                                                            plasma physiological
                                                                            ketone body
                                                                            concentrations peaked
                                                                            between 0·19 mmol/L
                                                                            and 0·36 mmol/L after
                                                                            30 min to 1 h, and
                                                                            remained above pre-
                                                                            concentrations for 4 h.

Brain MRI scans were obtained before (A and D), after 2 months (B and E), and after 9
months of treatment (C and F). There is diffuse involvement of the supratentorial white
matter both centrally and peripherally and in the corpus callosum (A, D). On the
posttreatment scans there is a progressive change in the central white matter with a
decrease in signal intensity. Cavitation can occasionally be seen (F)

   Electron micrograph of cell membrane

Hydrogenation produces
   abnormally shaped
    molecules called

Different vehicles use different fuels

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