I agree with sunshyne about DH brain being a bigger concern than his cardiovascular system and continue to give him the oil but I am not taking it myself, however, I plan to substiture it in place of other oils when possible.
I had him try the drawing clock face and signature last evening and he did not do as good as on the previous drawing, but he has not been doing as well all around as he was 2 weeks ago. (Drawing and signature is still better than before coconut oil ) This morning he is mentally pretty alert all around. I just don't understand all the ups and downs with the disease.
Just for (real) clarification, Accera is incorporating caprylic acid (C8:0) into their "medicinal food."
And, for you penny-pinchers, MCT oil (caprylic and capric acid mixture) is considerably less expensive than the better coconut oils. It also is pretty much tasteless, so you can mix it into various foods without affecting flavor. And it is an oil at room temperature, so you don't have to worry about it solidifying on you.
My Dh has been all over the place too-he is taking his meds and swallowing them whole which is new and a relief. and seems to know how to answer some questions he didnt before. and his bladder issues have subsided quite ab it and hes up only 1-2times now at nite ?? hallejuyah. i cant think that giving the COil in such small measures could improve as much as i see sometimes but maybe it has a good effect o the prostate somehow. but miracles do happen and until they put this new med out will continue to give it in breakfast -he just said what a lovely flower arrangment on my foyer..wow. wiered...Divvi
Lmohr, that's why we need clinical trials -- double-blind, placebo-controlled, long-term, "high-power" (that means a lot of participants enrolled), and with a battery of different tests to evaluate cognitive function, administered by people who know what they're doing -- to tell whether any treatment actually does any good for the average patient.
I don't remember whether it's been posted here, but they've finally released the results of a major trial on gingko biloba. Despite all the anecdotal reports that it helps ... it doesn't.
Right, Sunshyne. Only thing is, my DH is not elgibile for any clinical trials I know of and at this stage of the game, considering what is known now about the ad meds, I am game to try different things in the hope they will make his present condition more stable. It is like playing Russian Roulette, but I do feel a little better by having hope for a better tomorrow. (Within reason)
I wasn't suggesting that you enroll your husband in a trial, lmohr ... I was using what you had said to point out (for the umpteenth time, like a broken record) that we shouldn't get all excited because one person says something worked wonders for her spouse.
The Accera "medicinal food" has gone through clinical trials and FDA evaluation. I think it is exceptionally promising, and I am very anxious for it to be launched.
But that won't happen until sometime around March. And in the meantime, like you, if there's something I can do to approximate the benefits from their research to help my husband, then I'm all for it.
I'm just pointing out that their "medicinal food" is not coconut oil, and it is not simply caprylic acid. The more I read, the more convinced I become that there is a LOT more that needs to be involved to successfully treat AD patients -- even by the "MCT method" -- than just mixing an oil into their food.
And I think both Guy and Marsh (who have read Dr Henderson's papers) would agree that the man who developed the concept of using MCTs to help treat AD and developed the Accera product is extraordinarily intelligent and has a very strong and broad grasp of all the different factors that may be involved. So I also have high hopes that he can continue to improve upon the original product, and make it more broadly applicable (especially for improved treatment of APOE4 carriers.)
Because of the clinical trials and FDA approval, I have already told DH's doctor that we want a prescription as soon as Accera's medicinal food is released. I just hope insurance covers it. Like gingko biloba, coconut oil may seem to help but maybe does not. We'll try anything, though, to slow down this dreadful disease.
1. I can't see any improvement in DW after a full bottle at 2 Tbsp per day. Actually, in some ways she is worse. 2. I just got an e-mail from her doctor after he had read Dr. Henderson's paper. He was particularly concerned that Dr. Henderson is part of the company that is making the drug, so would have a bias. This is interesting in view of the other report from the neuropharmacologist who said the science in the paper is solid.
I will probably keep her on the coconut oil, since it doesn't seem to doing any harm, and await the release of Accera's "Medicinal Food".
Marsh, Dr Henderson's mother died of AD. He decided to change the direction of his career, to try to find a way to help other victims of AD. He did a lot of research, and gradually developed the hypothesis that's discussed in that very lengthy 2004 paper I sent to you. He founded Accera, but couldn't get any investment, or even much support from NIH, because his hypothesis was too far outside the mainstream ... so family and friends invested the money needed for the first clinical trial. That was what tipped the balance, and he finally started to get investment. (And he's got two of the better biotech venture capital firms investing in his company, now -- I think they're on the third, or maybe even the fourth round of financing, and that says a lot, especially in light of the country's current overall financial picture.)
He doesn't try to hide any of this ... he sent me a link to a newspaper article about the history:
Sure, the man has a bias ... he's been struggling to prove his hypothesis for years, and kept getting beaten up over it until he finally managed to get human clinical trial data. It's very frustrating that NIH will often balk at funding something that is out-of-the-box even when the underlying science is sound, and there's plenty of reason to believe a new approach will work. I've been on some of the review panels that did not have the best members in the world ... and I've been the victim of some of them, too. I don't know whether they bad-mouth good grant applications because they're jealous, or not intelligent enough to understand them, or afraid if they approve one and the project doesn't work, it will somehow reflect on their own competency. But they drive me nuts.
Venture capitalists simply NEVER invest in something drastically different from what other VCs are supporting. I'm in awe that he managed to win anyone over, let alone some of the top-tier firms.
In any event, do you know if your wife has the APOE4 allele? Because the disease is slowed in APOE4 carriers, but their symptoms do not improve. Dr Henderson thinks there may be a simple "fix" for them, based on genetic info, and that's next on his plate. He's also setting up a study, to be conducted up in Canada, designed to confirm that the MCTs actually improve brain activity (using brain imaging technology, presumably similar to PET scans.)
Dr Henderson is doing everything the right way, one step at a time, conducting properly-designed clinical trials, basic R&D to confirm the underlying hypothesis, etc ... and on a shoestring, too.
When my husband was diagnosed, his neurologist wanted him to start taking curcumin (curry is made from it) because research is suggesting it helps AD (India has one of the lowest incidents of AD in the world). MY DH has been on it for a year but I have no idea if it has helped or not. He was also started on aricept at that time. Thai food would be the perfect food because it has both curry and coconut in it. We eat thai frequently just because we like it.
Sandy, I contacted Greg Cole about the curcumin clinical trial results, back in April. (He had talked with Marsh about using curcumin.) Results so far have been disappointing. His response is at the end of the thread "A new low", which I've brought to the top.
Any reports on the cocanut oil? or the MCT oil? I am still giving DH 1 T. on the cocanut oil or the MCT oil daily. He is better than he was before I started, sometimes seeming normal but the next minute saying something off the wall. He is more alert. It seems like swiss cheese. Lots of "holes" in the behaviors. I am having him do the clock and signature today and he did the complete circle with straight lines through like a spoke wheel, no numbers. His name was not as good as last month. You just don't know, but we are continuing.
I found the MCT, orange flavored. DW has been taking this for about a week. I don't see any difference, except that she is doing more weird things (like chewing up her hearing aid). I don't know how long I will continue it.
Marsh, I started Frances on MCT products about two weeks ago -- 3 tsp orange-flavored MCT Fuel mixed with her orange juice at breakfast and 3 tsp MCT Oil at dinner -- either as a part of her salad dressing, or as a spread on toast, or just mixed in with veggies -- but I hadn't really expected to see any changes this soon. I did think, however, that she might have seemed a little "brighter" and more interested in things yesterday -- but thus far today isn't proving to be an especially great day -- asking to be walked to the potty about once every hour it seems like, and maybe a little more crochety. But it could be that my negative feelings about today are just a reflection of my own impatience with things -- I had set myself an objective today of composing our Christmas letter to family and friends, which I'm finding hard to do in half hour time increments. But anyhow, I intend to keep on with the MCT business for at least a month or two, or maybe even until Acera's new Axona product is on the market early next year. It's sort of like a story my father used to tell about old Judge Neville. As the story goes, one day during lunch recess of his court, Judge Neville and several lawyers were killing time out in a hallway before resumption of the Court. As Judge Neville reached in his pocket to retrieve something, a rabbit's foot fell out on the floor, prompting one of the young lawyers to exclaim, "Judge, I didn't know that you were superstitious!", to which the Judge responded, "Not a bit, Sir, but this rabbit's foot requires very little effort to carry -- and it MIGHT do some good....." So that's sort of how I feel about the MCT business (and cinnamon capsules too) -- they require very little effort (and expense) to try, and they MIGHT do some good -- at least worth a shot.
P.S. -- I'm going to be very careful not to let Frances get hold of MY hearing aids after hearing your story -- I had a puppy get hold of one of mine years ago, and at $2500 a pop that's serious business!
I am continuing to give DH both the coconut oil and cinnamon capsules. I'm like the Judge...just in case it works. Seriously, though, he does seem better with a combination of cinnamon capsules, fish oil, flax oil and coconut oil. I was put on Thera tears nutrition capsules for dry eye syndrone. They're a combination of fish oil and flax oil. My doctor said they had found the combination works better than either oil alone and that it was also good for the heart, skin, etc.
I would hate to have one of my hearing aids bitten into two pieces, that must take a lot of effort and strong teeth.
A little piece of information for you folks who are having hearing aid issues. You can find great buys on hearing aids at Costco, their prices are about 50% less than most hearing aid dealers. Not all Costcos have hearing aid centers, you can find the locations on their website. Their guarantees and service are top notch.
I know this doesn't have anything to do with Coconut Oil, but just thought I'd pass along the information for what it's worth.
My husband is at early stage 6. Lots of cognitive issues, no physical ones as yet. He gave up wearing his hearing aids almost a year ago. He gave up brushing his teeth about 6 months ago. In both cases I didn't realize he had given it up until way after it happened.
I know that his glasses are next. It is just the way this group of diseases work.
Mentioned the coconut oil to our pcp today and he just grinned. He is pretty strickly a buy the book Medic. I also asked him about the new something coming out after the first of the year and he wasn't too thrilled about that either. I think if he had an immediate family member with a bad disease he would change his mind about some of the "way out" natural meds.
Well short of planning a trip to the Sanctuary of Our Lady of Lourdes, what do they want us to do?
The current treatments are quite short of being effective. It's fine to question something, but to summarily dismiss it because "you" think you know best is the worst kind of dogmatism.
Hippocrates found that the bark and leaves of a willow tree was useful for headaches and pain relief. A willow tree for goodness sake! Coconut Oil, a Willow tree, what's the big dif?
It's so comforting to know that unless the FDA and big phramacutical companies don't give it their blessing, it just can't really work.
One day, I will haul off and give one these guys a good sock in the noggin'! It will make me feel good! -guy
Well, yeah, but the the Accera product HAS been approved by the FDA ... I guess some people just aren't impressed by anything. (Guy, you are too funny.)
Speaking of which ... I started my husband on MCT oil, very very gingerly, one month ago. We started off VERY slowly, went for more than a week at 1 tsp per day, then five days at two tsps per day, etc.
As y'all know, I am not too keen on the MMSE at all, let alone when administered by novices, so I haven't made any attempt to test him. He has his good days, and days where he has some problems. We have some good conversations (relatively speaking), and some days where he struggles more to find words. He remembers to wash his hair some days, argues that he's already bathed on others (this is new) but will go take "another" bath just to please me. When he has a problem, I despair, when he does well, I soar. Pretty much our usual status quo.
He was pretty stressed by the time we got to today's doctor visit. Monday I hauled his beloved cat to the vet, sure she would die before the week was out -- she had pretty much stopped eating and was beginning to stop drinking, as well. (The vet and I had a little heart-to-heart, and he agreed to change her meds. She is now eating again -- gingerly -- and drinking again, and looking considerably perkier, although she still struggles to breathe sometimes.) He had his regular eye exam on Tuesday (for his glaucoma) and then to the dermatologist yesterday for his skin cancer. No biopsies this time, thank heaven, but he did have to have 3 actinic keratoses frozen off his face, and one of these, near his eye, was weeping puss today and looking rather icky. Something icky-looking on his face bothers him inordinately.
So I wasn't expecting much from him today, since his symptoms are very sensitive to stress.
I wasn't expecting any testing, either, since the reason we went to see his neuro today was to talk about whether to adjust his huperzine A. I did want to take the opportunity to talk about whether he could get into any clinical trials if he stays on huperzine A, and to see which trials his neuro might recommend. However, he hasn't had any testing since the longitudinal study in June, and the neuro wanted to see how far he's declined since then before discussing his meds. I got the impression he figured my husband would have declined enough by now that he wouldn't qualify any more for any of the trials, and so was reluctant to talk about them. All told, the "interview" and testing took about an hour and a half.
I had to pick my jaw up off the floor several times.
Nobody would mistake him for the genius he used to be, and that's for sure, but he did surprisingly well. For the clock, for example, he drew a good circle, put the numbers on it correctly, and got the hour hand in the right place. He was confused by the way she gave him the time ("ten past eleven") and got the minute hand in the wrong place ... but it sure as heck was a minute hand. The intersecting pentagons were the closest he's ever come to being correct, a good pentagon in the upper left, and although the lower one was more of a parallelogram than a pentagon, its upper legs were at exactly the correct angle and intersected the upper pentagon in exactly the right way; and the relative size was about right. When told to take the paper in his right hand, fold it, and place it on the floor, he did so quickly and confidently. For the date, he was only off by one day, knew the day of the week and the season. He couldn't remember the three words, or even seem to want to try ... but when she gave him a clue for each, he got all three of them correct. No problem spelling "world" backward. When asked to write a sentence, he had to ponder for quite a while ... his first draft lacked a verb, but when asked if that was a complete sentence, he announced that it wasn't, and fixed it. And it was a fairly long sentence, too, about the Cardinals being sports teams that play baseball and football, with the spelling correct, and the handwriting better than it's been in a very long time. (He has resisted writing so much during the last few months, I thought he might not be able to any more.) She gave him a series of words in pairs, asking what they had in common. Orange and apple, easy. Chair and table, easy. They became more and more difficult ... boat and horse? "They're both methods of transportation."
Shiver me timbers.
Anyway, the neuro was now quite happy to discuss the pros and cons of the clinical trials that interest me, and encouraged me to get full details on all of them, decide what my priorities are, and we'll go from there. He seems to think we might get into the Bap trial, even though my husband is taking Plavix.
Sounds a lot like what I've seen with my wife. We also have been ever so slowly adding Coconut Oil to her diet. There are days when she is good, really good. We went to the Arlo Guthrie concert (with Pete Seeger mind you) at Carnegie Hall with some friends and she was in the back seat talking up a “storm”! My wife's nickname used to be "Brooke" as in babbling ...:>) I'm not testing her yet, just simply observing how she is doing. So far so good I would say. In a word, I am hopeful.
And for those who say that there may be a bias by someone who has developed a treatment because he is part of the company, well yes, there may be. BUT… the fact that Henderson's mother had AD is a strong motivating factor for doing "something" about it. That fact doesn't necessarily give me hesitation as there is some precedent:
"Felix Hoffmann, a German chemist, produced a stable form of acetylsalicylic acid, more commonly known as aspirin, in 1897. Hoffmann, was searching for something to relieve his father's arthritis. He studied French chemist Charles Gergardt's experiments and "rediscovered" acetylsalicylic acid--or aspirin, as we now know it!"
I put the MCT in her orange juice in the morning (it is orange flavored) and mix it with apple sauce in the evening - 1 Tablespoon each dose. I still am not sure it is doing any good, but she seems to be having more good days than bad. This could also be because I have changed my way of reacting.
one teaspoon a day and i can see minor improvements as well. my grandaugher and i heard him counting the tiles on the floor as he walked 1-10. something new. and he read the directory we have in the foyer and his saying which reads dont worry be happy! humm..small improvements but still any noteworthy change however minor is good. divvi
I told my husband's family doctor that there was an FDA approved "medical food" coming out in early 2009. His response was that he wanted to know what it was once it came out so we could check it out. I think the words "FDA approved" cut off any off handed stuff, but it turns out that HE is on fish oil, so I guess he has some willingness to listen if there have been clinical trials.
I told him about Sunshyne checking the clinical trials out, and that they had tested it on people who were already on dementia drugs.
Once I have his OK, and a prescription if one is needed, I'm going to put my husband on this stuff. Until then, I'm waiting.
While I was trying to learn more about saturated fats and looking for a good source of MCT oil, I picked up some Barlean's coconut oil at a nearby store, and started off with that. I put 1 -2 teaspoons in hot cocoa at breakfast, it's yummy. Even though I've found a good source for the MCT oil and it's a lot less expensive, I'll probably pick up some more Barlean's and continue giving him cocoa from time to time, for a change of pace.
MCT Fuel is emulsified and the closest thing I could find to the Accera product. It's orange-flavored, so they tell me ... not disgusting, for medicine, but not exactly the same as oranges fresh from the tree. The flavor definitely limits the number of ways to use it, and I suspect I'd have a rebellion on my hands if I tried to give it to him "neat". Since it's emulsified, you need to use more per day to get the same dose. I've been putting a couple of tablespoons of that into orange juice for breakfast. Fortunately, my husband likes that fine, too. (I don't even like the way it looks.)
MCT oil itself I mix a couple of teaspoons or a tablespoon into anything mixable. Low-fat yogurt -- he loves a lot of the different flavors, and that satisfies his sweet tooth for dessert. Scrambled eggs, mixing in the MCT oil before scrambling makes a nice texture. Soups, especially those new Campbell V8 soups, those are great -- I usually loathe butternut squash but that soup is the best of the bunch. Mashed potatoes (and yes, bluedaze, in my book, you make 'em with the potato skins, which has many nutrients, and I think adds to the flavor.) I often make a large salad for dinner, using baby spinach and summer mix -- I have several different types, e.g., veggies and avo and tuna or salmon and a ranch dressing, or nuts and granny apples and broiled chicken and a spicy honey-mustard dressing, and I just drizzle the MCT onto his and toss before adding the dressing. (One of the recipes calls for almonds browned with butter and sugar -- I tried replacing the butter with coconut oil and that was scrumptious.) He loves peanut butter and honey on toast, so like you, I'll spread either the MCT oil or the coconut oil on the toast before putting the peanut butter on. Some dishes -- pasta, fish, etc -- I just drizzle the MCT oil over the top of his helping.
So far, he hasn't objected to anything I've tried.
They say that coconut oil is good for the skin. I hope the same is true for MCT oil, because that's all over my hands nowadays...
We are on our 3rd container of coconut oil and have seen some small improvements. The other day we were in the drug store for pictures, my husband wandered away and when he returned he had a bag from the pharmacy, he had remembered that we had a message on our answering machine days ago saying our adult son had a script ready to be picked up (and he was out of town) I was amazed! For the last year I have checked little things like the sump pump when it rains to make sure it is working properly and I have changed the filter on our furnace. It was raining the other day and he went down and checked the pump to make sure it was working properly. Again a first in a long time!
Oh Sunshyne, that kind of improvement is fantastic. There are definite improvements in my DH also. He has been almost normal for the last few weeks, fixing things around the house, installing some equipment, etc. We've been going places and doing things. His MMSE score was higher this time and his doctor was very receptive when I mentioned the Accera product and was going to get some more information on it. I didn't tell them I was giving coconut oil already.
However, we had a day yesterday that wasn't so good. We've had two Christmas dinner/parties in two days this week. The last one was in a very noisy restaurant with a lot going on. When we got home, he forgot where we had been and kept asking where the restaurant was. I think I've read that lots of noise and unusual activity is not good. I hope this was just one day and I'm going to try to keep the rest of the Christmas celebrations small and a little quieter.
Dazed, I have to admit ... I didn't tell my husband's neuro about the MCT oil, either.
I know, I know, I said forty gazillion times to ask the doctor first ... <ducking everything that is being thrown at me> I just figured by the time I'd finished my lit searches, I knew a whale of a lot more than almost any doctor would. Plus marsh had his friend confirm that the underlying science was sound, AND the coconut oil was ok'ed by several other doctors, AND the product is FDA approved, AND MCT oils are considered "generally recognized as safe" by the FDA. (This is known as rationalization.)
And since we were talking clinical trials with the neuro, and there was already some question about whether we'd be accepted if my husband stays on huperzine A, well ... why throw a possible monkey wrench into the works? I mean, I've just changed the way that I cook, using a more healthy mixture of fats. <grin>
I'll have a chat about Accera's product with the doctors when it gets a little closer to launch, and I know whether my husband can get into one of the trials.
I should perhaps emphasize that the dose of the "active ingredients" you are giving your spouse in a Tablespoon of product depends on the type of product you're using. In their clinical trials, Accera was giving participants 20g of the caprylic acid (which is an MCT) per day. This is roughly the equivalent of:
5 Tablespoons (15 teaspoons) of MCT Fuel (the orange-flavored emulsion)
2.25 Tablespoons (~7 teaspoons) of coconut oil*
1.5 Tablespoons (4.25 teaspoons) of MCT oil
*This is assuming lauric and myristic acids have the same potential for being converted into ketone bodies as caprylic acid. I'm not sure that they do ... they can be processed by the lymph system as well as absorbed by the portal vein.
What about the soft gel Coconut Oil? I'm thinking about ordering the ones made by Source Naturals. 120 softgels in a bottle. I think they are 4 grams a capsule and the directions are to take 4 to 8 a day. -guy
That's a lot more pills to swallow, Guy. For us the solid is easier to just spread on bread and fold it in half to make a sandwich. A little jelly with it and you can't tell you are eating it. I have not had as easy a time with the liquid.
Well yeah I agree, but I just thought having the Coconut Oil, the MCT fuel and the softgels would give me more options. So that if we're running around and don't have time for dinner, or we skip breakfast for some reason, the softgels would be there to take.
OK, I have been threatening you with this for quite some time ... here 'tis. It is very long, and will undoubtedly have to be broken up into ten posts.
Thanks to Sandy D's refusal to accept the claim that the saturated fats in coconut oil are healthy, I have spent many days slogging through dozens of incomprehensible and/or totally boring papers, and hundreds of additional (and usually equally incomprehensible but mercifully shorter) abstracts. I have reached the following conclusions:
(1) Reading posts by Sandy D is hazardous to my health.
(2) Most people do not have a CLUE when it comes to fats. The people who publish dietary guidelines are usually ten years behind the research curve. (Sigh.) They have a nasty tendency to parrot older studies that have subsequently been shown to be seriously flawed.
(3) The only people who think coconut oil is a wonder food are the people who sell coconut oil.
(4) The fats in MCT oil, caprylic and capric acids (and the fat in the Accera product, which is caprylic acid) are not considered to be "saturated fats" by the FDA definition of the fats that are potentially harmful to your cardiovascular health. Caprylic and capric acids, although "saturated" in that they do not have carbon-carbon double bonds, have been found to be "neutral" with respect to having any effect on cholesterol levels or on cardiovascular risk factors -- they don't improve either one, nor do they make either one worse.
(5) The ultimate health effects of ANY type of fat depend on the rest of the diet. It is not just the amount of a particular fat that is important, but the balance of fats in the diet. Many other foodstuffs or nutrients can also counter-balance the effect of fats -- for better or for worse -- such as carbohydrates (especially fiber), protein, phytosterols, antioxidants, folic acid, calcium and alcohol.
(6) I'm going to stick pretty much to MCT oil for my husband. Maybe a little coconut oil for flavor now and then, as a change of pace (he loves some in hot cocoa at breakfast), but not a lot. I am convinced that majority of the fats in coconut oil are not heart healthy -- nor are they likely to be processed efficiently into ketone bodies.
(7) In the past, most research on diet and health has focused on single nutrients or foods and their effect on disease outcomes. However, more and more, researchers have come to realize that health cannot be improved by eliminating a particular food or type of nutrient from a diet -- in fact, doing so can often be harmful. Therefore, in recent years, the focus has shifted to include the total dietary pattern as a risk factor in epidemiologic studies. Saturated fats do play a role in maintaining a healthy body. As far as I can tell, the best diet guidelines for cardiovascular health, a lower risk of diabetes, and improved mental health are those for the Mediterranean diet, with wine and nuts. (Nuts!!! Not only is modest consumption of wine good for you, but so is daily consumption of nuts!!! Yay!!!) For those of you who don't want to drink alcoholic beverages, grapes, grape juice, and raisins contain many of the compounds in wine that have been found to be protective against cancer and/or cardiovascular disease.
If you don't like a lot of details, stop here. For those of you who not only want some details supporting these conclusions but are particularly masochistic, I've included links to a number of the better review articles at the end of this summary.
Basically, the older studies on fats made the assumption that consuming a fat is an isolated thing, unaffected by the other fats and/or foods you might be eating. We have now learned, through long and painstaking research, that nothing could be further from the truth. The processing of fats in the human body is very complex, and many, many factors can affect the end results. Ergo, many of the earlier studies came to conclusions that cannot be supported by more recent, broader studies that take other factors into account. Carbohydrates (especially fiber) are important, other fats (especially n-3 fatty acids) are important, trace constituents such as phytosterols are important.
In case you haven't noticed, our understanding of the impact that foods can have on the human body keeps changing. Avocados are now on the list of heart-healthy foods, where they used to warn that avocados are bad for your health due to their high fat content (most of which now has been found to be monounsaturated). When the fuss about cholesterol started up, they said to steer entirely clear of all eggs, since their cholesterol content is very high ... then they said a few eggs a week are okay ... now they've lifted restrictions on eggs entirely. I'm seeing a similar trend starting for dairy products such as cheese (I love cheese) and yogurt, possibly even whole milk. In fact, some studies have concluded milk will protect people against the risk of having a myocardial infarction.
In short, as one recent paper said: "Within the nutritional community there is a growing appreciation that health derives from an overall pattern of diet rather than from the avoidance of particular foods, and there has been a shift in the tone in recent dietary recommendations away from 'avoidance' messages to ones that promote healthy eating patterns."
Except, it seems, saturated fats. I have seen the abstracts from a couple of recent reviews that do mention that these fats play important roles in the human body, and most diet guidelines confirm that some amount of saturated fats in the diet are necessary for overall health. Still, there is no consensus of opinion as to how low a diet can go in saturated fat without becoming harmful, and most guidelines still simply encourage us to steer away from them as much as possible.
So, first off, what ARE "saturated fats"? I assumed that they would be fats that do not have any carbon-carbon double bonds in their structures, since that is what the term means to a biochemist ... but ... when it comes to the FDA and AMA warnings against the consumption of saturated fats, the definition is much more limited.
Per the FDA guidelines, saturated fats -- the fats that are listed on food labels because they are believed to contribute to cardiovascular disease -- are the sum of lauric (C12:0), myristic (C14:0), palmitic (C16:0) and stearic (C18:0) acids.
Now, although the FDA warns against all four of these, they do not all affect blood cholesterol levels equally -- myristic is the worst of the group, followed by lauric and palmitic, which are generally considered to be equivalent to each other. Some studies have found that stearic acid has almost no effect on blood cholesterol, while others found that it lowers HDL cholesterol, especially in women. However, all "saturated fats", including stearic, do promote postprandial lipaemia, which is thought to be important in promoting atherogenesis, as well as increase platelet adhesion and thrombosis. In some studies, stearic acid increased Lp(a) concentrations, and may have activated Factor VII and impaired fibrinolysis, all of which are also risk factors for cardiovascular disease.
The other fats that are "chemically" saturated are either referred to as "medium chain" triglycerides (MCTs) and fatty acids (MCFAs), containing 10 or fewer carbons in their chains; or are divided into short- (4 to 6 carbon) and medium-chain (8 to 10 carbon) fats. These fats, although "saturated", are considered to be "neutral" with respect to having any effect on cholesterol levels or on cardiovascular risk factors. They are absorbed from the intestine to the portal circulation and are turned into ketone bodies for energy. There is very little tendency for them to form adipose tissue (fat). Caprylic (C8:0) and capric (C10:0) have antiviral activity.
Once in a blue moon, you'll see a paper define MCTs as comprising fats with 8 - 12 carbons in their chains, but this is rarely done nowadays, since it misleading when it comes to the way in which the fatty acids are absorbed, digested, and metabolized. Lauric acid (C12:0) is more appropriately lumped with the long-chain fatty acids. I had already mentioned in a previous post that lauric acid could *sometimes* be processed like a long-chain triglyceride ... apparently, it *usually* is. The degree to which lauric acid constitutes a risk factor for cardiovascular disease is still somewhat controversial ... some studies have shown that it raises LDL cholesterol significantly, but it increases HDL levels even more (hence, it lowers the total cholesterol:HDL-cholesterol ratio.) However, there are other mechanisms whereby lauric acid can induce cardiovascular disease, and modern guidelines lump it firmly with the longer-chain "saturated fats".
Now, I was originally attempting to champion coconut oil as being heart-healthy. I mean, ALL of the coconut oil enthusiasts will tell you how incredibly good it is for you. Sandy D was just being stubborn, and a spoil-sport.
Coconut oil is some 50-55% lauric acid, 15-20% myristic acid, 10% palmitic acid, and 5% stearic acid. That's about 80%, give or take, saturated fat.
So if coconut oil is so terribly healthy, I figured that the problem with just looking at coconut oil in terms of its "saturated fat" content was that this does not look at how the other constituents in the oil affect humans. I mean, coconut oil proponents will carry on and on about populations that consume huge amounts of coconut oil and have no cardiovascular disease at all (in Sri Lanka, for example). So obviously, the thing to do was to track down epidemiological studies. However, I had considerable difficulty tracking them down. The few I did manage to find were very poorly planned / conducted, and it was not possible to rely on their conclusions. One study that is cited repeatedly was done on two populations of Polynesians who consume very high amounts of coconut meat and oil, but have low incidences of vascular disease. Well, that is apparently true, but the reason is unknown. It may be due to the extremely low levels of dietary cholesterol and sucrose, for example. What I found VERY interesting is that, despite the coconut oil proponents carrying on and on about the "MCTs" in coconut oil being turned into energy rather than into fat, analysis of human samples from these Polynesians showed that their fat had very high lauric and myristic contents. So ... the lauric and myristic acids were NOT being turned into ketone bodies.
So much of what I was reading was confusing and contradictory, I decided I was going to have to take a different tack, and look into recent, large-scale, controlled feeding studies involving humans.
The vast majority of my search was on cardiovascular health. The bad news is that what is currently considered to be healthy from a cardiovascular standpoint (which also tends to be healthy from a diabetes standpoint) may not be so good from the standpoint of some cancers. Also, advances in fatty acid biochemistry are uncovering new mechanisms by which fatty acids could potentially modify immune responses, which could open a whole, new can of worms. I did not dig into any major health areas other than cardiovascular, but if someone has a particular concern, let me know... But please do keep this in mind if you are brave (foolhardy) enough to continue reading.
Also, I decided to ignore most, if not all, studies done with cells, tissues, and animal models. There are just too many difference between cells or tissues and the whole body for such studies to do more than give hints as to underlying mechanisms. And as far as I can tell, there are no truly reliable animal models for studies on fat digestion, absorption, and metabolism. Pigs are relatively representative, but too expensive to be used very often. Guinea pigs are reasonable animal models for certain types of studies on fat, especially in comparison with rats and mice, but although less expensive than pigs and easier to handle, are still rarely used, so we don't have a full picture of how relevant guinea pig studies might be.
The research that is compelling, in my opinion, was done with humans -- controlled feeding studies, not historical -- and also factored in the rest of the diet, as well as the effects of different races (genetic profile), ages, gender, and overall health. Each of these can affect how fats are processed and the impact they may have on cardiovascular risk factors. People who are hypercholesterolemic respond differently from those who have naturally low cholesterol levels, for example. There are significant differences between men and women, even when race, age, and overall health are controlled for.
Moreover, the results that are the most meaningful came from studies that looked at a variety of cardiovascular risk factors, NOT just total cholesterol levels. It is pretty well accepted now that the ratio of total cholesterol:HDL-cholesterol is a much better measure of cardiovascular risk. Even so, other risk factors should be considered, as well, to understand what effects a particular fat or combination of fats/other diet constituents may have on the body. These include lipoprotein (a), apo A-1, apo B, intermediate density lipoproteins, small dense LDL or LDL subclass pattern B, and oxidized LDL. Other possible new and emerging risk factors are still being evaluated to determine whether they play a part in the development of cardiovascular disease, such as plasma homocysteine, platelets, thrombosis, prothrombin F1+2 levels, plasma fibrinogen, factor VIIC, effects of early nutrition, and intrauterine development.
As noted above, short- and medium-chain fatty acids are "neutral" with regard to cardiovascular risk factors. I found little, if anything, to refute this. So MCT oil, MCT Fuel, and Axona (the Accera product) should not be a concern in terms of raising "bad" cholesterol levels etc.
The impact of "bad" saturated fats can be mitigated by other constituents in the diet. For example, I couldn't get away from reports that fiber is important -- it lowers total cholesterol and LDL levels, helps reduce weight, helps prevent colon cancer, and so on and so forth ad nauseum. A recent meta-analysis of ten prospective cohort studies (91,058 men and 245,186 women) found that each 10g/day increment of total dietary fiber was associated with a 14% reduction in risk of all coronary events and 27% reduction in coronary mortality. All fiber is not created equal, however. Numerous studies have demonstrated that diets rich in soluble fiber are more effective in lowering "bad" blood cholesterol levels and decreasing the fraction of small, dense LDL particles than are diets rich in insoluble fiber. The key soluble fibers are beta-glucan (found in oats, barley, and yeast), psyllium (found in husks of blonde psyllium seed), and pectin (found in fruit). Some of these studies -- but not all -- concluded that cereal fiber was more effective at reducing risk than vegetable or fruit fiber. One study reported that dark breads (wheat, rye, pumpernickel) were associated with a lower risk of cardiovascular disease compared with cereal fiber from other sources.
Cutting down on fats is not necessarily the key to cardiovascular health. A high-carbohydrate, low-fat diet can produce an unfavorable lipid profile by decreasing HDL-cholesterol and increasing triglycerides, for example.
"Good" fats can also affect the blood lipid profile. Monounsaturated fatty acids appear to exert a neutral effect or to be mildly hypocholesterolemic. Polyunsaturated fatty acids elicit the most potent hypocholesterolemic effects. The source of the fat may be important, because the food may contain other constituents that are present in trace amounts, yet can exert a strong impact. Vegetable oils often contain phytosterols, which can lower total and LDL cholesterol levels significantly (apparently by suppressing cholesterol absorption in the gut). For example, the Mediterranean diet calls for cooking with olive oil, which is high in monounsaturated fat (primarily oleic acid). It might be preferable to substitute canola oil, however, since some studies have found that in comparison with olive oil, this high-oleic oil has more favorable effects on blood lipids and plasma apolipoproteins, as well as on the number and lipid content of LDL subfractions. Some of the differences may be attributed to differences in the squalene and phytosterol contents -- olive oil is low in phytosterols.
The one really nice thing that came out of all my reading was finding that nuts and seeds are now considered to be really, really good for you -- even peanuts, and macadamia nuts. (I love macadamia nuts.) Peanut butter is good, but you still need to stick to low-fat. (They don't remove peanut fats to make low-fat peanut butter; instead, they don't ADD as many other, very unhealthy, fats.) Tree nuts, peanuts, and seeds have a favorable fatty acid profile (low in saturated fatty acids and high in polyunsaturated and monounsaturated fatty acids) and are a rich source of nutrients and other bioactive compounds that may reduce the risks for cardiovascular disease and diabetes, such as fiber, phytosterols, folic acid, and antioxidants. Daily consumption of nuts is associated with an improved serum lipid profile, and lower rates of coronary artery disease. Some studies have even found that adding a modest amount of nuts (30 grams/day) to your normal daily diet will not cause weight gain, and will improve the body mass index. I'm not sure I believe that, but I did like hearing it. <grin> Weight loss may be promoted by the incomplete digestion of the nuts and seeds and subsequent "enhancement of satiety"; there is also some evidence that individuals on nut-rich diets excrete more fat in stools.
Another VERY intriguing finding: studies that looked at the impact of age concluded that saturated fat consumption is more of a risk factor in younger people than in older people. One suggested that the reason may be that older people are a more "select group"; i.e., that a large number of the potential study base had already died or been excluded because of coronary disease, and so the remaining group is less vulnerable to environmental factors such as saturated fat. In other words, if an older person was going to develop coronary disease, s/he was more likely to have already have done so when younger. (That's why I figure I can still give my husband a little coconut oil now and then, as a change of pace.)
When all the dust had settled, from everything that I've read, it does appear that the Mediterranean diet (with wine and nuts) is, overall, the most heart-healthy and is also the most likely to reduce the risk of diabetes. Now, the latter is important, I think, because of the very close ties between diabetes and Alzheimer's (which is sometimes called the "diabetes of the brain" or "Type III diabetes.")
The Seven Countries Study stimulated interest in the "Mediterranean diet" when it was reported that the 15-year mortality rate from coronary heart disease in southern Europe was two to three times lower than that in northern Europe or the US, yet the mean serum total cholesterol values were similar. Diet composition varies in this region but tends to emphasize fruits, vegetables, breads, cereals, potatoes, beans, nuts, olive oil, and seeds. Other common characteristics include dairy products (mainly cheese and yogurt), fish and poultry (rather than red meat), and wine consumed in low to moderate amounts. Since then, the dietary patterns characteristic of the Mediterranean region have been extensively studied, and several very large epidemiologic studies, such as the ATTICA, Lyon Heart, and Indo-Mediterranean Diet Heart studies, have confirmed that diets fitting this description yield beneficial effects on known cardiovascular risk factors and reduce recurrent coronary events.
Since I'm sure that you've found all of this absolutely fascinating, you will undoubtedly wish to read more. Good papers:
And, finally, the following article is a review of the major effects of various types of fatty acids on plasma lipid concentrations and the mechanisms involved:
Most peanut butter has some of the peanut oil removed and replaced with a less expensive oil. In Florida our local Publix supermarket makes their own peanut butter in their own stores. Ingredient: peanuts..... No salt, sugar or any added oils. It doesn't need refrigeration and doesn't separate. Only problem is I eat it from a spoon-no crackers. And no-my cats don'tget to lick the lid. :-)
Much to my surprise, my geriatric cat loves peanut butter!!! I found this out when I turned my back on her one day, and later discovered most of the peanut butter missing from my toast.
...I am not researching peanut butters, bluedaze. I am so tired of reading about fats, I can't begin to tell you! I wish to high heaven scientists would try writing in English for a change, instead of incomprehensible techno-mumble.
(Did you actually read all of the stuff preceding the nuts paragraph, or were you just skimming the first paragraph of each post???)
Way to go, Sunshyne -- you've reclaimed your title for submitting the longest posts!!!! Actually, I stand in awe of your energy, intelligence, tenacity, etc. that lets you research and summarize AD stuff so thoroughly and readily -- I read every word of your five-part post on coconut oil, and I'm more than willing to accept your summarization (is that a word?) of the referenced technical articles without trying to understand them myself. Incidentally, I passed the posts on to my health freak son who is living with us now -- like you, he's nuts about nuts.....
Oh rats....I've just bought another jar of coconut oil when I should be buying MCT oil. Was it just our imagination that this stuff was making them better?