Dr. Mary T. Newport was a neonatologist (a pediatrics subspecialty focused on the medical care of newborn infants) for 30 years. She became an integral researcher and advocate for using coconut oil, MCT oil, and exogenous ketones to treat Alzheimer’s disease (AD) after her husband, Steve, was diagnosed with early-onset dementia and AD at the age of 51.
Dr. Newport shares much of her expertise in her various books, including Alzheimer’s Disease: What If There Was A Cure? The Story of Ketones (2011); The Coconut Oil and Low-Carbohydrate Solution for Alzheimer’s, Parkinson’s, and Other Diseases (2015); and The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements (read the full Keto-Mojo book review here).
Here she answers questions about her pioneering research:
Your husband, Steve, was diagnosed with early-onset dementia and Alzheimer’s disease. What inspired you to treat him with coconut oil and MCT oil?
In May 2008, I was online looking at the risks and benefits of two clinical trial medications that Steve was going to screen for. By accident, I came across a press release about a medical food that was progressing towards FDA recognition and claimed to improve memory and cognition in almost half of people with Alzheimer’s who took it in two clinical trials. I found out from their patent application that it was MCT oil (C8) and learned that MCT oil is usually extracted from coconut oil or palm kernel oil. It seemed reasonable to try coconut oil and MCT oil as a strategy to help him.
What were the most memorable or surprising improvements in Steve’s thinking or behavior, both scientifically and personally, after adopting a more ketogenic diet?
There were several surprising improvements after Steve adopted a more ketogenic diet. Basically, we started giving him two tablespoons of coconut oil at breakfast, quickly increased it to several times per day, then added MCT oil, gradually working up to nine to 11 tablespoons per day over several months. He was already on a Mediterranean-type diet for about two years at that point, but we gradually removed the bread, pasta, cereal, rice, and most other carbs, which would have resulted in a more ketogenic diet, though we did not have handheld monitors available at the time to measure levels.
The first big surprise was that he increased his [mini-mental status exam aka MMSE] score enough from the day before to the day he started coconut oil to qualify for a clinical trial period. The next surprise was an amazing improvement in his clock drawing [a simple test requiring him to draw] over just 14 days, from just a few random circles and numbers to a complete circle with all of the numbers in the right order. Steve said it felt like a light bulb came on in his head the day he started coconut oil, and his mood went rather quickly from chronically depressed to feeling like he had a future.
One of the biggest surprises occurred about three to four months after starting coconut oil. Steve announced that he could read again and explained to me that the words would shake on the page when he would try to read lately, but that had stopped. At about nine months, Steve told me details about an article he had read in Scientific American on Einstein several hours earlier, indicating that his memory was improving significantly. He improved so much that he was able to start volunteering in the supply warehouse at the hospital where I worked.
How did your background as a neonatologist influence your ability to help Steve?
When I learned the medical food in the press release was MCT oil, I knew right away what that was. We used MCT oil in the feedings of our extremely tiny premature newborns to help them grow faster back in the early 1980s. Then companies began adding MCT oil to infant formulas, which is still occurring today. In fact, coconut oil is added to virtually every commercial infant formula in the world to mimic the naturally-occurring MCTs found in human breast milk.
You’ve said that Steve’s AD came out of nowhere. He was healthy, active, and young. Are there signs, symptoms, or other medical conditions people should watch out for to catch AD early and start treatment ASAP?
Yes, some memory problems are very common, such as misplacing one’s wallet or keys, and may not necessarily indicate that someone is headed towards Alzheimer’s. Many people have the experience that they will walk into a room and forget what they went after, but most people will eventually remember, whereas someone with dementia will likely not remember. If someone begins repeating the same question or story several times in a given day, that is a common early symptom. If someone has been able to find their way around and follow a map their whole life and now is unable to do that, it could be a tip-off.
In Steve’s case, he was only 51 when he began having symptoms, and the biggest tip-off to me was that he could not remember if he had been to the bank and post office. He would often misplace important mail in odd places, like out in the garage. Putting objects in unusual places, like a DVD in the microwave or refrigerator, for example, is not normal!
Stats show 70 percent of people with type 2 diabetes (T2D) go on to develop Alzheimer’s, which is now known as type 3 diabetes. Based on your experience and research, how are the current protocols for preventing and treating these failing? What could help address these costly health issues in a significant way?
Yes, people with type 2 diabetes have a much higher chance of going on to develop dementia. It would seem logical that high blood sugar is the underlying problem. So a simple answer would be to reduce sugar in the diet.
Education on avoiding excessive sugar should begin in early childhood. People look to their pediatricians to give them advice on feeding their children and look to their own doctors for guidance on nutrition for themselves. A big part of the problem is that doctors receive minimal education in nutrition and medical schools focus mainly on treating with pharmaceuticals. I only received instruction on nutrition one afternoon for about three hours during my entire medical school enrollment, and it is not much better these days. Most doctors don’t have dieticians in their practice. As a result of all this, most diabetics do not get proper training in nutrition.
I do home visits with people that have chronic medical conditions including diabetes, and most of them do not have a clue what a carbohydrate is. They still consume sugary drinks and sweets while taking two or three oral medications and sometimes insulin as well. Inexplicably, and up until very recently, the American Diabetes Association has encouraged a diet that is low-fat and high-carb (around 65 percent of calories). Most people do not seem to be aware that wheat and rice are converted to nearly 90 percent glucose after they are digested.
Doctors Eric Westman and Steven Phinney have done much to study and publish on the low-carb/higher-fat approach to treating type 2 diabetes, and they have had tremendous success in getting thousands of people into remission and off their medications. Now the American Diabetes Association is starting to acknowledge that there may be a role for a low-carb diet to treat diabetes, but it is not the mainstay of their guidance as of yet. I believe the best thing we can do is to become messengers for this much more successful approach to diabetes as a grassroots effort since it does not seem to be coming from the top down.
How do you convince people with type 2 diabetes or Alzheimer’s to adopt a low-carb diet? What’s the biggest selling point? What’s the biggest challenge?
I think the biggest selling point is to consider what sugar does to the body. When someone eats too much sugar, advanced glycation end products (AGEs) form, and these sticky, harmful substances can damage many tissues and cause inflammation, eventually resulting in the various chronic diseases that are associated with diabetes. Another selling point that may hit home with some people is that they will likely experience markedly fewer sugar cravings if they go low-carb.
The biggest challenge is that most people are not able to make a very drastic change to their diets, let alone sustain a very strict ketogenic diet for extended periods. I think a better approach for many people, especially diabetics and the elderly, is to help them make gradual, reasonable changes in their diet, such as eliminating sugary drinks and obvious sweets, working toward eating a more whole-food type of diet instead of processed foods, adding more healthy fats to their diets such as olive oil and coconut oil, changing from refined to unrefined grains, and eating more vegetables and low-sugar fruits, such as strawberries and avocados. I also suggest that they try low-carb snacks such as cheese or nuts in place of cookies or other high-carb snacks. Instead of expecting people to eliminate certain carbs right away, such as bread, rice, and pasta, encourage them to cut their portions in half. When they are used to that, cut it in half again.
While my second book, The Coconut Oil and Low-Carbohydrate Solution for Alzheimer’s, Parkinson’s, and Other Diseases, is all about how to move towards a reasonable low-carb diet and is geared toward people who are elderly and/or have neurological conditions, my latest book, The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements, goes much further into how to plan ketogenic diets, varying from mild to deep ketosis, and how to incorporate other ketogenic strategies into the plan.
Should healthy people with a family history of T2D and Alzheimer’s use more coconut oil and MCT oil for prevention?
Dr. Stephen Cunnane from Sherbrooke University in Canada has done considerable work on this using ketone and glucose PET scans. He has been able to show that MCT oil does increase energy to the brain as ketones, and that ketones are taken up normally in the Alzheimer’s brain. In his studies, people with memory impairment improved while taking MCT oil for six months, and this is supported by other studies. Dr. Cunnane has been able to demonstrate that the more MCT oil consumed, the higher the ketone uptake is in the brain. In their studies, they use two tablespoons and then three tablespoons per day, so this would be a good place to start.
There is an Alzheimer’s study currently underway in Australia in which they are planning to slowly increase to six tablespoons per day of a product called CocoMCT, which is an MCT oil with about 32 percent lauric acid (C12). Lauric acid, which makes up 50 percent of coconut oil, has been shown to stimulate ketone production directly in brain cells called astrocytes that nourish nearby neurons. This is just one good reason why I encourage people to also use whole coconut oil in their diet.
In The Complete Book of Ketones, you mention that babies transition from a high-fat to high-carb diet as they progress through childhood. Do you support putting kids and teens on a low-carb or modified keto diet? Would this support better dietary decision-making in adulthood to prevent insulin resistance issues?
I do not think that a strict ketogenic diet with very low carbohydrates is a good idea for younger children unless they have a medical condition that warrants it (such as epilepsy) and they are supervised closely by their physician and dietitian. This type of diet can result in slower growth and affect bone development, so it is a risk versus benefits situation for those children.
I think the best approach with healthy children is to avoid sugary drinks and obvious sweets and encourage them to eat a whole-food diet with small amounts of whole grains. Encourage healthy fats and protein-rich foods like eggs and cheese and introduce them to a variety of vegetables when they are very young. I think a good guideline is to look at the macronutrient ratio in breast milk; this is about 40 percent to 50 percent fat, 30 percent to 40 percent carbohydrates, and the rest is protein. This is very important for a growing child.
For overweight teenagers, I would take the same approach, but perhaps go a little bit lower in carbs and higher in fat, which may help them grow into their weight. Studies show that children who ate full-fat dairy were less likely to be obese adults than children eating low-fat or fat-free dairy. Full-fat milk, cheese, and yogurt are great snacks for children and adults who tolerate lactose, in my opinion. I do firmly believe that helping children establish sound eating habits in childhood and during their teen years would go a very long way towards continuing good habits in adulthood and avoiding diabetes (and potentially lowering the risk for AD).
Why do you think trusted institutions, like the American Heart Association, vilify healthy fats like coconut oil?
I think the biggest problem is that there are corporate interests heavily involved on the boards of directors for these types of organizations, especially the soybean oil and sugar industries. There is a heavy bias as to what they put out in their advisories, and their recommendations are mostly based on very old, small studies, many of them flawed, while ignoring much larger, more recent studies.
I have written extensively about this issue in my books and feel like I am fighting it often when the media puts out yet another misinformed news item. I can’t resist writing copious comments in response to such news items. If they would closely read the articles they report on and analyze the information, they might not put out so much misleading information. Many doctors are also guilty of only reading summaries instead of the whole article and not scrutinizing the information carefully.
Besides coconut, which foods or ingredients are the most powerful for brain health and the prevention of AD? Which foods or ingredients are the most dangerous for your brain?
I encourage people to eat whole foods — organic whenever possible — to avoid the many different synthetic chemicals that appear in packaged, processed foods and could be harmful to the brain. I believe it is important to become a label reader when buying food.
Cumin, blueberries, and dark chocolate contain antioxidants that seem to have benefits for brain health. Eggs are rich in many nutrients, such as phosphatidylcholine and other phospholipids, that are very important to the brain. Getting enough DHA, the main form of omega-3 used by the brain, is very important too. Eating DHA-rich foods like salmon or taking a supplement is ideal. Eating a variety of types and colors of vegetables will provide important nutrients to the brain as well.
I believe the most dangerous foods or ingredients for the brain are excessive sugar, which is highly inflammatory, and nitrates and nitrites, which have been shown to produce insulin resistance in the brain by the same researchers who coined the term “type 3 diabetes” for Alzheimer’s. Nitrates and nitrites are found in many foods, such as refined flour and rice, deli meats and processed cheeses, certain beers and liquor, and tobacco products.
Another dangerous group of foods: oils that contain trans fat. Fortunately, these are being phased out in the US (and have already been banned in several European countries). However, manufacturers are still allowed to include trans fats without reporting them on the label if the food contains less than half a gram of trans fat per serving. I advise people to look at the ingredients list for the words “partially hydrogenated,” which would indicate an ingredient with trans fats.
Your latest book mentions exogenous ketones as one of the ways to increase ketone levels. When and how often is the best time to consume exogenous ketones for boosting mental health?
I believe most people would benefit from having a serving of exogenous ketones in the morning and then perhaps one or two more times a day after that, particularly if they are dealing with a problem like cognitive impairment. The brain needs ketones 24 hours a day, so it stands to reason that maintaining a high level of ketones for as much of the 24 hours as possible would be beneficial.
Ketone levels after consuming exogenous ketones stay elevated for four to six hours. If you also add MCT oil and coconut oil to your diet or to your food, which also raise ketone levels, you may be able to maintain a steadier baseline of ketones throughout the day. Exogenous ketones can then be used to further boost the levels for a period of time as needed.
Is there anything else you would like to address that we have not touched on?
I have been attending the Alzheimer’s Association International Conference every year for the past few years, and they now recognize that modifiable lifestyle risk factors may explain about 30 percent of dementia cases. Poor diet is at the top of that list, and they also stress getting adequate sleep (between seven and eight hours a night), evaluating and treating sleep apnea (a well-known cause of dementia), getting regular exercise and staying active, evaluating for and controlling high blood pressure, and encouraging people to maintain social connections rather than becoming isolated.
At the Alzheimer’s Association International Conference in 2017, they held the first-ever session on ketones for Alzheimer’s disease through a ketogenic diet and MCT oil. Another session is planned for the 2020 conference. And they are currently funding studies of MCT oil, ketogenic diets, and ketone esters in people with Alzheimer’s.
It is gratifying to me that the Alzheimer’s Association is finally recognizing that a ketogenic approach may help with symptoms, or may even prevent progression to Alzheimer’s.
You’ve authored three books based on your experience and research with coconut oil, MCT oil, and Alzheimer’s. What are your current and future projects focused on, and what can we expect to learn?
I have several other books up my sleeve. I plan to write a book for parents about feeding their children better and also plan to write a book directed to teenagers about how to eat a healthier diet, of course stressing lower sugar and more high-quality foods. I want to explain to them not just what to do, but why it is so important. I want to include some history for them about how people used to eat before all of the overly processed packaged foods came into existence, which has resulted in an epidemic of obesity, diabetes, and dementia.
I would also like to write a book about the keto approach focused on helping people with diabetes. It’s my goal to increase awareness of the damage chronically-elevated sugar can cause and highlight the benefits of the low-carb, higher healthy fat approach to avoiding diabetes and all of its many serious complications.
Read the Keto-Mojo book review on Dr. Mary T. Newport’s book, The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements, here.
Shop Dr. Newport’s books:
- The Complete Book of Ketones: A Practical Guide to Ketogenic Diets and Ketone Supplements (2019)
- The Coconut Oil and Low-Carbohydrate Solution for Alzheimer’s, Parkinson’s, and Other Diseases (2015)
- Alzheimer’s Disease: What If There Was A Cure? The Story of Ketones(2011)
