Transcript COCONUT OIL & ALZHEIMER’S DISEASE

COCONUT OIL &
ALZHEIMER’S DISEASE
Ketones as Fuel
for Neurons
Dr. Mary Newport
November 2009
www.coconutketones.com
Steve Newport 2009
Steve Newport
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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,
kayaking
Can fix anything, invents tools
Onset Of Alzheimer’s Disease
Early clues (retrospective):
 Grade School:
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Early adult:
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Couldn’t remember rules of football
“Fired” as altar boy – couldn’t remember flow of the
service
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
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Hoarding – amasses garage full of “stuff”
Onset Of Alzheimer’s Disease
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Age 50-51:
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Frequently forgets appointments even with 30 minute
reminders
Often loses wallet and keys
Age 51-52:
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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
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Age 56:
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Can no longer follow map – gets lost in New Port
Richey
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
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Age 57:
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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
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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
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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
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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
 Glucose
is 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”
PET SCANS FOR
GLUCOSE UPTAKE
NORMAL BRAIN
ALZHEIMER’S BRAIN
ALZHEIMER’S VS. NORMAL BRAIN
Medium chain triglycerides converted in liver
to Ketones
Ketone Bodies
Ketones: Metabolism’s Ugly
Duckling
Theodore B. VanItallie, M.D.,
and Thomas H. Nufert, B.A.
Nutrition Reviews , Vol. 61, No.
10
KETONES AS FUEL
Ketones can be taken up by neurons that
cannot use glucose
KETONES CONVERT TO
ENERGY IN NEURON
+
=
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.”
DAY BEFORE COCONUT OIL
INTERVENTION
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Steve screens for clinical
trial in St. Pete
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Scores only 14 of 30 on
MMSE, needs 16 to qualify
Doctor asks him to draw a
clock – consistent with
moderately severe
Alzheimer’s
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
1st DAY OF COCONUT OIL
INTERVENTION
 Receives
at least 35 grams coconut oil
with breakfast
 Screens
at Johnnie Byrd Center for
vaccine clinical trial
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Scores 18 of 30 on MMSE
Qualifies for study
First Days after Coconut Oil
Intervention
 Begins
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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
COCONUT OIL
14 DAYS ON
COCONUT OIL
37 DAYS ON
COCONUT OIL
More Research
 Ketones,
medium chain triglycerides, fatty
acids, coconut oil
 Dr.
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Richard Veech/NIH – Ketone expert
Ketone ester (beta-hydroxybutyrate)
Suggested ketone levels
Ketone Ester
Dr. Richard Veech – NIH-Rockville, MD
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Became interested in studying ketones in
early 1990’s
Developed an ester of ketone body betahydroxybutyrate – oral or IV
Can achieve levels comparable to starvation
– 10 x coconut oil or MCT oil levels
No adverse effects in recent human toxicity
testing
Needs funding to mass produce for testing
in AD and other diseases
[bHB]
Plasma ketones & glucose vs time
0.3
[Glucose]
6
0.25
5
0.2
4
0.15
3
0.1
2
dinner
0.05
1
0
0
0
2
4
6
8
time (hr after breakfast)
10
35 grams (7 teaspoons) coconut oil
with breakfast and with dinner
12
[Glucose] (mM)
Plasma [ketone] (mM)
[AcAc]
Plasma [bHB] & [AcAc] after C-8 breakfast
Plasma [bHB] & [AcAc] (mM)
1 bHB
0.45
1 AcAc
0.4
2 bHB
0.35
2 AcAc
0.3
0.25
0.2
0.15
0.1
0.05
0
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
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a result of levels with coconut oil also
used measured amounts at lunch and
dinner
 Mixing coconut oil and MCT oil
 Substituting foods with MCTs for others:
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Goat’s milk and cheese for cow’s milk and
cheese
Coconut milk for other liquids in cooking
Between 2 - 4 months
after Intervention
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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
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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
back.”
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
 Article:
“What If There Was a Cure for
Alzheimer’s Disease and No One Knew?”
July 2008
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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: www.coconutketones.com
Legislators March 2009
Diseases With Decreased Glucose
Uptake into Brain/Nerve Cells
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Alzheimer’s disease
Parkinson’s disease
Multiple sclerosis
Huntington’s chorea
ALS/Lou Gehrig’s
disease
Duchenne muscular
dystrophy
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Some forms of autism
Down’s syndrome –
develop Alzheimer’s
disease by ages 30-40
Acute brain injury,
accompanied by lack
of oxygen
Type I and Type II
diabetes
100
90
80
70
60
50
40
30
20
10
0
RESPONSES OF PERSONS WITH DEMENTIA TO MEDIUM CHAIN TRIGLYCERIDES
N = 47
89.5
Percent
66
47
36
32
21
10.5
2
8.5
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
4
8.5
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:
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Coconut oil
Palm Kernel Oil
Babassu Oil
Ucuhuba butter
Butter
Nutmeg Butter
Sheanut Oil
59%
54%
55% (Amazon palm)
13% (Amazon tree seed)
11.5%
3.1%
1.7%
Foods with Short and Medium
Chain Fatty Acids
 Per
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8 ounces:
Goat Milk
Whole Cow Milk
Human breast milk
Infant formula
Cottage Cheese
1.7 grams
0.9 grams
0.78 grams
1.0 grams
0.64 grams
Foods with Short and Medium
Chain Fatty Acids
 Per
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ounce:
Goat cheese
Feta cheese
Cream cheese
American cheese
Mozarella
2.0 grams
1.4 grams
0.96 grams
0.85 grams
0.78 grams
Newborns and Ketones
 Newborn
develops “ketosis” at onset of
breastfeeding
 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
 10
pound breastfeeding baby gets about
3.12 grams MCFAs per quart breast milk =
 47
 5.5
grams MCFAs for 150 pound adult =
tablespoons of coconut oil
Coconut Oil Equivalents
 Coconut
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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
Use only NON-HYDROGENATED
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
minutes
 Some foods may help retain oil – cottage
cheese
 Try grated coconut or coconut milk as
alternative for part of “dose”
Food Ideas
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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:
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Oatmeal or other hot cereal.
Rice, vegetables, noodles, pasta.
Half and half with salad dressings.
Soup, chili or spaghetti sauce.
Food Ideas
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Use a measured amount of coconut oil to stir fry or
sauté any of your favorite dishes.
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Purchase or make coconut macaroons made from
all natural products.
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Make Coconut oil “fudge”
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Eat a 2” x 2” square of raw coconut for a snack to
provide 15 grams of oil.
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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:
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MCT Oil 16 ounces + Coconut oil 12 ounces
Can emulsify with soy lethicin (about ½
teaspoon)
Start low and increase as tolerated
Take with each meal
Mixing MCT and Coconut Oil
 Advantages:
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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
purpose:
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Supports thyroid
Anti-microbial properties – kills certain viruses
and bacteria that some research implicates in
Alzheimer’s and Parkinson’s
• Herpes viruses
• Helicobacter pylori
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May be other factors in the “whole” oil that
benefit Alzheimer’s and other diseases
Why not use just
Coconut Oil?
 Ketone
 Recent
levels higher with MCT oil
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
rest
 Consider risks vs. benefits in making
decision to try this intervention in
Alzheimer’s and other diseases
Expectations
 Most
people will not have immediate or
dramatic response and some “stabilize”
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Keep a journal
 Must
be consistent and persistent
 Cannot miss a day
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If no fuel in the tank the car won’t run
 Strongly
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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?
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Mother’s Observation: Child developed
neurologic symptoms of autism after
discontinuing infant formula at 18 months
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Lack of MCFAs the culprit?
Do MCFAs delay onset of neuro symptoms?
Onset of autism often during second year
 Parental
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Survey:
Most autistic children not breastfed
www.coconutketones.com
 Website
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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
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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
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1924 – Peterman reports effectiveness of diet
from Mayo Clinic – 51% seizure free after 2 ½
years on diet
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(continued):
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
KETOGENIC DIET
 Reported
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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.
SULLIVAN, M. G. HERRERA, AND
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
people: glucose
100% of fuel
Starvation:
Ketones about
2/3 of fuel
Diagram from: Ketone Bodies as a Fuel for the Brain during Starvation - Oliver E. Owen‡
BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION
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
means
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‡
BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION
Printed in U.S.A. Vol. 33, No. 4, pp. 246–251, 2005
Ketone Effects
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Presence of ketone in circulation, even at low levels
increases cerebral blood flow by as much as 40%
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Ketones used within mitochondria to drive the chain
reaction that produces ATP
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Reduces generation of free radicals and at same time
increases the scavengers of free radicals linked to the
NADP system, such as glutathione.
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Activates anti-inflammatory mechanisms
Ketone Effects
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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
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“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.”
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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
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Would allow diabetics to maintain better
control of blood sugars without fear of
hypoglycemic consequences and thereby
prevent the vascular changes in eye and
kidney
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, et.al., Lancet 2003; 361: 1433–35
After a 150 mg/kg dose
of D,L-3hydroxybutyrate,
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 pretreatment
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)
CELL BASICS –
SIMPLE DIAGRAM
CELL
CELL MEMBRANE
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Electron micrograph of cell membrane
CELL MEMBRANE
FATTY ACIDS
FATTY ACIDS
Hydrogenation produces
abnormally shaped
molecules called
transfats
FUEL ANALOGY
Different vehicles use different fuels
NEURONS
NEUROTRANSMITTERS