1. Dr. Mary Newport
November 2009
www.coconutketones.com
COCONUT OIL &
ALZHEIMER’S DISEASE
Ketones as Fuel
for Neurons

2. Steve Newport 2009

3. 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,
kayaking
 Can fix anything, invents tools

4. 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
service
 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”

5.  Age 50-51:
 Frequently forgets appointments even with 30 minute
reminders
 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
Onset Of Alzheimer’s Disease

6.  Age 56:
 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!
Mild to Moderate
Alzheimer’s Disease

7.  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
Moderate Alzheimer’s Disease

8. 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

9.  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
Clinical Trials

10. Glucose as Energy
Glucose is the usual source of energy
for neurons (brain cells).

11. 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.

12. “Diabetes of the Brain”

13. PET SCANS FOR
GLUCOSE UPTAKE
NORMAL BRAIN ALZHEIMER’S BRAIN

14. ALZHEIMER’S VS. NORMAL BRAIN

15. Medium chain triglycerides converted in liver
to Ketones

16. Ketone Bodies

17. Ketones: Metabolism’s Ugly
Duckling
Theodore B. VanItallie, M.D.,
and Thomas H. Nufert, B.A.
Nutrition Reviews , Vol. 61, No.
10

18. KETONES AS FUEL
Ketones can be taken up by neurons that
cannot use glucose

19. KETONES CONVERT TO
ENERGY IN NEURON
+ =

20. Neuron Can Function
And Stay Alive

21. 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

22. Normal neurons can use glucose or ketones
but usually use glucose if available

23. For neurons that cannot use glucose,
Ketones can serve as an “alternate fuel.”

24. DAY BEFORE COCONUT OIL
INTERVENTION
 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
Alzheimer’s
 We pick up coconut oil on
the way home
 More internet research,
learn about medium chain
triglycerides, ketones

25. HOW MUCH?
Coconut Oil is 60% MCT oil
4 teaspoons MCT Oil or 7 teaspoons Coconut oil
provide same amount of
medium chain triglycerides

26. 1st DAY OF COCONUT OIL
INTERVENTION
 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

27. First Days after Coconut Oil
Intervention
 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

28. 14 Days After Starting Coconut Oil

29. 37 Days After Starting Coconut Oil

30. Steve’s Clocks
DAY BEFORE
COCONUT OIL
14 DAYS ON
COCONUT OIL
37 DAYS ON
COCONUT OIL

31. More Research
 Ketones, medium chain triglycerides, fatty
acids, coconut oil
 Dr. Richard Veech/NIH – Ketone expert
 Ketone ester (beta-hydroxybutyrate)
 Suggested ketone levels

32. 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
testing
 Needs funding to mass produce for testing
in AD and other diseases

33. Plasma ketones & glucose vs time
0
0.05
0.1
0.15
0.2
0.25
0.3
0 2 4 6 8 10 12
time (hr after breakfast)
Plasma
[ketone]
(mM)
0
1
2
3
4
5
6
[bHB]
[AcAc]
[Glucose]
[Glucose]
(mM)
dinner
35 grams (7 teaspoons) coconut oil
with breakfast and with dinner

34. Plasma [bHB] & [AcAc] after C-8 breakfast
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0 0.5 1 1.5 2 2.5 3
time (hr)
Plasma
[bHB]
&
[AcAc]
(mM)
1 bHB
1 AcAc
2 bHB
2 AcAc
20 grams (4 teaspoons) medium chain triglyceride oil (C:8)

35. Expanded Coconut Oil Intake
 As 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:
 Goat’s milk and cheese for cow’s milk and
cheese
 Coconut milk for other liquids in cooking

36. 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

37. 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
back.”
 Wants to do more with his life - volunteers in
hospital warehouse
 Vacuums, cuts grass and weeds gardens again
(instead of taking equipment apart!)

38. 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
 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

39. Diseases With Decreased Glucose
Uptake into Brain/Nerve Cells
 Alzheimer’s disease
 Parkinson’s disease
 Multiple sclerosis
 Huntington’s chorea
 ALS/Lou Gehrig’s
disease
 Duchenne muscular
dystrophy
 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

40. 89.5
2
10.5
66
47
36
32
21
8.5
4 4
8.5
0
10
20
30
40
50
60
70
80
90
100
RESPONSES OF PERSONS WITH DEMENTIA TO MEDIUM CHAIN TRIGLYCERIDES
N = 47
Percent
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

41. 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

42. 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%

43. 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

44. 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

45. 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?

46. Newborn MCFAs
Equivalent in Adult
 10 pound 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

47. 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

48. Use only NON-HYDROGENATED
Coconut Oil

49. 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”

50. 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.

51. 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

52. 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
teaspoon)
 Start low and increase as tolerated
 Take with each meal

53. 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

54. Do Eat Foods with
Omega-3 Fatty Acids

55. Eat Whole Foods

56. Don’t Eat Foods with Transfats
and Hydrogenated or Partially
Hydrogenated Oils

57. Why not use just MCT oil?
 Many other fatty acids of all chain lengths
in coconut oil that may serve special
purpose:
 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

58. 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

59. 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

60. Expectations
 Most people will not have immediate or
dramatic response and some “stabilize”
 Keep a journal
 Must be 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

61. 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

62.  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
www.coconutketones.com

63. Drs. George Cahill, Mary Newport & Richard Veech
in Capitol Building – March 2009

66. 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”

67. 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

68. KETOGENIC DIET
 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

69. 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

70. 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
Overnight in normal
people: glucose
100% of fuel
Starvation:
Ketones about
2/3 of fuel

71. 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
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.

72.  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

73.  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

74.  “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.
Ketone Effects

75.  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
Potential Effects of Ketones

76. 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-3-
hydroxybutyrate,
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-
treatment
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)

78. CELL BASICS –
SIMPLE DIAGRAM

79. CELL

80. CELL MEMBRANE
 Electron micrograph of cell membrane

82. CELL MEMBRANE

83. FATTY ACIDS

84. FATTY ACIDS
Hydrogenation produces
abnormally shaped
molecules called
transfats

85. FUEL ANALOGY
Different vehicles use different fuels

86. NEURONS

87. NEUROTRANSMITTERS