Fasting, Carbs and Coconut Oil: An Expert Weighs in on Treating Alzheimer’s

When it comes to disease and the internet, anyone who’s ever googled a symptom as harmless as a cough knows that it can be hard to find information that isn’t alarming. When that disease is Alzheimer’s, which has no cure, it can be even more difficult to separate fact from fiction. So we took some of the more popular questions about diet and Alzheimer’s—on whether coconut oil benefits the brain, if fasting can help Alzheimer’s patients, and how the brain processes carbohydrates—to Dr. Ed Blonz, biochemist and nutrition researcher at UCSF. 

• A Mediterranean diet has been correlated with a lower risk of Alzheimer’s
• Only 8 percent of the fatty acids in coconut oil actually get turned into ketones
• There is no benefit to extra-virgin coconut oil vs. regular coconut oil, said Dr. Blonz

This is part two of a two-part interview. Read part one here.

Being Patient: For a person in the early stages of Alzheimer’s, what is the ideal time to fast between dinner and breakfast and how frequently is it recommended to fast per week to get the ketogenic benefit?

Dr. Ed Blonz: I would not fast. I think we need the nutrients from food. If you’ve got a weight problem, you want to lose weight, but you have to fast for 24 to 48 hours before ketones start being produced. We have a type of stored glucose in our liver called glycogen, and between meals, the liver starts to break down the glycogen to keep that blood glucose level up. We need that blood glucose because if you were to need to sprint out of the room or get out of harm’s way, you need to have glucose in your bloodstream. You can’t just fast between meals and think that’s going to solve a problem. It’s better to eat a healthful or Mediterranean-style diet, which has been correlated with a lower risk of Alzheimer’s, and you eat well and work on that. Now if you’ve got a situation where you’ve got early onset Alzheimer’s, you still want to eat well, but then you should talk to your neurologist or who’s taking care of you and find out whether it would be reasonable to even experiment with some of these exogenous ketones. But work with your neurologist, don’t just start it on your own.

Being Patient: Are carbs bad for your brain?

Dr. Ed Blonz: No, carbs are essential for your brain. Glucose is a carb. It’s when you don’t have enough of that carb that you run into trouble. Carbs only become a problem when you’re eating simple sugars, like soda pops and added sweeteners, or processed foods. Refined sugars become glucose. All carbs become glucose. But if you eat a teaspoon of sugar every day, that won’t cross the blood-brain barrier; that’s the key. Just getting it into your bloodstream doesn’t get it where it needs to go and if your blood sugar gets too high and you do that on a routine basis, you could end up having what’s called insulin resistance, which is a risk factor for Alzheimer’s because it makes it that much harder for the glucose to get across the blood-brain barrier. Don’t be afraid of carbs, just be afraid of adding simple sugars or too much sugar. Keep carbs in their place and don’t have added sugar. Whole foods, not processed foods.

Being Patient: Many researchers say it is frustrating when people say, ‘If I just take coconut oil, I won’t get Alzheimer’s.’ What’s the truth about coconut oil?

Dr. Ed Blonz: These days, there’s just so much information and misinformation out there. We saw what goes on with Facebook and all this other nonsense out there. In the same way that politics can be twisted, science can be twisted as well. Normally, one of the big enemies of lipids is oxidation, but because coconuts grow in a very hot, tropical climate, they tend to be much more saturated. Saturated fats don’t oxidize as readily as unsaturated fats. We tend to find very saturated fats in tropical climates, like the palm kernel and the coconut, but only 8 percent of the fatty acids in coconut oil actually get turned into ketones. The rest of them are just saturated fatty acids and calories.

Being Patient: So coconut oil is a source of ketones, but you’d have to eat a lot to benefit your brain?

Dr. Ed Blonz: Exactly. Someone said that she has a tablespoon of coconut oil between meals and she wondered what that would do for her. A tablespoon of coconut oil would be about 14 grams of fat. Eight percent of that would be maybe a gram of that eight carbon fatty acid. A gram of caprylic acid of that eight carbon fatty acid isn’t going to do anything for your brain—no significant effect. And if you do eat too much coconut oil, then you’d have other problems.

Being Patient: So the idea that coconut oil is good for your brain goes with the theory that what’s good for your heart is good for the brain because if you’re eating too much fat, that’s not good for your heart, right?

Dr. Ed Blonz: Exactly. The whole idea of coconut oil as being the way to go, there’s no biochemical logic to that. And then there’s also questions about virgin coconut versus other coconuts. I’m a big proponent of organic coconuts for environmental reasons and the farm workers, but the idea behind virgin coconut, I don’t even know why they call it virgin coconut. We get this from virgin olive oil, where the extra virgin olive oil, you get all the phytochemicals that are present in the olive that are then in the olive oil; whereas when you deal with refined olive oil, you just have the fatty acids, and when you have olive oil, you want all those phytochemicals. With coconut, you’re not interested in those phytochemicals; they really don’t have that many phytochemicals. The main protectant of the coconut is that shell and the fact that it’s mostly saturated fat [means] it doesn’t have all of those same phytochemicals that you find in olives, nuts and so forth where they have exposure to the environment. With coconut, you just want those fatty acids, so the same fatty acids will be in virgin, versus extra virgin, versus conventional. It’s all got the same fatty acids—that same eight percent caprylic acid. I like to encourage farmers to grow organically, but it’s not going to make a bit of difference in terms of nourishing the brain.

Being Patient: If we know that ketones are good for our brains and there’s a way to supplement ketones, why not just do that? 

Dr. Ed Blonz: It’s expensive. You can buy various products on Amazon. They’re powders, and one tablespoon of those will give you eleven grams of beta-hydroxybutyrate, which is definitely more than you’d get in coconut oil. And then there’s other products that are just concentrated sources of caprylic acid that are being sold as dietary supplements as well. So as long as you’re getting just that beta-hydroxybutyrate or its precursor, which is that eight carbon fatty acid, then you’re in the game, but just turning to coconuts is a bit problematic.

Being Patient: What’s the research behind these theories? Has there been any research on the supplementation of ketones?

Dr. Ed Blonz: There is some research being done right now at the University of Sherbrooke in Canada. A doctor is taking people with cognitive impairment and supplementing with ketones to try to find improvements in cognition. They’ve done that with experimental animals, so there is a body of research that’s growing with cognition. These are people who already have Alzheimer’s. What I’m dealing with, with the neuroenergetic hypothesis, is to stop Alzheimer’s from even beginning. Don’t wait for the cognitive impairment to already take hold, because then you’ve got decades of problems that have developed to the point where you finally realize, ‘I don’t know what day it is.’ You don’t want to wait that long. Science is very slow when it comes to these types of changes. We’re trying to get to the point where people will start to look at ways to prevent Alzheimer’s. I believe Alzheimer’s is a preventable disease. I don’t think we’re going to find a cure for Alzheimer’s because once you’ve got it, the damage has been done. They’ve tried doing various pharmaceuticals that will improve your cognition, but nothing has really worked. No drugs have been able to stop or reverse Alzheimer’s; they can slow it down, but nothing’s working. That’s why I’m hoping looking at it from neuroenergetics to stop it in its tracks before it even starts.

This interview has been edited for length and clarity.