Page 40 - Summer 2019 Journal

Ketones can replace brain glucose energy deficits in cognitive impairment and Alzheimer’s disease.
calories as carbohydrates should be adequate to prevent micronutrient deficiencies. A recent article on carbohydrate needs suggested “an initial carbohydrate intake target of 100 grams per day”—about 20 percent of calories.3 (There are about 50 grams of carbohydrates in one po- tato, one sweet potato, one slice of bread, one serving of cooked oatmeal and one serving of cooked rice.)
Other strategies to induce autophagy and produce ketones while avoiding the problems of nutrient deficiencies that may occur during a continuous ketogenic diet include engaging in intermittent fasting (limiting food intake to four to eight hours per day) or undertaking a ketogenic (high-fat, low-carbohydrate) diet for eighteen to twenty-eight hours just one or two days per week. Autophagy can also be activated by intense exercise. Certain foods, including turmeric, ginger, ginseng, elderberries, green tea and coffee help activate autophagy, and it can be helpful to consume fats before carbs.
CAPRYLIC AND CAPRIC FATTY ACIDS Ketones are produced by the medium-chain triglycerides (MCTs) caprylic acid (C8) and capric acid (C10), which comprise about 15 percent of coconut oil. Caprylic acid produces about 2.7 times more ketones than capric acid. These medium-chain triglycerides are widely available either as 100 percent caprylic acid or as a mixture of caprylic and capric acids. Two tablespoons of the mixture of caprylic and capric acids are equivalent to 8 to 9 percent of brain
energy. I usually use caprylic MCT oil.
The use of medium-chain triglycerides for ketone production has fewer side effects and produces more ketones than the ketogenic diet. A study that compared ketogenic diets that used long-chain fatty acids (LCFAs), the kind in but- ter and meat fats, with a ketogenic diet that used the medium-chain triglyceride caprylic acid found that the diet that used MCTs produced twice as many ketones as the diet using LCFAs.4 A couple of studies suggest that the keto- genic caprylic and capric medium-chain fatty acids may activate autophagy. A recent study demonstrated that increased dietary medium- chain fatty acids (MCFAs) boosted the MCFA/
LCFA ratio, restored suppressed autophagy and mitigated nonalcoholic steatohepatitis (NASH), a type of nonalcoholic fatty liver disease.5 However, MCTs do not deplete glucose and will not activate autophagy to the same extent as a ketogenic diet or exercise.
BRAIN SUPPORT IN LATER LIFE Alzheimer’s disease affects about five mil- lion people and Parkinson’s disease about five hundred thousand in the United States. By age group, Alzheimer’s affects about 2.5 percent of sixty-five-year-olds, rising to 30 percent of those
over eighty-five years of age.
Although the brain relies on blood glucose
as its main energy source, research shows that glucose uptake is lower in the frontal cortex of people over sixty-five years old, “despite cog- nitive scores that are normal for age.”6 In fact, several studies have shown a 10 to 15 percent lower brain glucose uptake in the elderly, a deficit that increases to 20 to 25 percent in individuals with Alzheimer’s disease.
Whereas uptake of brain glucose decreases in the cognitively impaired, ketone uptake remains similar to that of cognitively healthy, age-matched controls. Ketones can therefore re- place brain glucose energy deficits in cognitive impairment and Alzheimer’s disease.6
In a 2013 study, eight healthy young adults took thirty grams per day of MCT oil for three weeks.7 The researchers reported that the MCT supplementation protocol “was mildly and safely ketogenic and had no side effects in healthy humans on their regular diet.” They also estimated that this degree of ketonemia (increased circulating ketones) contributed up to 8 to 9 percent of brain energy metabolism.
In a 2015 study, patients with mild cognitive impairment received either fifty-six grams of medium-chain triglycerides daily or a placebo for twenty-four weeks.8 The MCT dose provided 18 percent of the brain’s energy needs. After measuring serum ketone levels and carrying out cognitive assessments, the researchers found that intake of MCT oil increased serum ketones and improved memory; intake of a placebo did not show improvement of any of the cognitive measures tested.
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Wise Traditions
SUMMER 2019