THE BENEFITS OF COCONUT OIL 1

The Benefits of Coconut Oil and its Use as a Treatment for Alzheimers Disease
Naomi Stamper
May 9, 2013
California State University, Chico
NFSC 345-Spring 2013
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ABSTRACT
Coconut oil has one of the highest amounts of medium chain fatty acids of any food.
There are a variety of medium chain fatty acids in coconut oil, but the two that are found in the
largest amount are caprylic acid and lauric acid. One or more of these medium chain fatty acids
is attributed to many of the purported health benefits of coconut oil. Coconut oil has been said to
improve immune function, increase metabolism, decrease the risk of heart disease, and have
neuroprotective effects. It has been suggested that the neuroprotective effects can treat
neurological conditions including Alzheimers disease. In Alzheimers disease, coconut oil is
thought to provide an alternative fuel source for the brain since glucose utilization is impaired.
With Alzheimers, the brain cannot use glucose as efficiently. An alternative fuel source, such as
ketones, could prevent further cognitive decline or even improve cognitive function in a patient.
In Alzheimers patients, an increase in plasma ketone concentrations has been shown to increase
cognitive function. Medium chain fatty acids are ketogenic and therefore increase the
concentration of ketones in the blood regardless of other foods consumed. Coconut oil is often
used as a source of medium chain fatty acids for ketogenic supplements. No studies have used
whole coconut oil to see whether it is effective in raising ketone levels in blood enough to
improve cognitive function. However, the amount of coconut oil that would have to be
consumed to obtain the necessary rise in plasma ketones would be about four and a half
tablespoons per day. This indicates that it should not be recommended as a treatment for
Alzheimers disease.

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INTRODUCTION
History
Coconut oil has been used extensively throughout history, especially in tropical regions
of the world. It has been consumed as a food, but has also been used to treat various medical
conditions including: asthma, constipation, baldness and gonorrhea (Coconut Research Center,
n.d.). Coconut oil is composed mostly of saturated fats and is unusual in its large proportion of
medium chain fatty acids. The numerous purported benefits of coconut oil are generally
attributed to one or more of these medium chain fatty acids. Coconut oil is thought to have the
ability to decrease the risk of cardiovascular disease, increase metabolism, support the immune
system, treat some degenerative neurological conditions as well as treat many other diseases and
conditions (Coconut Research Center, n.d.; Mercola, 2013). Though there are many purported
benefits of coconut oil, there is very little research that supports these claims.
Composition
There are many forms of coconut oil which can be grouped into two main categories:
unrefined (also referred to as virgin or extra-virgin) and refined (Krishna, Raj, Bhatnagar,
Kumar, & Chandrashekar, 2010). These two types of coconut oil can be further processed in
various ways. Different types of coconut oil have different health effects. The purported
benefits of coconut oil are generally associated with unrefined coconut oil. During the 1970s
through today, hydrogenated coconut oil has been used in research as a way to purposefully
increase the cholesterol levels in animal models so that treatments for high cholesterol could be
studied (Enig, 2000). This led to an association of high cholesterol with all types of coconut oil.
However, hydrogenated coconut oil effects health differently than other types of unmodified
coconut oil (Enig, 2000).
Coconut oil is composed of more than 90 percent saturated fat, with about 60 percent of
these fats as medium chain fatty acids (Krishna et al., 2010). This composition makes coconut
oil unusual because generally the western diet is composed of over 98 percent long chain fatty
acids (Coconut Research Center, n.d.). There are two major medium chain fatty acids in
coconut oil. While these exact percentages vary from between products, lauric acid generally
makes up about 50 percent of the total fatty acids and caprylic acid generally makes up about 10
percent of the total fatty acids (Ghosh & Bhattacharyya, 1997; Krishna et al., 2010). These fatty
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acids are generally the components of coconut oil that are attributed to the many purported health
benefits.
Purported Benefits
Coconut oil has been associated with an ever-increasing list of possible health benefits
including: boosting ones metabolism; antifungal, antiviral and antibacterial properties;
decreasing the risk of heart disease, increasing bone and tooth health, promoting thyroid health,
helping digestion and helping regulate blood glucose levels (Coconut Research Center, n.d.;
Mercola, 2013). Coconut oil has also been said to treat neurological conditions and disease such
as epilepsy, Parkinsons and Alzheimers disease. It is thought that the medium chain fatty acids
in coconut oil play a role in the treatment of these diseases. Coconut oil itself has not been
studied. However, the medium chain fatty acids used in the study of the efficacy of this
administration of a dietary supplement come almost exclusively from coconut oil (Krishna et al.,
2010).
DISCUSSION
Alzheimers Disease
Alzheimers disease is a neurodegenerative disorder which arises from several different
issues in the brain. The first is beta-amyloid plaques which are caused by increased synthesis of
a specific protein; the protein accumulates too fast for the brain to clear the excess, leading to
inflammation and the destruction of brain cells (Fotuhi, 2003). Another component of the
disease is tau protein tangles caused by mis-folded proteins; these proteins normally transport
nutrients and the loss of these functional proteins leads to neuronal cell death and brain atrophy
(Fotuhi, 2003). The last component of the disease is a decreased ability for the brain to utilize
glucose (Henderson, 2008). This last component of Alzheimers disease is thought to be what
coconut oil is effective in treating.
Brain Hypometabolism
Decreased cerebral glucose utilization, or brain hypometabolism, is observed in brain
scans of patients with Alzheimers disease; a decrease of glucose utilization throughout the brain
is seen as low as 25 percent of normal utilization (Henderson, 2008). This decrease in glucose
utilization is associated with decreased cognitive function (Henderson, 2008). While
hypometabolism has been documented in patients with Alzheimers, it is not known whether it is
a cause of decreased cognitive function or an effect due to other issues occurring in the brain
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(Cunnane et al., 2011). However, since decreased glucose utilization has been documented in
patients brains before cognitive decline is seen, it has been suggested that hypometabolism
contributes to the decline in cognitive function (Correia et al., 2012). Regardless of whether it is
an effect seen due to other components of Alzheimers disease or it is a contributing cause to the
development of the disease, it is important that the brain have fuel to meet its energy needs.
Proposed Physiologic Mechanism
With Alzheimers, while the brain shows decreased utilization of glucose, it is still able to
use ketones as an alternative fuel (Cunnane et al., 2011). Studies have indicated that raising
ketone levels in the blood 0.4-0.5 mM corresponds to an increase in cognitive function compared
to a control (Cunnane et al., 2011). One study used medium chain fatty acids to increase ketone
levels in the blood (Henderson, 2008). The patients were administered a 40 g dose of medium
chain fatty acids and, on average, an increase in blood ketones levels of 0.5 mM was seen
(Henderson, 2008). Two important aspects were noted in this study: this mild increase in blood
ketone levels showed improvements in cognitive function compared to the control and this
increase in blood ketones was seen regardless of other components of the diet (Henderson,
2008). Generally when ketogenic diets have been used to treat neurological conditions such as
epilepsy, the amount of fat required in the diet to significantly increase plasma ketone levels
makes it highly unpalatable. However, in this case, significant differences in cognitive function
occurred by simply adding a dose of medium chain fatty acids to the diet (Henderson, 2008; Neal
& Cross, 2010).
Medium chain fatty acids are considered ketogenic because they are transported to the
liver, go into the mitochondria without requiring activation, and are then converted into ketone
bodies and released into the blood (Cunnane et al., 2011). In contrast, long chain fatty acids are
transported through the lymphatic system and can be stored as fat. Here they would not be
immediately available to the brain to use as an alternative energy source. Even when the brain is
not capable of using glucose as efficiently, medium chain fatty acids in the diet could potentially
provide enough ketones for the brain to use as fuel. This could potentially prevent cognitive
decline in patients at risk for Alzheimers disease or prevent further cognitive decline in patients
diagnosed with Alzheimers disease (Cunnane et al., 2011).
Efficacy
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There is an emerging body of research that shows that it may be possible to increase, or at
least prevent further decrease of, the cognitive function of Alzheimers patients by inducing mild
ketosis (Cunnane et al., 2011). Mild ketosis can be induced by supplementing the diet with
medium chain fatty acids and coconut oil is an important source of medium chain fatty acids
(Yao, Rettberg, Klosinski, Cadenas, & Brinton, 2011). While coconut oil is often used to obtain
medium chain fatty acids for supplements, whole coconut oil (with its naturally occurring
components) has never been studied as a treatment for Alzheimers or even as a way to induce
mild ketosis.
In 2009 a medical food was developed to treat Alzheimers disease using caprylic acid,
one of the medium chain fatty acids found in coconut oil. The fatty acids contained in this
medical food are derived from coconut oil and palm oil (Axona: Fuel the Brain, n.d.). The
product went through the first two phases of clinical drug trials at which point the manufacturer
decided to market it as a medical food (Shah, 2011). The product showed increases in blood
ketones levels of about 0.4 mM as well as improvements in cognitive function; however, the
number of participants in the study was small (Axona: Fuel the Brain, n.d.; Shah, 2011). The
improvement was seen when patients consumed 40 grams of the medical food per day which is
the equivalent of consuming 40 g of medium chain fatty acids per day (Axona: Fuel the Brain,
n.d.). Axona contains only caprylic acid while coconut oil contains various medium chain fatty
acids. Caprylic acid makes up only about 10 percent of the total fatty acids in coconut oil and it
is unknown whether all medium chain fatty acids would increase blood ketone levels to the same
extent (Shah, 2011). Even assuming all the fatty acids in coconut oil would raise blood ketone
levels to the same extent, a person would have to consume about four and a half tablespoons of
coconut oil per day to get the same amount of medium chain fatty acids as a 40 gram packet of
Axona.
Safety Concerns
Generally ketosis is regarded as an undesirable state for the body to be in; the western
diet is so high in carbohydrates that generally the body does not reach very significant states of
ketosis except in some conditions such as diabetes (Henderson, 2008). However, the use of
ketones as an alternative fuel source for the brain when glucose is not available is an important
survival mechanism. At low concentrations ketones in the blood should not negatively impact
health (Henderson, 2008). There are some populations should not purposefully attempt to induce
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mild ketosis for any reason. People who are diabetic and are at risk for developing ketoacidosis
would not be advised to include large doses of medium chain fatty acids in their diet because it
would put them at further risk for developing ketoacidosis.
The high number of calories in coconut oil, especially when consumed in such large
volumes should also be considered. Consuming four and a half tablespoons of coconut oil per
day would add approximately 525 kilocalories a day to a persons diet. A slightly smaller
amount, about 430 kilocalories, would be added if the medical food, Axona, was consumed
(Axona: Fuel the Brain, n.d.). Medium chain fatty acids, even with potential benefits, still
have approximately nine kilocalories per gram. The major type of fat in coconut oil is saturated
fat which is associated with an increased risk of heart disease. However, some recent studies
have suggested different types of saturated fatty acids may have different effects on heart disease
and blood lipid profiles (Siri-tarino, Sun, Hu, & Krauss, 2010a, 2010b).
Another concern of incorporating coconut oil into a persons diet is gastrointestinal
distress. When a large increase in fat is added to the diet it can lead to gastrointestinal problems
such as diarrhea. This side effect was seen in participants when taking the product Axona
(Axona: Fuel the Brain, n.d.). This was not noted in the studies on medium chain fatty acids
and coconut oil, however it should be considered if the amount of fat in a persons diet is going
to be increased drastically and quickly.
Professional Opinion
The treatment of Alzheimers disease by inducing ketosis appears promising in terms of
improving cognitive function or preventing further decline of cognitive function. Mild ketosis
could benefit a patient with Alzheimers, especially in combination with other treatments.
However, some studies show that when brain glucose utilization decreases, the ability of the
brain to use ketones also decreases, just not to the same extent (Cunnane et al., 2011; Yao et al.,
2011). Scans of the brain can show decreased glucose utilization in Alzheimers patients.
However, more research needs to be done to determine the effectiveness of ketones as a
replacement fuel.
While medium chain fatty acids may be a promising treatment, complete coconut oil has
never been studied as a way of inducing mild ketosis. The amount that would need to be
consumed before the increase of ketones in the blood is equivalent to that of the studies done on
medium chain fatty acids is large. Without any studies linking coconut oil directly to
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improvements in cognitive function it should not be suggested as a treatment for Alzheimers
disease. However, coconut oil can be incorporated into a varied diet and poses little risk. It is
not something that should be discouraged to be used as an alternative to other fats and oils.
CONCLUSION
Coconut oil is touted as a miracle food by many. Most of these benefits are attributed to
its high medium chain fatty acid content. While the long list of benefits makes coconut oil seem
to be the cure for almost anything, most of these benefits are supported by nothing more than
anecdotal evidence or personal beliefs. This is true of its supposed ability to treat Alzheimers
disease. A decrease in glucose utilization is seen with Alzheimers disease and ketones may be
an alternative fuel source for the brain to help improve cognitive function; mild ketosis can be
induced using ketogenic supplements that are composed of medium chain fatty acid and coconut
oil is one of the largest natural sources of those fatty acids (Henderson, 2008). However, there
is no direct link between the consumption of coconut oil and improvement in cognitive function.
No studies have been done which have tested the efficacy of coconut oil on the cognitive scores
of patients with Alzheimers disease. Even if coconut oil produced this benefit, the amount that
would need to be consumed to achieve a therapeutic dose would be unreasonable to recommend
to a patient as a treatment for Alzheimers disease.

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