A new alternative treatment for Alzheimer’s doing the rounds seems to be based on a misunderstanding of the underlying science.
The title of this piece is a question posed by the ‘health correspondent’* in one of our local rags. It was inspired by a video doing the rounds on the internet of an American doctor who is using coconut oil to treat her husband’s Alzheimer’s. The doctor’s name is Mary Newport and she also has a book out: Alzheimer’s Disease: What If There Was a Cure? The Story of Ketones.
So what are ketones and could coconut oil be the new wonder cure for Alzheimer’s? Normally carbohydrates in the diet are converted into glucose which is then used by the body as fuel. However, when facing starvation, the body can burn fats in place of carbohydrates. The liver converts the fats into ketones which can be used in place of glucose. Where it gets interesting is that a particular high-fat diet is being used to successfully treat another brain disease – epilepsy. The ketogenic diet is a strictly controlled, high-fat, adequate protein, low-carbohydrate diet, which has been shown in numerous peer-reviewed scientific studies to be effective for controlling seizures in the group of children that don’t respond to medical treatment (so-called drug resistant epilepsy). Unfortunately studies have shown that it is less effective in adults.
So the ketogenic diet is more than just supplementing the diet with coconut oil. And it isn’t without side effects either, which can include weight loss, kidney stones, and constipation. While these are not insurmountable, the diet can be fatal for people with genetic disorders of fat metabolism. People like these will not be able to use the fats provided in the diet and if insufficient protein and carbohydrate are given, they will start breaking down their own protein stores for fuel, which can lead to coma and death.
So what about ketones and Alzheimer’s? Well it turns out that there are a number of studies looking at raising ketone levels in people with mild to moderate late onset Alzheimer’s. And it looks like they are doing it without the strict ketogenic diet. In a randomised, double-blind, placebo-controlled, multicentre trial1, subjects were given a daily drink of a ketogenic compound called AC-1202 on top of their normal diets (and prescribed Alzheimer’s medication), and assessed for changes in cognitive performance.
But there was also a little twist to this story. One of the major risk factors for late onset Alzheimer’s is possession of one or more copies of the epsilon 4 variant of the apolipoprotein E gene (APOE4). The more copies of APOE4 you have, the higher your risk of developing the disease. So did AC-1202 improve cognitive performance? Yes, but only for people who didn’t carry any copies of APOE4. What this means is that your genes affect whether or not you respond to ketones. Interestingly, about 10 percent of subjects got a little better without any treatment too.
So what is AC-1202? It is NeoBee 895®, a common food ingredient made using glycerin from vegetable oil and fatty acids from, you guessed it… coconut oil! Although palm kernel oil is also often used. But before you race off to check your APOE4-type and stock up on coconut oil, let’s return to Mary Newport and her husband for a moment. Mary blogs2 about their life with Alzheimer’s, and despite being on coconut oil since 2008, all is not rosy. So if you started this article thinking that adding a little coconut oil to your diet would be the answer, I’m sorry to disappoint you. As Ben Goldacre would say, I think you’ll find it’s a little more complicated than that!
*A Vitamin and supplement peddler, so I am always a little sceptical of his claims !
Henderson ST, Poirier J (2011). BMC Medical Genetics. 12:137.