Dr. Mary NewportDr. Mary Newport

November 2009November 2009

www.coconutketones.comwww.coconutketones.com

COCONUT OIL &COCONUT OIL &ALZHEIMER’S DISEASEALZHEIMER’S DISEASE

Ketones as Ketones as Fuel for Fuel for NeuronsNeurons

Steve Newport 2009Steve Newport 2009

Steve NewportSteve Newport BSBA in Accounting from Xavier University, BSBA in Accounting from Xavier University,

Cincinnati, OhioCincinnati, Ohio Worked for 9 years as accountant/office Worked for 9 years as accountant/office

manager for mental health centers until 1980manager for mental health centers until 1980 1980’s to 2003 - Worked from home for medical 1980’s to 2003 - Worked from home for medical

practice – accounting, management, billing, practice – accounting, management, billing, while caring for our childrenwhile caring for our children

Computer wizComputer wiz Loves landscaping, cooking, reading novels, Loves landscaping, cooking, reading novels,

kayakingkayaking Can fix anything, invents toolsCan fix anything, invents tools

Onset Of Alzheimer’s DiseaseOnset Of Alzheimer’s Disease

Early clues (retrospective):Early clues (retrospective): Grade School:Grade School:

Couldn’t remember rules of footballCouldn’t remember rules of football ““Fired” as altar boy – couldn’t remember flow of the Fired” as altar boy – couldn’t remember flow of the

serviceservice Early adult:Early adult:

Couldn’t catch on to card gamesCouldn’t catch on to card games Did not feel he was functioning as well in accounting/ Did not feel he was functioning as well in accounting/

office manager position by late 20’soffice manager position by late 20’s 30’s and 40’s30’s and 40’s

Hoarding – amasses garage full of “stuff”Hoarding – amasses garage full of “stuff”

Age 50-51:Age 50-51: Frequently forgets appointments even with 30 minute Frequently forgets appointments even with 30 minute

remindersreminders Often loses wallet and keysOften loses wallet and keys

Age 51-52:Age 51-52: Payroll errorsPayroll errors Procrastinates with tax reportsProcrastinates with tax reports Misses deadlinesMisses deadlines Can’t remember going to bank and post officeCan’t remember going to bank and post office Misplaces important mailMisplaces important mail Psychiatrist believes it is depression rather than Psychiatrist believes it is depression rather than

dementia - starts anti-depressants and counselingdementia - starts anti-depressants and counseling

Onset Of Alzheimer’s DiseaseOnset Of Alzheimer’s Disease

Age 56:Age 56: Can no longer follow map – gets lost in New Port Can no longer follow map – gets lost in New Port

RicheyRichey Misses turn and ends up in JacksonvilleMisses turn and ends up in Jacksonville Can’t remember how to turn on windshield wiperCan’t remember how to turn on windshield wiper Confusion at tollboothConfusion at tollbooth Gives up drivingGives up driving Stops reading – can’t explain whyStops reading – can’t explain why Often walks around house and yard with one shoeOften walks around house and yard with one shoe

• No matching pairs of shoes in the house!No matching pairs of shoes in the house!

Mild to Moderate Mild to Moderate Alzheimer’s DiseaseAlzheimer’s Disease

Age 57:Age 57: Doesn’t recognize some relatives at family reunion – Doesn’t recognize some relatives at family reunion –

lost and confusedlost and confused Loses 10 pounds in 3 weeks – no longer preparing Loses 10 pounds in 3 weeks – no longer preparing

meals for himselfmeals for himself Develops intention tremor and problem with keeping Develops intention tremor and problem with keeping

food on forkfood on fork Develops jaw tremor when talkingDevelops jaw tremor when talking Gait becomes slow, can no longer runGait becomes slow, can no longer run Forgets that he “sired” older daughterForgets that he “sired” older daughter Personality and sense of humor fadingPersonality and sense of humor fading Takes lawn tractor and vacuum cleaner apartTakes lawn tractor and vacuum cleaner apart difficulty spelling simple written words, such as “out” difficulty spelling simple written words, such as “out”

and “put,” and trouble recalling many common words and “put,” and trouble recalling many common words when speaking when speaking

Moderate Alzheimer’s DiseaseModerate Alzheimer’s Disease

Clinical TrialsClinical Trials

Age 58 (May 2008):Age 58 (May 2008): Participates in ADRC annual evaluation and Participates in ADRC annual evaluation and

screens for vaccine trial at Johnnie Byrdscreens for vaccine trial at Johnnie Byrd• MRI: “Diffuse involutional change of frontal and MRI: “Diffuse involutional change of frontal and

parietal lobes and moderate left-sided and severe parietal lobes and moderate left-sided and severe right-sided amygdala and hippocampal atrophy right-sided amygdala and hippocampal atrophy with no ischemic change, which would support a with no ischemic change, which would support a clinical diagnosis of Alzheimer’s disease.” clinical diagnosis of Alzheimer’s disease.”

• Scores only 12 of 30 on MMSE Scores only 12 of 30 on MMSE Doesn’t qualify for study – told to try again in a Doesn’t qualify for study – told to try again in a

couple of weekscouple of weeks

Scheduled for screenings for 2 different clinical Scheduled for screenings for 2 different clinical trials May 20 and 21, 2008trials May 20 and 21, 2008

Late night internet research “risks and benefits”Late night internet research “risks and benefits” Learn about Accera product, Ketasyn, now Learn about Accera product, Ketasyn, now

called Axona – read patent applicationcalled Axona – read patent application Active ingredient is medium chain triglyceride oil – Active ingredient is medium chain triglyceride oil –

derived from coconut oilderived from coconut oil 47% in pilot study had significant improvement in 47% in pilot study had significant improvement in

memory (ADAS-COG,) the rest declined minimallymemory (ADAS-COG,) the rest declined minimally

Clinical TrialsClinical Trials

Glucose as EnergyGlucose as Energy

Glucose is the usual source of energy Glucose is the usual source of energy for neurons (brain cells).for neurons (brain cells).

Glucose as EnergyGlucose as Energy

In certain diseases, neurons and/or other In certain diseases, neurons and/or other brain and nerve cells have a problem with brain and nerve cells have a problem with transporting glucose into the cell and transporting glucose into the cell and essentially starve and die. essentially starve and die.

““Diabetes of the Brain”Diabetes of the Brain”

PET SCANS FOR PET SCANS FOR GLUCOSE UPTAKEGLUCOSE UPTAKE

NORMAL BRAIN ALZHEIMER’S BRAIN

ALZHEIMER’S VS. NORMAL BRAINALZHEIMER’S VS. NORMAL BRAIN

Medium chain triglycerides converted in liver Medium chain triglycerides converted in liver

to to KetonesKetones

Ketone BodiesKetone 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 FUELKETONES AS FUEL

Ketones can be taken up by neurons that cannot use glucose

KETONES CONVERT TO KETONES CONVERT TO ENERGY IN NEURONENERGY IN NEURON

+ =

Neuron Can Function Neuron Can Function And Stay AliveAnd Stay Alive

Diagram from: Parkinson disease: primacy of age as a risk factor for mitochondrial dysfunctionTheodore B. VanItallie, Metabolism Clinical and Experimental

57 (Suppl 2) (2008) S50–S55

Normal neurons can use glucose or ketonesNormal neurons can use glucose or ketonesbut usually use glucose if availablebut usually use glucose if available

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

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

DAY BEFORE COCONUT OIL DAY BEFORE COCONUT OIL INTERVENTIONINTERVENTION

Steve screens for clinical Steve screens for clinical trial in St. Petetrial in St. Pete Scores only 14 of 30 on Scores only 14 of 30 on

MMSE, needs 16 to qualifyMMSE, needs 16 to qualify Doctor asks him to draw a Doctor asks him to draw a

clock – consistent with clock – consistent with moderately severe moderately severe Alzheimer’sAlzheimer’s

We pick up coconut oil on We pick up coconut oil on the way homethe way home

More internet research, More internet research, learn about medium chain learn about medium chain triglycerides, ketonestriglycerides, ketones

HOW MUCH?HOW MUCH?

Coconut Oil is 60% MCT oilCoconut Oil is 60% MCT oil

4 teaspoons MCT Oil or 7 teaspoons Coconut oil provide same amount of

medium chain triglycerides

4 teaspoons MCT Oil or 7 teaspoons Coconut oil provide same amount of

medium chain triglycerides

11stst DAY OF COCONUT OIL DAY OF COCONUT OIL INTERVENTIONINTERVENTION

Receives at least 35 grams coconut oil Receives at least 35 grams coconut oil with breakfastwith breakfast

Screens at Johnnie Byrd Center for Screens at Johnnie Byrd Center for vaccine clinical trialvaccine clinical trial Scores 18 of 30 on MMSEScores 18 of 30 on MMSE Qualifies for studyQualifies for study

First Days after Coconut Oil First Days after Coconut Oil InterventionIntervention

Begins daily consumption of coconut oilBegins daily consumption of coconut oil Measured dose at breakfast, cooking and other Measured dose at breakfast, cooking and other

coconut containing foods for dinnercoconut containing foods for dinner More alert - Personality and sense of humor More alert - Personality and sense of humor

resurfaceresurface Steve says the Steve says the “light switch came back on” “light switch came back on”

and the “fog lifted”and the “fog lifted” Facial tremor disappearsFacial tremor disappears Intention tremor infrequentIntention tremor infrequent

14 Days After Starting Coconut Oil14 Days After Starting Coconut Oil

37 Days After Starting Coconut Oil37 Days After Starting Coconut Oil

Steve’s ClocksSteve’s Clocks

DAY BEFORE COCONUT OIL

14 DAYS ON COCONUT OIL

37 DAYS ON COCONUT OIL

More ResearchMore Research

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

Dr. Richard Veech/NIH – Ketone expertDr. Richard Veech/NIH – Ketone expert Ketone ester (beta-hydroxybutyrate)Ketone ester (beta-hydroxybutyrate) Suggested ketone levelsSuggested ketone levels

Ketone EsterKetone Ester

Dr. Richard Veech – NIH-Rockville, MDDr. Richard Veech – NIH-Rockville, MD Became interested in studying ketones in Became interested in studying ketones in

early 1990’s early 1990’s Developed an ester of ketone body beta-Developed an ester of ketone body beta-

hydroxybutyrate – oral or IVhydroxybutyrate – oral or IV Can achieve levels comparable to starvation Can achieve levels comparable to starvation

– 10 x coconut oil or MCT oil levels– 10 x coconut oil or MCT oil levels No adverse effects in recent human toxicity No adverse effects in recent human toxicity

testingtesting Needs funding to mass produce for testing Needs funding to mass produce for testing

in AD and other diseasesin AD and other diseases

Plasma ketones & glucose vs time

0

0.05

0.1

0.15

0.2

0.25

0.3

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

Pla

sma

[ket

one]

(m

M)

0

1

2

3

4

5

6

[bHB]

[AcAc]

[Glucose]

[Glu

cose

] (m

M)

dinner

35 grams (7 teaspoons) coconut oil with breakfast and with dinner

35 grams (7 teaspoons) coconut oil with breakfast and with dinner

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)

Pla

sma

[bH

B]

& [

AcA

c] (

mM

)1 bHB

1 AcAc

2 bHB

2 AcAc

20 grams (4 teaspoons) medium chain triglyceride oil (C:8)20 grams (4 teaspoons) medium chain triglyceride oil (C:8)

Expanded Coconut Oil IntakeExpanded Coconut Oil Intake

As a result of levels with coconut oil also As a result of levels with coconut oil also used measured amounts at lunch and used measured amounts at lunch and dinnerdinner

Mixing coconut oil and MCT oilMixing coconut oil and MCT oil Substituting foods with MCTs for others:Substituting foods with MCTs for others:

Goat’s milk and cheese for cow’s milk and Goat’s milk and cheese for cow’s milk and cheesecheese

Coconut milk for other liquids in cookingCoconut milk for other liquids in cooking

Between 2 - 4 months Between 2 - 4 months after Interventionafter Intervention

Visual disturbance resolvesVisual disturbance resolves Normalization of gait – able to run againNormalization of gait – able to run again Completes household and gardening tasks with Completes household and gardening tasks with

minimal to no supervision and without distractionminimal to no supervision and without distraction Wears both shoes and keeps pairs togetherWears both shoes and keeps pairs together His ability to initiate and continue a course of His ability to initiate and continue a course of

conversation improvesconversation improves Recognizes family members that he couldn’t Recognizes family members that he couldn’t

recall one year earlier recall one year earlier Family says he no longer looks lost, conversation Family says he no longer looks lost, conversation

makes sensemakes sense

Between 4 -10 Months Between 4 -10 Months After InterventionAfter Intervention

Conversational skills continue to improveConversational skills continue to improve Reading comprehension improvesReading comprehension improves Short term and recent memory improvesShort term and recent memory improves Stops having episodes of near syncope Stops having episodes of near syncope No longer depressed – Says, No longer depressed – Says, “I have my life “I have my life

back.”back.” Wants to do more with his life - volunteers in Wants to do more with his life - volunteers in

hospital warehousehospital warehouse Vacuums, cuts grass and weeds gardens again Vacuums, cuts grass and weeds gardens again

(instead of taking equipment apart!)(instead of taking equipment apart!)

Getting the Message OutGetting the Message Out Family confirms Steve has improvedFamily confirms Steve has improved

Article: “What If There Was a Cure for Article: “What If There Was a Cure for Alzheimer’s Disease and No One Knew?” July Alzheimer’s Disease and No One Knew?” July 20082008 Sent letters to high profile persons to investigate MCT oil Sent letters to high profile persons to investigate MCT oil

studies and make public awarestudies and make public aware Chicago ICAD conferenceChicago ICAD conference Grass roots method/internetGrass roots method/internet St Petersburg Times article October 2008St Petersburg Times article October 2008 Website: www.coconutketones.comWebsite: www.coconutketones.com Legislators March 2009Legislators March 2009

Diseases With Decreased Glucose Diseases With Decreased Glucose Uptake into Brain/Nerve CellsUptake into Brain/Nerve Cells

Alzheimer’s diseaseAlzheimer’s disease Parkinson’s diseaseParkinson’s disease Multiple sclerosisMultiple sclerosis Huntington’s choreaHuntington’s chorea ALS/Lou Gehrig’s ALS/Lou Gehrig’s

diseasedisease Duchenne muscular Duchenne muscular

dystrophydystrophy

Some forms of autismSome forms of autism Down’s syndrome –Down’s syndrome –

develop Alzheimer’s develop Alzheimer’s disease by ages 30-40disease by ages 30-40

Acute brain injury, Acute brain injury, accompanied by lack accompanied by lack of oxygenof oxygen

Type I and Type II Type I and Type II diabetesdiabetes

Other Reported ImprovementsOther Reported Improvements

Parkinson’s diseaseParkinson’s disease Multiple sclerosisMultiple sclerosis Improved blood sugars in type II diabetesImproved blood sugars in type II diabetes Down’s syndromeDown’s syndrome Bipolar disorderBipolar disorder GlaucomaGlaucoma Macular degenerationMacular degeneration Cognition in elderly dogCognition in elderly dog

Foods with Short and Medium Foods with Short and Medium Chain Fatty AcidsChain Fatty Acids

Fats/Oils:Fats/Oils: Coconut oil Coconut oil 59%59% Palm Kernel Oil Palm Kernel Oil 54%54% Babassu OilBabassu Oil 55% (Amazon palm) 55% (Amazon palm) Ucuhuba butterUcuhuba butter 13% (Amazon tree seed) 13% (Amazon tree seed) Butter Butter 11.5%11.5% Nutmeg Butter Nutmeg Butter 3.1%3.1% Sheanut Oil Sheanut Oil 1.7%1.7%

Foods with Short and Medium Foods with Short and Medium Chain Fatty AcidsChain Fatty Acids

Per 8 ounces:Per 8 ounces: Goat Milk Goat Milk 1.7 grams1.7 grams Whole Cow Milk Whole Cow Milk 0.9 grams0.9 grams Human breast milk Human breast milk 0.78 grams0.78 grams Infant formula Infant formula 1.0 grams1.0 grams Cottage CheeseCottage Cheese 0.64 grams0.64 grams

Foods with Short and Medium Foods with Short and Medium Chain Fatty AcidsChain Fatty Acids

Per ounce:Per ounce:

Goat cheeseGoat cheese 2.0 grams2.0 grams Feta cheeseFeta cheese 1.4 grams1.4 grams Cream cheeseCream cheese 0.96 grams0.96 grams American cheese American cheese 0.85 grams0.85 grams MozarellaMozarella 0.78 grams0.78 grams

Newborns and KetonesNewborns and Ketones

Newborn develops “ketosis” at onset of Newborn develops “ketosis” at onset of breastfeedingbreastfeeding

Ketones provide 25% of energy Ketones provide 25% of energy requirements during first weeks of liferequirements during first weeks of life

Even with equivalent amount MCTs in Even with equivalent amount MCTs in formula, same degree of “ketosis” doesn’t formula, same degree of “ketosis” doesn’t occur – missing factor?occur – missing factor?

Newborn MCFAs Newborn MCFAs Equivalent in AdultEquivalent in Adult

10 pound breastfeeding baby gets about 10 pound breastfeeding baby gets about 3.12 grams MCFAs per quart breast milk = 3.12 grams MCFAs per quart breast milk =

47 grams MCFAs for 150 pound adult = 47 grams MCFAs for 150 pound adult =

5.5 tablespoons of coconut oil5.5 tablespoons of coconut oil

Coconut Oil EquivalentsCoconut Oil Equivalents

Coconut oil - 1 tablespoon =Coconut oil - 1 tablespoon = Coconut Milk (undiluted) – 4 ½ tablespoonsCoconut Milk (undiluted) – 4 ½ tablespoons Coconut meat – 2” x 2” x ½” pieceCoconut meat – 2” x 2” x ½” piece Coconut grated – 1/3 cupCoconut grated – 1/3 cup Coconut oil capsules (1 gm) – 14 capsulesCoconut oil capsules (1 gm) – 14 capsules

Use only Use only NONNON-HYDROGENATED -HYDROGENATED Coconut OilCoconut Oil

START START SLOWSLOW Common effectCommon effect – – DiarrheaDiarrhea

Begin with 1 teaspoon and increase slowlyBegin with 1 teaspoon and increase slowly Start on a day when you don’t have to go Start on a day when you don’t have to go

somewhere immediately!somewhere immediately! Take with other foodTake with other food Can take it slowly during meal over 20-30 Can take it slowly during meal over 20-30

minutesminutes Some foods may help retain oil – cottage cheeseSome foods may help retain oil – cottage cheese Try grated coconut or coconut milk as alternative Try grated coconut or coconut milk as alternative

for part of “dose”for part of “dose”

Food IdeasFood Ideas

Use coconut oil instead of butter on toast, English Use coconut oil instead of butter on toast, English muffins, bagels, grits, corn on the cob, potatoes or muffins, bagels, grits, corn on the cob, potatoes or sweet potatoes.sweet potatoes.

Add coconut oil or coconut milk to your favorite Add coconut oil or coconut milk to your favorite smoothie recipe.smoothie recipe.

Mix coconut oil into:Mix coconut oil into: Oatmeal or other hot cereal.Oatmeal or other hot cereal. RRice, vegetables, noodles, pasta.ice, vegetables, noodles, pasta. Half and half with salad dressings. Half and half with salad dressings. Soup, chili or spaghetti sauce. Soup, chili or spaghetti sauce.

Food IdeasFood Ideas

Use a measured amount of coconut oil to stir fry or Use a measured amount of coconut oil to stir fry or sauté any of your favorite dishes. sauté any of your favorite dishes.

Purchase or make coconut macaroons made from Purchase or make coconut macaroons made from all natural products. all natural products.

Make Coconut oil “fudge”Make Coconut oil “fudge”

Eat a 2” x 2” square of raw coconut for a snack to Eat a 2” x 2” square of raw coconut for a snack to provide 15 grams of oil.provide 15 grams of oil.

Add flaked or grated coconut to hot or cold cereal, Add flaked or grated coconut to hot or cold cereal, yogurt, fruit or vegetable saladsyogurt, fruit or vegetable salads

Mixing MCT and Coconut OilMixing MCT and Coconut Oil

Reason: to achieve higher and continuous Reason: to achieve higher and continuous levels of ketoneslevels of ketones

One combination:One combination: MCT Oil 16 ounces + Coconut oil 12 ouncesMCT Oil 16 ounces + Coconut oil 12 ounces Can emulsify with soy lethicin (about ½ Can emulsify with soy lethicin (about ½

teaspoon)teaspoon) Start low and increase as toleratedStart low and increase as tolerated Take with each mealTake with each meal

Mixing MCT and Coconut OilMixing MCT and Coconut Oil

Advantages:Advantages: Stays liquid when mixedStays liquid when mixed Mixes more easily into many foodsMixes more easily into many foods Takes advantage of properties of each oilTakes advantage of properties of each oil More portable for eating away from homeMore portable for eating away from home

DoDo Eat Foods with Eat Foods with Omega-3 Fatty AcidsOmega-3 Fatty Acids

Eat Whole FoodsEat Whole Foods

Don’tDon’t Eat Foods with Transfats Eat Foods with Transfatsand Hydrogenated or Partially and Hydrogenated or Partially

Hydrogenated OilsHydrogenated Oils

Why not use just MCT oil?Why not use just MCT oil? Many other fatty acids of all chain lengths in Many other fatty acids of all chain lengths in

coconut oil that may serve special purpose:coconut oil that may serve special purpose: Supports thyroidSupports thyroid Anti-microbial properties – kills certain viruses Anti-microbial properties – kills certain viruses

and bacteria that some research implicates in and bacteria that some research implicates in Alzheimer’s and Parkinson’sAlzheimer’s and Parkinson’s• Herpes virusesHerpes viruses• Helicobacter pyloriHelicobacter pylori

May be other factors in the “whole” oil that May be other factors in the “whole” oil that benefit Alzheimer’s and other diseasesbenefit Alzheimer’s and other diseases

Why not use just Why not use just Coconut Oil?Coconut Oil?

Ketone levels higher with MCT oilKetone levels higher with MCT oil

Recent evidence that medium chains Recent evidence that medium chains cross blood brain barrier and appear to cross blood brain barrier and appear to also be used by neurons as fuelalso be used by neurons as fuel

Cholesterol IssueCholesterol Issue

Proponents of each side of issue can find Proponents of each side of issue can find studies to support their beliefsstudies to support their beliefs

Large scale study with men and women of Large scale study with men and women of all ages needs be done to lay the issue to all ages needs be done to lay the issue to restrest

Consider risks vs. benefits in making Consider risks vs. benefits in making decision to try this intervention in decision to try this intervention in Alzheimer’s and other diseasesAlzheimer’s and other diseases

ExpectationsExpectations Most people will not have immediate or Most people will not have immediate or

dramatic response and some “stabilize”dramatic response and some “stabilize” Keep a journalKeep a journal

Must be consistent and persistentMust be consistent and persistent Cannot miss a dayCannot miss a day

If no fuel in the tank the car won’t runIf no fuel in the tank the car won’t run Strongly suggest at least three month trialStrongly suggest at least three month trial

Monitor closely if stopping this interventionMonitor closely if stopping this intervention Some don’t realize how much it was helping until Some don’t realize how much it was helping until

they stop itthey stop it

Is there a relationship between Is there a relationship between lack of MCFAs AND AUTISM?lack of MCFAs AND AUTISM?

A Mother’s Observation: Child developed A Mother’s Observation: Child developed neurologic symptoms of autism after neurologic symptoms of autism after discontinuing infant formula at 18 monthsdiscontinuing infant formula at 18 months Lack of MCFAs the culprit?Lack of MCFAs the culprit? Do MCFAs delay onset of neuro symptoms?Do MCFAs delay onset of neuro symptoms? Onset of autism often during second yearOnset of autism often during second year

Parental Survey: Parental Survey: Most autistic children not breastfedMost autistic children not breastfed

Website for information onlyWebsite for information only Copies of article, “What If…?Copies of article, “What If…? Diet guidelines and FAQsDiet guidelines and FAQs Complete articles - scientific references Complete articles - scientific references

related to ketones that can be printed outrelated to ketones that can be printed out InterviewsInterviews Can email me with questionsCan email me with questions UpdatesUpdates BlogBlog

www.coconutketones.comwww.coconutketones.com

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

KETOGENIC DIETKETOGENIC DIET

HistoryHistory Fasting used as treatment for seizures and Fasting used as treatment for seizures and

epilepsy in biblical times and middle agesepilepsy in biblical times and middle ages Early 1900’s - NY Pediatrician Rawle Geyelin Early 1900’s - NY Pediatrician Rawle Geyelin

successfully fasted children to control successfully fasted children to control seizures (15 day fast) – 18% were helpedseizures (15 day fast) – 18% were helped

1921 – Wilder proposed that benefits of 1921 – Wilder proposed that benefits of fasting (increase in ketone bodies) could be fasting (increase in ketone bodies) could be produced by diet rich in fats and low in produced by diet rich in fats and low in carbohydrates - - “ketogenic diet”carbohydrates - - “ketogenic diet”

KETOGENIC DIETKETOGENIC DIET

History (continued):History (continued): 1924 – Peterman reports effectiveness of diet from 1924 – Peterman reports effectiveness of diet from

Mayo Clinic – 51% seizure free after 2 ½ years on Mayo Clinic – 51% seizure free after 2 ½ years on dietdiet• 1 gram protein per kg body weight1 gram protein per kg body weight• 10-15 grams/day carbohydrate10-15 grams/day carbohydrate• Remainder of calories as fatRemainder of calories as fat• Total calories Basal Metabolic Rate + 50%Total calories Basal Metabolic Rate + 50%

Identical to ketogenic diet used today – some Identical to ketogenic diet used today – some variations exist – including MCT oil version – half of variations exist – including MCT oil version – half of calories are MCT oilcalories are MCT oil

KETOGENIC DIETKETOGENIC DIET Reported positive effects of ketogenic diet:Reported positive effects of ketogenic diet:

EpilepsyEpilepsy Alzheimer’s diseaseAlzheimer’s disease Parkinson’s diseaseParkinson’s disease Lou Gehrig’s disease (ALS)Lou Gehrig’s disease (ALS) Traumatic brain injury and strokeTraumatic brain injury and stroke Oxygen toxicityOxygen toxicity Glioblastoma and other cancerous tumorsGlioblastoma and other cancerous tumors Weight lossWeight 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 InvestigationVol. 46, No. 10, 1967

First report of ability of brain to use ketones as 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

Overnight in normal people: glucose

100% of fuel

Overnight in normal people: glucose

100% of fuel

Starvation: Ketones about

2/3 of fuel

Starvation: Ketones about

2/3 of fuel

Diagram from: Ketone Bodies as a Fuel for the Brain during StarvationOliver E. Owen‡

BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATIONPrinted 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.

Presence of ketone in circulation, even at low levels Presence of ketone in circulation, even at low levels increases cerebral blood flow by as much as 40%increases cerebral blood flow by as much as 40%

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

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

Activates anti-inflammatory mechanismsActivates anti-inflammatory mechanisms

Ketone EffectsKetone Effects

Presence of ketone in circulation, even at Presence of ketone in circulation, even at low levels increases cerebral blood flow by low levels increases cerebral blood flow by as much as 40% as much as 40%

Rectify cerebral energy metabolism Rectify cerebral energy metabolism (provide alternative fuel)(provide alternative fuel)

Protect cerebral functionProtect cerebral function Suppress cerebral edema and reduce Suppress cerebral edema and reduce

extent of cerebral infarction in brain injuryextent of cerebral infarction in brain injury Treat diseases involving free radical Treat diseases involving free radical

damage such as occurs in coronary damage such as occurs in coronary reperfusion, diabetic angiopathy, reperfusion, diabetic angiopathy, inflammatory bowel disease, pancreatitisinflammatory bowel disease, pancreatitis

Ketone EffectsKetone Effects

““Utilizing the nerve growth/ stimulatory effects of Utilizing the nerve growth/ stimulatory effects of the ketone bodies…cells that are still viable can the ketone bodies…cells that are still viable can be caused to improve beyond the state to which be caused to improve beyond the state to which they have degenerated and accordingly some they have degenerated and accordingly some improvement of function will be seen in patients.”improvement of function will be seen in patients.”

Veech has shown in mice receiving 30% ketone ester Veech has shown in mice receiving 30% ketone ester diet, significant increase in brain peptides BDNF and diet, significant increase in brain peptides BDNF and NGF, compared to high CHO or high fat diet.NGF, compared to high CHO or high fat diet.

Ketone EffectsKetone Effects

Would allow diabetics to maintain better Would allow diabetics to maintain better control of blood sugars without fear of control of blood sugars without fear of hypoglycemic consequences and thereby hypoglycemic consequences and thereby prevent the vascular changes in eye and prevent the vascular changes in eye and kidneykidney

May treat refractory epilepsy and other May treat refractory epilepsy and other seizure related disorders currently treatable seizure related disorders currently treatable with ketogenic dietwith ketogenic diet

Potential Effects of KetonesPotential Effects of Ketones

D,L-3-hydroxybutyrate treatment of multiple acyl-CoA dehydrogenasedeficiency (MADD,) Johan L K Van Hove, et.al., Lancet 2003; 361: 1433–35

After a 150 mg/kg doseof 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)

CELL BASICS – CELL BASICS – SIMPLE DIAGRAMSIMPLE DIAGRAM

CELLCELL

CELL MEMBRANECELL MEMBRANE

Electron micrograph of cell membraneElectron micrograph of cell membrane

CELL MEMBRANECELL MEMBRANE

FATTY ACIDSFATTY ACIDS

FATTY ACIDSFATTY ACIDS

Hydrogenation produces Hydrogenation produces abnormally shaped abnormally shaped molecules called molecules called

transfatstransfats

FUEL ANALOGYFUEL ANALOGY

Different vehicles use different fuelsDifferent vehicles use different fuels

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