May 31, 2012 in Alzheimer's disease & dementia Millions of people around the world, including thousands of scientists, are desperately seeking a good treatment for Alzheimer's disease—or, almost beyond hope, a cure. So it's no wonder that many readers have been asking us about a new book enticingly called Alzheimer's Disease: What If There Was a Cure? by Dr. Mary Newport (a pediatrician), which has gotten lots of media coverage. The proposed cure is not one of those expensive Alzheimer's drugs (which have marginal benefits), but rather a simple food that's supposed to have dramatic effects on people with the disease. The food is coconut oil.
The appeal of a personal story Dr. Newport's book is highly personal. Her husband, Steve, has Alzheimer's, and this is her search for something to halt or reverse his decline. Her quest led her to research suggesting that ketones may help treat various neurological disorders, including Alzheimer's. Ketones are byproducts of the breakdown of fats in the body; small amounts are normally produced. Ketone levels rise when you fast or go on a very-low-carbohydrate diet (which can lead to a state called ketosis). Another way to boost ketones in your body is to consume fats called medium-chain triglycerides (MCTs), of which coconut and palm kernel oils are good sources. MCTs are converted in the liver into ketones, which can be used by the brain and other organs as fuel; they are a more immediate source of energy than other fats and are not as readily stored as body fat. Ketones can provide energy to cells without the need for insulin, the hormone the body relies on to get glucose from the blood into cells. The theory is that ketones might provide an alternative energy source for brain cells that have lost their ability to use glucose as a result of Alzheimer's. So Dr. Newport began feeding her husband coconut oil, later combining it with a more-concentrated MCT oil. She reports that this improved his short-term memory, alleviated his depression, revived his personality, and reduced his walking and vision problems—and that an MRI showed that his brain had stopped shrinking. That's a powerful story, but just anecdotal evidence. The course of Alzheimer's can vary from person to person, and there may be stable periods and temporary improvements within the long-term decline. Dr. Newport cites research showing that ketone-producing diets may help treat difficult cases of epilepsy and possibly Parkinson's and other neurological disorders, as well as improve cognition and health in general. Nearly all of this has been highly technical, theoretical work—or else preliminary research done in animals. In any case, apparently none of this research has used coconut oil, but rather special ketone solutions or products containing concentrated MCTs. A 2009 study of a pricey prescription "medical food" providing high doses of MCTs (Axona, whose maker funded the study) found some minor improvements in patients with mild to moderate Alzheimer's. According to the Alzheimer's Association, "a few people have reported that coconut oil helped with Alzheimer's, but there's never been any clinical testing of coconut oil for Alzheimer's, and there's no scientific evidence that it helps." The same is true of over-the-counter MCT oils.
Coconut oil—the bigger picture • Research on ketones and MCTs for dementia and other neurological problems has been interesting and should continue. At this point, it's not clear whether they are beneficial—and if so, under what conditions. Even if they are, it's probably a leap of faith to think that coconut oil would yield enough ketones to have a meaningful and persistent effect. • Countless health claims have been made for coconut oil in recent years. There was even a book called The Coconut Oil Miracle. The oil is supposed to strengthen immunity, improve digestion, cause weight loss, slow aging, and prevent heart disease and arthritis, for instance. (Interestingly, cognitive benefits have seldom been mentioned before.) As we've reported previously, these claims don't hold water. Because of its MCTs, it does take a few more calories for the body to process coconut oil, compared to other fats—but any calorie-burning effect would be insignificant. • Coconut oil is high in calories—115 calories per tablespoon, like other oils. That can add up when the recommended doses are 4 to 8 tablespoons or more a day (Dr. Newport's husband was taking 11 tablespoons a day at one point!). Large amounts can also cause diarrhea and other gastrointestinal problems, as Dr. Newport describes in her book. Despite fears about the saturated fat in tropical oils raised in the late 1980s, the fatty acids in coconut oil apparently do not have an adverse effect on blood cholesterol. You can use it in cooking occasionally if you like the flavor, though we recommend vegetable oils such as canola, olive, soy, or safflower for regular use. • Keep in mind that although Dr. Newport's book focuses on treating Alzheimer's, some of our readers have asked if coconut oil can prevent the disease. There's no reason to think so. Other dietary interventions, notably omega-3 fats (from fish) and the Mediterranean diet, have been proposed for general brain health. Unfortunately, as several major reviews have concluded, there's no solid evidence so far that any food, eating pattern, nutrient, or supplement can help prevent age-related cognitive decline or dementia. BOTTOM LINE: We wish we could tell you that the book makes a convincing case for coconut oil, but we can't. The most important thing to do if a family member has serious memory problems is to consult a doctor, preferably a neurologist. Don't just assume it is Alzheimer's disease. There are other causes of memory problems and other forms of dementia, some of which are reversible. A vitamin B12 deficiency, hypothyroidism, hypertension, and depression can all lead to symptoms that may be mistaken for early Alzheimer's. Certain medications can also impair memory. Thus, it's important to rule these out and not be sidetracked by self-treatments such as coconut oil.
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