When Dr. Mary Newport's husband was diagnosed with early-onset Alzheimer's disease, she began looking for answers. Her research brought her to ketosis as a possible nutritional protocol and the results were amazing. On episode 568 of the 40+ Fitness Podcast, we discuss her book, Clearly Keto.
Let's Say Hello
[00:01:48.790] – Allan
[00:01:49.720] – Rachel
Hey, Allan. How are you today?
[00:01:51.420] – Allan
I'm doing all right. Kind of dealing with a stomach bugs. So I've kind of laid low the last few days and done most of my things from here at Lula's in our apartment. As you can see from the video, I'm in my studio, my fitness studio here at Lula's. And so I'm staying here because I don't want to be more than maybe 10ft away from the bathroom. So just trying to stay hydrated, taking some and things like that. Kind of get myself to a point where I can get through this thing with this little bug, but it's the thing.
[00:02:28.010] – Rachel
Well, I hope you feel better soon.
[00:02:29.770] – Allan
Thank you, but everything's great.
[00:02:31.510] – Rachel
[00:02:32.740] – Allan
How are things with you?
[00:02:34.410] – Rachel
[00:02:35.320] – Rachel
I just wanted to update you and our listeners real quick. I've shared that Mike, my husband Mike, has been battling kidney cancer, and our surgery is slated. It should be in another week or so. And they're going to remove his whole kidney and the nearby lymph nodes and adrenal gland and his pre surgery EKG and blood work. He had one more Cat scan which showed the tumor shrunk, which is great. Everything is looking good. And so I hope to have some good reports in about a week or so. But I wanted to share real quick, too, that we were talking to the oncologist and of course, all surgeries are high risk and it's always scary to go under the knife, but our doctor assured Mike that he was a pretty healthy patient. He's of good weight. His blood pressure is controlled. He is in good shape for surgery. And so it was really nice to hear that reassurance from the doctor that all that we do with our running and our dietary choices and everything has made him healthy enough to be able to manage a pretty big surgery like this coming up. So it was just nice to hear that reassurance.
[00:03:47.410] – Rachel
So if the oncologist feels good, then we feel good. So, good news.
[00:03:52.260] – Allan
Good. So, Mike's fit, trim, ready to go?
[00:03:55.770] – Rachel
[00:03:56.980] – Allan
Big takes scar.
[00:03:57.930] – Rachel
That's right. Yup. So we're very optimistic.
[00:04:02.430] – Allan
That's good to hear. So you're ready to talk to Dr. Newport?
[00:04:06.640] – Rachel
[00:05:08.140] – Allan
Dr. Newport. Welcome to 40+ Fitness.
[00:05:11.040] – Dr. Newport
Oh, hi, Allan. Thank you so much for having me on your program.
[00:05:14.170] – Allan
So the book we're going to talk about today is called Clearly Keto: For Healthy Brain Aging and Alzheimer's Prevention. And the one thing I would say is I think cancer scares everybody to some extent, as it should. But the numbers that we see for Alzheimer's cases, and particularly the forward-looking statistics on what that's going to look like in 40 years, 30 years is terrifying.
[00:05:42.850] – Dr. Newport
It is terrifying. I think everybody knows somebody or has a family member that has been dealing with Alzheimer's.
[00:05:50.810] – Allan
Yes. I come from kind of a long life family. So on my father's side, my grandfather lived into his mid 90s. Not well, but he did live yeah, my grandmother lived into her late 80s. But towards the end, I think she was also starting to suffer from some dementia issues. In fact, the last time I saw her, I don't think she recognized me. I think she thought I was my father because just the way she was carrying on and talking and things like that, I think she had confused me. So this is just one of those topics that I'm like, okay, if I can figure this out, I'm going to feel a lot better about getting old, growing old and together. You might not be together.
[00:06:35.190] – Dr. Newport
Right. You might not be together. That's what happened with me and my husband, right?
[00:06:40.690] – Allan
Yeah. Can we talk a bit about Steve's case and what happened there?
[00:06:44.980] – Dr. Newport
Yeah. So you probably mentioned already with my biography that I'm a physician. I practiced newborn intensive care for 30 years, and Steve was an accountant, and it worked out perfectly for our family because he stayed home with our children. He could work from home. He was the original Mr. Mom, and he was a perfectionist. He was in the kayaking. He read novels. But when he was 51, he started having memory issues, and I thought, maybe it's just a midlife crisis. He would miss appointments. He started shuffling around. His accounting work, like quarterly tax return was fairly simple for our practice. It should have taken him 20 minutes, and it would take him several days, and he would shuffle everything around and procrastinate, and it was becoming worrisome. And then he started forgetting if he'd been to the bank, in the post office, and he would misplace mail. And that was bad because it was, you know, checks that people were sending in for payments that he would misplace. So he saw a neuropsychiatrist who evaluated him and said this could be dementia, but more likely it's depression. And Steve was depressed, but retrospectively, most likely he was depressed because he knew he was not functioning well and that's something was wrong.
[00:08:03.480] – Dr. Newport
He was put on an antidepressant. We continued to get worse over the next few years. Driving, getting terrible, couldn't follow a map, was losing his accounting skills. Slowly but surely. They always say, use it or lose it. He was using it. He still lost it. I mean, that's how Alzheimer's is. And he was diagnosed with Alzheimer's, early onset Alzheimer's. At this point, when he first started having symptoms, he was 51. He was diagnosed at age 54 already. So that's early onset. Younger than 65 is considered early onset, and it's maybe 1% to 2% of people with Alzheimer's or early onset. So this was, as you were saying, you hope to live out into old age with your partner. And as I'm researching Alzheimer's at the time, I'm finding out the average lifespan is about seven years after diagnosis. And I thought, well, we're not even going to get to retire together. So that was just put a very big damper on our future. And so constantly looking for clinical trials or anything, we were always told by the Alzheimer's Association that we were within five years of a cure. We heard this over and over every year.
[00:09:20.620] – Dr. Newport
We're within five years of a cure, donate the research. But we were always watching for clinical trials, and they were kind of few and far between in our area. We lived north of Tampa and Florida, but he continued to progress. By age 56, he had lost all of his accounting skills. He had worked on the computer all day, every day, and they play on it when he wasn't working on it. Always had to have the fastest computer, but at age 56, he couldn't even figure out how to turn it on or use, much less use a mouse or do any accounting work. He also had to quit driving that same year. It's hard to think after diagnosis, someone with Alzheimer's still driving, but people do until they can, and, I mean, it's a very slow process. There's an awful lot you can do for a long time. A lot of people socially don't realize that you have a problem, and it changes how people look at you once you tell them. So we were not aggressively telling family and friends that he had this diagnosis right away, but at age 57, so about six years into symptoms, he stopped being able to make meals for himself.
[00:10:39.990] – Dr. Newport
He would just not eat when I was working. So our younger daughter, Joanna, ended up moving back in with us, and she would be with him in the daytime when I was working and make sure that he ate and that type of thing. But in 2008, when he was 58, it just felt like he was spiraling downwards, you know, I was pretty much giving up hope that we were going to come across that cure. And we had already, a couple of years before that, switched to a Mediterranean diet, mediterranean style diet. I had read some research that the people who ate the most Mediterranean like diet that had Alzheimer's lived on average, four years longer than people who ate the least Mediterranean like diet. I said, okay, well, maybe this will buy us some time. And that was the first I had even considered that nutrition might have anything to do with Alzheimer's. So then I was keeping my eyes doing, like, wider searches, thinking of nutrition and other factors that we might be able to address that possibly help him. But so when he was 58, this is May of 2008, two clinical trials became available in our area.
[00:11:51.060] – Dr. Newport
And we're like, oh, my gosh, maybe he'll qualify. Like in previous studies, you would be disqualified if you had a history of depression. If you were an early onset Alzheimer's and you knew it, wouldn't you be depressed? Who wouldn't be depressed? But these two did not disqualify you if you'd had depression. These were the first studies that came along in our area that had those criteria. And so he was scheduled for two days in a row to try out to be tested, to get into these clinical trials. Two different centers, two different cities. And the night before, I thought, I'm going to look up these two drugs and look at the risks and the benefits, because we might get a choice. If he qualifies for both studies, we'd have to choose. So I came upon a press release for a medical food that was going to come out in about a year from then. And they had done a pilot study in which nearly half of the people who had taken it had improved memory and cognition after one dose. And this was something you never hear improved with any drugs for Alzheimer's, that it improves memory or cognition.
[00:13:08.070] – Dr. Newport
It might slow the disease down for six months or so. So it didn't say what it was or what it did, how it worked. So I was able to find a patent application, and I read through that, and I learned a whole lot about Alzheimer's as the type of diabetes of the brain, which I think we'll talk about in a few minutes, and that ketones are an alternative fuel for the brain. And that one of the things that happens in Alzheimer's, is that there's decreased glucose uptake into certain areas of the brain. And glucose is a fuel. It's the basic fuel. If we're eating a typical higher carb American diet, we're running off glucose most of the time, and our brain in particular is running off glucose. But if you have a problem getting glucose into cells, the cell can be surrounded by glucose, but it can be starving, because the glucose just literally cannot get into the cell and provide the fuel that the cell needs to produce energy. This energy molecule called ATP. But it was discovered in the 1960s that when you starve or fast, that you use up the glucose that stored in your body fairly quickly within 36 or 48 hours.
[00:14:22.390] – Dr. Newport
And when that runs out, then you start breaking down fat, and you break down some muscle, too, possibly to make glucose. But since we have fat, we can break down fat. And some of that fat is converted to ketones, which are taken up very well by the brain and can provide fuel to the brain. So this was really a neat idea. This is cool. And where the medical food came in, it turned out it was MCT oil, medium chain triglyceride oil. It was a very specific medium chain fatty acid. And what happens they also found this out in the 1960s. When you consume MCT oil, your liver converts part of it to ketones. So it's kind of a neat trick to bypass that problem of glucose uptake in the brain. And I thought, oh, my God, this is brilliant, brilliant idea. And I remembered this thing about ketones and starvation and MCT oil converted to ketones. That kind of refreshed my memory. From medical school, I had heard about this. So in a patent application, I learned that MCT oil is actually extracted from coconut oil, which is the richest natural source of it. And so I thought, okay, I knew MCT Oil.
[00:15:34.620] – Dr. Newport
I thought it might be available in hospitals. I wasn't sure if I could even get it. But I knew I could get coconut oil because I had seen it in health food stores. So at this point I'm reading about all of this and it's about 01:00 A.m.. And he's set up to screen at 09:00 A.m. That same day. And so I didn't have time to do anything about it. We went to the screening. It was in Tampa, Florida. No, actually, I'm sorry. It was in St. Petersburg, Florida. And he did terrible there was a mini mental status exam. He needed to get 16 out of 30 points correct to qualify. They were looking for people with mild to moderate Alzheimer's. He scored only 14. So he did not get accepted into the trial. And the doctor asked him to draw a clock. And that's a very specific test for Alzheimer's. And I have it here, and I know you're not going to be showing the video on the book, but what he drew, so you can see it a few little random circles and a few numbers, four numbers. It was very disorganized. And the doctor said he's on the verge of severe Alzheimer's.
[00:16:40.710] – Dr. Newport
And I kind of knew it, but that really hit home. And I thought, what do we have to lose? I'm going to go get some coconut oil. And so we bought that on the way home. And then I kind of refreshed my freshman biochemistry with our medium chain fatty acids. And I found a fatty acid composition of coconut oil. And I learned that it was 60% medium chain triglycerides. And I figured out how much coconut oil I would need to give him to equal what he would get with that medical food that wouldn't be out for a year. And so the next day, he was scheduled again for a testing for a different clinical trial, a different location. And we tried, we went over what is the season, what is the day of the week. He couldn't remember any of that on the way there. The testing was about 3 hours. Well, I put a little over two tablespoons is what it added up to, an oatmeal in the morning. He had that for breakfast. And then about 3 hours later, he was tested. And he actually gained four points from the day before, which was really surprising.
[00:17:46.060] – Dr. Newport
And he qualified for the study. And I thought, okay, well, either we just got really lucky or maybe this actually did something, this coconut oil, and I'm going to just keep it going. And so the next day and every day after that, I would give them a little over two tablespoons of coconut oil. But I thought, why would you only use one dose of in the patent application? The peak level of ketones was about 90 minutes after taking the MCT oil, and it was down at 3 hours. So I thought, well, what does your brain do the other 21 hours? Your brain needs fuel 24/7. Even when you're sleeping, your brain is extremely active and uses a lot of calories, a lot of energy. So I just started cooking with it throughout the day. I got, like, every recipe I could get my hands on, and he was getting it basically at every meal from that point on. And just over the next few days, he had several symptoms that improved pretty dramatically. And, I mean, he himself said that the day he started coconut oil, that it was like a light switch came back on in his brain.
[00:18:53.260] – Dr. Newport
And before the coconut oil, he would be very sluggish in the morning, and his gait had become abnormal. He would pick up a seat kind of higher than normal and walk very slow. He couldn't run anymore, even though he looked physically fit. He had tremors. His jaw would tremor when he tried to talk. His hand would tremor when he tried to eat, had trouble finishing sentences he couldn't figure out. Like, he'd go to the drawer to get a spoon, and he come back with a knife over and over and over. He'd do that six times before he finally got the right utensil. And after the coconut oil, he just had more energy. He was more talkative. He started whistling again. He was a great whistler. He was all these great medleys making jokes, and he could get the utensil. And by about the fourth or fifth day, we're like, you know, something has changed. Something has changed for the better. This might actually be working. And so I was, in the meantime, researching everything I could about ketones. And I called Dr. Richard Veech, who was a world renowned ketone expert. Sadly, he passed away in early 2020 at age 84, still working at the NIH.
[00:20:06.700] – Dr. Newport
But he was considered the world expert on ketones. He had been studying them for decades, and he had been working on a ketone ester that could greatly increase ketone levels much more than coconut oil or MCT oil. He sent me all kinds of hypothesis papers that he and others had written. He had some of his associates who had written papers who were interested in ketone research call me. It was really kind of amazing when I told him what happened with Steve. And, well, at two weeks after that clock, so about two weeks after he started the coconut oil, he drew another clock. And this time it had the full round circle. All the numbers were there. They were in the right order. It was really messy. There were a lot of hands of the clock, but it was so much more organized. And Dr. Veech, I faxed in the first and second clocks, and he said, this is unexpected. He thought it would take much, much higher ketone levels for anybody with alzheimer's to improve. And then Steve just kind of progressed after that. I probably should let you get a word in edgewise.
[00:21:14.590] – Allan
No, the interesting thing here, and this is kind of my takeaway, is sometimes we're faced with tragedy, right? And then we have to make a choice and I just appreciate that your choice was to help anyone else that you can by sharing information about Steve and his story. And then again, some of the stuff that's happened since probably would have never happened if you hadn't done what you did and then reached out. So it's just not just, oh, I found something that works for my husband and we're good, that was, okay, I'm going to share this with the people who are doing these studies, with people who know people that are doing these studies. So there's some proposed studies that are actually going to give us good information because it's so hard to get a food study funded.
[00:22:04.780] – Dr. Newport
[00:22:05.890] – Allan
And the people that were going to do it, I'm assuming maybe they got their product released at some level, but they did it because they had a product. They did it because they were going to sell something.
[00:22:16.090] – Dr. Newport
[00:22:16.590] – Allan
And you just did this because you saw it was helping Steve and you're helping people yourself now. So I just want to thank you for that and say that we lost Steve at some point here, but I know that you made his life as good as it possibly could have been, particularly in those last years with this treatment. So I want to take a step back because we've talked about a few things and I've said this a few times on the show, because I've read it, that Alzheimer's is sort of like is sort of like diabetes type three, if we wanted to, some people call it that. But it's basically an issue with the brain getting energy. So with us having difficulty getting energy to the cells in the brain, we call a glucose uptake. Can we talk about a little bit more detail of, okay, what's going on in there? Because I know there's the tau strands and there's the amyloid structures and all those things, but those are the outward symbols of what's going on. The inward chemical stuff is where the real magic is because you just got to find a way to fuel those brain cells.
[00:23:23.680] – Allan
Can you talk about a little bit about how that happens? Because you talked a little bit about ATP, but we really didn't get into I've always known of it as the Krebs cycle, but you use the…
[00:23:34.320] – Dr. Newport
Cycle is another word. Cycle is another yeah. So basically well, I think a lot of people know that insulin is very important. Insulin has to do with getting glucose into cells in the brain. It's somewhat more indirect, it's indirectly involved, but it's still involved in some insulin does cross the blood brain barrier. It used to be thought that insulin was not made in the brain. It didn't cross into the brain. It had nothing to do with the brain. But it turns out it has everything to do with the brain. It actually does cross the blood brain barrier. It's just much lower levels than what are present in our blood. But in Alzheimer's, there's a problem that seems to be related to insulin resistance and insulin deficiency. There are some researchers that have found evidence that insulin is made in the brain. They don't know exactly where in the brain yet, but with Alzheimer's, ten to 20 years before you begin to have symptoms, there's already this problem of glucose uptake in the brain being defective. And part of it is glucose actually getting into the brain itself is depressed, and that seems to be related to insulin in some way.
[00:24:55.180] – Dr. Newport
And then glucose getting into cells, there are glucose transporters. So these are molecules that are kind of openings, I guess, in the cell membrane that allows glucose to enter a cell. And the ones that are involved in glucose getting across the blood brain barrier into the brain and into brain cells are deficient. In Alzheimer's. There's another problem. There's a complex called PDH complex, one that is right at the level of mitochondria, which are factories where ATP is made. We have like anywhere from 100 to 1000 or so of these mitochondria in a cell in which energy is produced, but also, like, thousands of proteins are produced in these mitochondria as well. And the PDH complex is required for glucose to actually be it's converted there's like six steps, and then it has to be converted to pyruvate to enter into that TCA cycle, which is located in the mitochondria. And this complex is deficient as well. And there's a thing called mitochondrial dysfunction. That's one area of study that hasn't gotten as much attention as these plaques and tangles that you mentioned. But basically there seems to be a problem with insulin resistance and insulin deficiency that affects glucose getting into the brain, getting into these mitochondria where ATP is made.
[00:26:28.350] – Dr. Newport
And Dr. Steven Cunnane in Canada has done incredible amount of work. He's at Sherwood University and he and his associates have been studying this very intensively, and they have been using ketone and glucose Pet scans. They've studied over 300 adults of all ages, including many healthy adults, healthy older adults, people with mild cognitive impairment, which precedes Alzheimer's and people with Alzheimer's. And they have found that there is what he calls a brain energy gap. So there's a gap between how much energy the brain needs and how much it actually gets. And this is present even in people who test normal in their 70s, cognitively normal, there's a gap of about seven to 9% between how much energy the brain needs and how much it actually gets. And in people with mild cognitive impairment, that widens to ten or 12%. In people with Alzheimer's at the earliest stages, it's 20%, a 20% gap between how much energy the brain needs and how much it gets. And it just continues to get worse as Alzheimer's progresses. So that's a very interesting finding. And then along with that, he has found that ketones are taken up normally in the same areas of the brain that are affected by Alzheimer's.
[00:27:43.860] – Dr. Newport
And it supports this idea that Dr. Veech had back in the 1990s, that ketones could possibly help someone with Alzheimer's. And he has tested MCT Oil, which is the medical food that I read about in that press release. And he has found that MCTL does contribute to increased fuel uptake and energy production from ketones, and it also improves cognitive performance in people with mild cognitive impairment. He did a six monthly study. They received two tablespoons a day of MCT Oil. After the study, he told me that he felt like three tablespoons a day would have been even better, that they might have gotten even better results. But they did all five cognitive domains that they studied. There were improvements in these people, and the level of ketones they produced from the MCT Oil was sustained throughout the six months. It wasn't that their body adjusted, and they weren't making ketones anywhere they were. They actually were making the same amount as at the beginning of the study. So basically, insulin resistance is a big part of the problem. It's something that happens with aging. But many, many people develop prediabetes and diabetes. By age 75, about three quarters of people have either diabetes or prediabetes.
[00:29:07.320] – Dr. Newport
So it's very prevalent. It doesn't always affect all organs in the body. So somebody might not have type one or type two diabetes, but they can still have diabetes of the brain. So the insulin resistance can affect the brain directly. And this seems to be a really big part of the problem. So it's insulin resistance not allowing glucose into cells, and then the brain needing some kind of fuel to fill in the gap from glucose, and ketones can fill that in. So it's kind of a neat idea. Using ketogenic strategies, so to speak, that will increase ketones could help overcome both of those problems, the insulin resistance and filling in the brain energy gap.
[00:29:54.190] – Sponsor
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[00:31:31.330] – Allan
If someone wanted to address this aging, particularly healthy aging of the brain, marrying ketosis with the Mediterranean diet is sort of your prescription. Can you talk a little bit about why those would be so protective?
[00:31:46.240] – Dr. Newport
Yeah. There have been hundreds of studies of the Mediterranean diet and cognition. I think I found over 500 when I did a search on PubMed. And basically the standard American diet has gone in the junk food route. Ultra processed foods, a lot of fructose, which is very harmful, very inflammatory, and cells in many cells of tissues, just not getting the right nutrients, not getting the right forms of vitamins. And with a Mediterranean diet, a whole food diet, basically a whole food Mediterranean diet, you're eating whole grains, legumes. It emphasizes fish, more so than red meat. It doesn't completely eliminate red meat, necessarily, but just suggest limiting that moderate amount of dairy and full fat dairy. This is not a fat free, low fat diet and emphasizes olive oil, healthy fats like olive oil and monounsaturated fats, which are in olive oil, nuts and seeds are very rich in them. Avocados, a lot of foods like that that you can eat. The interesting thing about dairy fat, while human breast milk has medium chain triglycerides in it, the newborn goes into ketosis. Within hours, a newborn that is strictly breastfed goes into ketosis. They break down their fat, which helps get through the first few days while the milk is trying to come in.
[00:33:18.190] – Dr. Newport
And the breast milk does have medium chain triglycerides. So the newborn, it gets quite a lot of its energy from ketones and ketones. Dr. Cunnane, again, he was studying newborns before he switched and started studying Alzheimer's. They found that fatty acids are broken down into ketones. And ketones are the building blocks for lipids in the brain, and the brain is about 60 or 70% lipids, including cholesterol, and ketones are the building blocks for all of that. So very important in the newborn. So back to the diet anyway. Dairy fat, cow milk, goat milk. It also has medium chain triglycerides in it. And I think these days, even there's been this idea around for several decades, I think about 50 years now, american Heart Association. We should eat a low fat diet, avoid saturated fats. And even now, like USDA, what they prescribed for children, the Women the Wick program, women's, Infants, and Children Feeding program for underprivileged people, it emphasizes lowfat dairy, even for little children that are just coming off breast milk. And breast milk is about 50% fat, and more than half of it is saturated fat. And now we're supposed to eat a low fat, fat free diet.
[00:34:41.490] – Dr. Newport
Even the dairy in a tiny growing child whose brain is actively growing and lipids are accumulating very quickly in this brain. So, you know, basically, you know, the Mediterranean diet is a it emphasizes healthy fats. It's not a low fat diet, but you can get most of the vitamins and other nutrients that you need for healthy brain aging by eating a Mediterranean diet. So I like the idea. And there are so many diets that can be adapted to a keto kind of a diet. So basically, when you do a Mediterranean keto diet, you're using the principles of the Mediterranean diet, but eating more fat and less carbohydrate. So basically eating smaller portions. I still remember the food pyramid from 1992, my god, the base of the period was General Mills of the pyramid. Yeah, it was.
[00:35:43.480] – Allan
It was General Mills.
[00:35:45.100] – Dr. Newport
Six to eleven servings of breads, pasta, cereals, all of that a day. And I mean, at the time I was overjoyed because, you know, I was buying into this low fat, hooked line and sinker. But, you know, I developed a really serious weight problem and I was eating skim milk. I was eating these that I thought were healthy cereals with a lot of fiber and this kind of thing. But it was a real struggle to not keep gaining weight, counting every calorie. And yet the low fat diet, it's a nuisance because you crave it's high carb. If you eat low fat, you're going to make up the calories with carbohydrates. And when you eat so much carbohydrate, it spikes your insulin level. And then when the insulin level comes back down, you get hungry again, and you're constantly craving thinking about your next meal and craving those sweets. And that's kind of where I was at for a lot of years until we switched to a Mediterranean diet. And within about three days, I stopped craving, constantly thinking about what my next meal was going to be and craving sweets. It was really kind of amazing.
[00:36:50.210] – Dr. Newport
But basically, you just tweak. What I tell people is when you look at the starchy foods, bread, rice, pasta, cereals, that type of thing, a lot of people don't want to give that up completely. And I think that's I'm an older person now, so I'll say, okay, older people, you get a little bit fixed and what your diet is like, and it's hard to completely give that up, and you might not have to. So I encourage people to reduce the carbohydrates, but kind of start with cutting portions in half of, like, bread, rice, pasta, and when you're used to that, cut it in half again. So basically eating smaller portions, eating more healthy fats. And for me, coconut oil is a healthy fat. I've studied it quite a lot, and there are a lot of myths out there about coconut oil being artery clogging fat and all of that. It just isn't. So it was made up. It was a competitor with Cisco and other shortenings that look very similar and had a long shelf life. So they kind of put out these myths there that have been perpetuated. But olive oil staying away from certain fats like oils that are reheated over and over.
[00:38:08.920] – Dr. Newport
A lot of fast food restaurants, they'll keep the same oil in their fryers for a week.
[00:38:14.910] – Allan
Yeah, I can testify to that. I work fast food when I was in college, and it's one of those things where there's a standard for how often you're supposed to change it, and that's even too long. But most managers will sit there and say, look, we're spending too much money on oil. So one more day, scrape out and filter it. You get all the stuff out of it and take it for one more day, right?
[00:38:41.510] – Dr. Newport
Yeah. And it's heated to a very hot temperature. You think about throwing French fries in there and how quickly they have to be, or whatever you're frying in it, and it creates a lot of toxic lipids that are very harmful for a long time, until very, very recently, they were loaded with hydrogenated fats, trans fats. And this could have played very well into this Alzheimer's epidemic that we were seeing, these trans fats. Every cell membrane is made up of lipids, and it should be very fluid, the cell membrane. But when you add trans fats and they get into the cell membrane, which they do, makes the cell membrane stiff, and the cell doesn't live as long, it affects what's transported in and out of the cell. So a lot of problems, and fortunately, they've almost been banned from the US. They were kind of phased out between 2013 and 2018, and they're still allowed to have up to a half gram of trans fat per serving. So some manufacturers adjusted their serving size downward so that they can still use some trans fat. And now they're exploring these fats where they remove they still make them hydrogenated fats, but they're removing the trans fats.
[00:39:53.670] – Dr. Newport
So it's still not really a normal fat. And some of these foods that they're experimenting with. So just so many reasons to go with a whole food like Mediterranean style diet, just many vitamins, minerals, other things like choline is a good example. Most people may not have ever heard of choline, but they might have heard of DHA, omega three fatty acids. But the omega three DHA attaches to choline, phosphatol choline. And it's a really important part of the cell membrane of the brain. Choline is also part of acetylcholine, which is a neurotransmitter that's involved with learning and memory. It's deficient in Alzheimer's disease. So you wanted to get plenty of choline, and that's something you can get with the Mediterranean diet. It's in certain nuts, it's in animal meats, fish, that type of thing. Eggs are really rich.
[00:40:55.310] – Allan
[00:40:55.310] – Dr. Newport
The yolk of the eggs, right? You don't throw away the yolk in the Mediterranean diet. You eat the yolk. It's just so many good nutrients. And it increases HDL cholesterol. Some people still believe it increases your cholesterol. It increases HDL cholesterol primarily. And eating this type of diet will help overcome insulin resistance if you reduce the carbohydrate in the diet.
[00:41:20.350] – Dr. Newport
And I kind of suggest trying to stay under 60 grams a day, a lot of people might still want some carbohydrates. They might want more than that, maybe limiting to 130 grams a day and then including enough healthy fats in the diet. But under 60 grams, there's a good chance that you will be in ketosis most of the time, stay in ketosis. And then adding coconut and MCT oil can help sustain, like, a constant level of mild ketosis. They call it mild nutritional ketosis. And there are supplements out there, too. Ketone, salsa, ketone ester that Dr. Veech was developing in the 1990s that's been out on the market, really marketed to athletes. But a lot of people with neurological diseases are trying it so that out there, ketone salts are out there, there's other ketone, all kinds of ketone products coming along. We didn't have access to any of that, but I knew about it as these things were being developed. And I think of those kind of supplements as like a way to further boost your ketone levels. It usually will sustain for three or 4 hours, and then it's kind of back to baseline again.
[00:42:29.670] – Dr. Newport
When you take a supplement, I think of using MCT and coconut oil as part of the food to help sustain at least a baseline level of ketosis. And then for people that want to supplement, they'll get a temporary boost in between.
[00:42:45.640] – Allan
Now we call ketosis. When you get your blood ketone level to .5, to basically around 5. And most professionals out there, experts on, say you don't really want to spend too much time above 5. But for someone who feels like they're having some cognitive issues and wants to have family history of this happening around them, and so I just want to be careful, where would you say that they should sort of keep their ketone levels for the most part of the day?
[00:43:17.910] – Dr. Newport
I'd say between .5 and 1, maybe 1.5. A lot of people are having really good success, and people with Alzheimer's and Parkinson's disease with mild nutritional ketosis. The higher range seems to be most effective for people that are dealing with epilepsy, drugresistant epilepsy, people with cancer. You mentioned cancer at the beginning of this, and there are quite a few studies going on, several dozen studies of using ketogenic diet as an adjunct to standard of care treatment for various types of cancers. It was researched first for glioblastoma, which is severe brain cancer. Most people don't survive more than six months from diagnosis. And it's really kind of amazing how the ketogenic diet seems to be able to slow down the growth of the cancer and even shrink tumors, obliterate how to get rid of metastases when it spreads to other parts of the body. And I have met some people at conferences who have glioblastoma, and they've been on a ketogenic diet for years now and have managed to survive so far. And they do also get other treatments, most people with cancer, but it kind of supports it. It seems to be effective for certain types of cancer and even possibly taking ketone ester.
[00:44:41.310] – Dr. Newport
There are some animal research suggesting that ketone ester could help before getting radiation, for example. And it can help shrink a tumor, make it smaller, which makes it more amenable to surgical removal. If you can get a smaller tumor, like in the brain or whatever it's being studied for breast cancer, colon cancer, prostate cancer, many different types of cancer. There are clinical trials going on now. Couldn't even say that a few years ago. But these things are happening now, and the ketone esther, Dr. Veech even though he worked for the NIH, he was competing with thousands of other researchers for research dollars related to Alzheimer's disease, and he could not get funding for a clinical trial for Alzheimer's with his ketone ester. But now, finally, the National Institute of Aging does have a study that's in progress. It's supposed to finish in 2023. And they're studying 150 people. They're looking at all the different blood, spinal fluid, imaging, biomarkers related to cognitive impairments. And it's people that have metabolic syndrome, which is pre-diabetes. And they're studying older people. I think they're between 50 and 70 years old and following them over time and with the ketone ester, and they're taking pretty hefty doses of it.
[00:46:02.380] – Dr. Newport
My husband Steve was actually the first person with Alzheimer's to use the ketone ester in a clinical trial. It was a pilot study of one person. And Dr. Veech picked Steve. I'm a doctor. I can monitor him. He felt very confident, and he literally sent us the this was in 2010, about two years after he started the coconut oil, and he sent us the raw material. It tasted horrible, just horrible. And he told me, figure out what to do with this. And I tried all kinds of flavorings and everything, and Steve shuddered every time he took it, but he took it willingly, had Alzheimer's. He knew all about the ketones ester. He was at a point where he had had some setback, and it turned him around again very quickly, and he was very stable for another 20 months after that. And thanks to Dr. Veech, I felt like we got nearly four extra better quality years than the year before he started the coconut oil. And what happened with Steve was that I had a lady that stayed with him when I went to work. And he hugged and kissed me goodbye, said he loved me.
[00:47:14.290] – Dr. Newport
Five minutes later, she called me and she said he had fallen straight back, had a seizure. It lasted 20 minutes. He stopped breathing. He turned blue by the time I got home. I got there before emergency services got there, and he was still blue. He wasn't breathing very well. He had another seizure on the way to the hospital. And I guess with his brain already so fragile from Alzheimer's, the head injury and the seizure, lack of oxygen, he became completely dependent after that. And he would have a seizure periodically, even though he was on anti-seizure medication and that kind of thing. And he continued to get the ketone ester in coconut oil. He lived another two and a half years. I really didn't dream he would live that much longer. And I think perhaps the ketogenic, these things we were doing helped sustain him. And he remained very healthy weight. A lot of people with Alzheimer's, they become almost emaciated as time goes on. And he ate very well up until a couple of weeks before he passed away. And then he just went unresponsive just fairly suddenly. And then we lost him a couple of weeks later.
[00:48:29.220] – Dr. Newport
So he actually did die from Alzheimer's disease, and many people die with it, but from something else, a lot of elderly people.
[00:48:38.440] – Allan
So Steve was not in a condition where he could really exercise to enhance his program all that well. But for someone who is able to do some exercise, how does that help this process?
[00:48:51.190] – Dr. Newport
Yeah, so exercise is very interesting. The Alzheimer's Association, now, they have speakers listen to their conference every year, and they say that somewhere between 30 or 40% of Alzheimer's may be preventable by modifiable life, by changing your lifestyle. Top being diet, eating a healthier diet. Exercise is the second is number two. Getting enough sleep is another one. Controlling blood pressure, if you have high blood pressure. But exercise, an interesting thing about it is that it stimulates ketone production. That's just one of the benefits that we know about. And if you, like, walk vigorously or elliptical, something like that, for 30 to 40 minutes, it will stimulate ketone production. This was actually discovered around the 1930s, and it was studied very intensively for about 20 or 30 years. There were quite a few studies, and they called it post exercise ketosis. And basically the ketone level would increase kind of into that mild range as we get with the MCT and coconut oil, and it would be sustained for eight or 9 hours, which is quite interesting. So exercise is another strategy. Some people, as much as they try, they can't tolerate coconut and MCT oil. But exercise is a way to stimulate ketones.
[00:50:16.840] – Dr. Newport
Overnight fasting is another great way to do that. And basically, if you fast overnight, you don't eat any solid food. You can still drink clear liquids without, you know, calories about ten to 12 hours after that you deplete the glucose that's stored in the liver and then you start breaking down fat and you start making some ketones. So you'll go into mild ketosis and the longer you extend the fast, the higher the ketone level will become. And some people kind of, some people call it bulletproof coffee, I guess that's one version of it. But you put coconut oil or MCT oil in your coffee or tea in the morning, it's only fat. And it actually increases further increases your ketones. And it will support you can do that while you're on fast and it will just kind of enhance your ketosis at that point. But there are a lot of people now that are doing a twelve to 16 hours overnight fast. They're basically skipping breakfast, maybe having the coconut or institute on their coffee and then having their first meal around twelve or one in the afternoon. They also call it time restricted eating, where you limit your eating to between a six and ten hour window.
[00:51:33.110] – Dr. Newport
For me, I kind of am around a seven or eight hour window. I've been doing this for quite a long time and I used to wake up hungry, want breakfast right away. And you just get used to it. You get used to it. It's a way to kind of keep your brain healthy by providing ketones to your brain.
[00:51:55.120] – Allan
Yeah, I usually have dinner around 07:00 6:30 7 o'clock, but I'm through eating before seven and then I won't eat until somewhere between twelve and two the next day and it's breakfast. I'm still making eggs and doing my thing, but it's just become kind of my normal structure. I want to first get up, I do other things. I don't necessarily eat straight away. I'm not really hungry. And I think that's the other thing. When you really get to a point where you're using ketosis appropriately, those hunger cues are a lot easier to pick up on. And you don't just eat because it's the habit of, oh well, it's breakfast, I just woke up, I have to eat something.
[00:52:33.190] – Dr. Newport
[00:52:33.810] – Allan
It actually gets a little easier when your body's burning fat for energy because I got plenty, right?
[00:52:40.770] – Dr. Newport
Yeah, you and me both.
[00:52:44.960] – Allan
So you wrap this all up. The book is excellent, by the way, and you wrapped it up with plan called the Clearly Keto Whole Food, Mediterranean Style Diet. Love every word of that.
[00:52:57.660] – Dr. Newport
[00:52:58.240] – Allan
I love every word of that. It's a really good, clear, easy thing to do. You also have recipes in the book, so you've pretty much souped to nuts made it to where someone that wants to work on their brain health using ketosis and the Mediterranean diet, it's there. So the book is called Clearly Keto. If someone wanted to learn more about you, Dr. Newport or the book, where would you like for me to send them?
[00:53:24.560] – Dr. Newport
I have a website. It's coconutketones.com. And that's C-O-C-O-N-U-T-K-E-T-O-N-E-S. There's no Y in ketones.com. And you can see links to my books. There's all kinds of information. I've had this website since late 2008 and I've just been slowly accumulating all kinds of information. I have a page of scientific articles. There are many studies now with MCT oil, but mostly smaller to medium studies. Larger studies are in progress. A lot of information, scientific reports about ketone esters and salts and ketones in general. Dr. Cunnane's research is on there. I've written some articles about how to use things like coconut and MCT oil and ketone salt, ketone esters. But basically there's a whole lot of information that people can find there. And my books are available. My publisher is Turner Publishing. The last I looked, they had a pretty good price, pretty comparable or maybe even a little less than Amazon for ordering my book. But Amazon, all the major book sites are carrying the book to pre order right now. And I do have other books before that, three other books that I've written. This one is kind of more back to Alzheimer's again. And it goes beyond I would say the first half of the book is all about ketogenic strategies, mediterranean diet, keto, but there's a whole lot of other things other things to do and other things to avoid that are not necessarily related to ketones.
[00:55:04.900] – Dr. Newport
A lot of certain foods and not overdoing certain supplements that could be harmful. And then the last chapter took me ten months to write. It was the first chapter I wrote, but I thought if I put this first in the book, nobody will ever get to the rest of the book. It's very science-y. It's all about what goes wrong in the Alzheimer's brain, all the different pathologies. So many of them are connected to insulin. Insulin resistance. I was really kind of astounded myself how much of this is related to insulin and lack thereof. Like those plaques and tangles, insulin resistance seems to promote formation of plaques and tangles, but the plaques and tangles themselves seem to promote more insulin resistance. It's like vicious cycles. And it kind of, to me, explains why Alzheimer's is progressive. You have this constant vicious cycles of related to insulin and insulin resistance, and it's just a downhill path from there. Just gets worse and worse over time. So that's for readers who are really interested in the science as well. I think it was a bonus chapter.
[00:56:17.360] – Allan
I geeked out. So, yeah, I enjoyed it. Yeah, you can go to 40plusfitnesspodcast.com/568 and I'll be sure to have the links there. Dr. Newport, thank you for being a part of 40 Plus Fitness.
[00:56:30.630] – Dr. Newport
Oh, you are very welcome. And thank you so much for inviting me to be on your program. Again, allan, this has been wonderful. Thank you for this discussion.
[00:56:37.750] – Allan
[00:56:48.260] – Allan
Welcome back, Ras.
[00:56:49.920] – Rachel
Hey, Allan. This was a really amazing interview. A couple of things just hit me right off the bat. It's quite tragic that her husband was only 51 when he started to experience some Alzheimer dementia symptoms, which kind of hit me hard cause I'm 51, but it was hard to see him progress. And it's so true, you know, like cancer. I think we all have someone in our lives that might be touched with Alzheimer's or dementia, which we are. I've been watching my aunt decline, and it's a tragic disease to watch it unfold, but there is some things that we can do about it, isn't there?
[00:57:29.370] – Allan
Yeah, well, the base point I want to bring up is that she brought that he had early, what they call early onset. Okay. And that's important. That's an important delineation in this because it used to be that you really didn't see a lot of people with Alzheimer's until they were well into their 70s and 80s. And so it was a very uncommon disease to see when we were younger, like 51. And the same thing happened with type two diabetes, okay? So they used to have type one diabetes, which is where your body kind of your beta cells start to die out and then you don't create insulin. So you have to start taking insulin because your pancreas just can't create enough or actually stops creating it at all. And so that's type one diabetes. Type two diabetes used to be called adult onset diabetes, but they stopped calling it that when kids started getting diabetes. Okay? So it is definitely a lifestyle related issue where we're looking at diet and people who are eating excess sugar and excess refined carbs are getting these diseases earlier. Now, I'm not saying that's what Dr. Newport's husband did, but there's definitely a problem with our food and our lifestyles.
[00:58:45.880] – Allan
And a lot of these things are shifting and they're happening earlier and earlier. And it could be just anything. It could have been toxins he was associated with at one point, another outside his control, could have been some things that were within his control. We'll just never really know.
[00:59:02.460] – Rachel
[00:59:02.820] – Allan
But like you said with Mike, if we're doing the things we need to do to take care of ourselves, we're limiting our risk. And that's really all we can do in this whole math of getting older and avoiding disease, is to just do things that lower our risks. And I can tell you a whole food clean diet that's giving you all the nutrients your body needs. Exercising regularly, sleeping well, having great relationships, all the self care stuff, managing stress, all those are really, really important aspects of health. That if you're just doing what you can in each of those areas, you're going to not just feel and perform better. But you're giving your body more resilience to be able to keep these things from happening, or at least happening early. Because that's the other side of it. We don't know. But why is early onset happening? And I haven't really heard any good answers. But obviously, from what you've heard in this episode, by switching to a ketogenic diet, he was able to extend the length and quality of his life, which, again, I'm not going to say this is a scientific study, but there are more studies happening.
[01:00:20.110] – Allan
Because Mary, Dr. Newport shared his story and scientists became very interested in what was going on there. There'd be more studies to say, could this have actually prevented Alzheimer's from ever occurring? So those are some things to think about. It's not that the keto diet is the best diet. Don't get me wrong. Ketosis is a tool.
[01:00:43.140] – Rachel
[01:00:43.720] – Allan
But really, I believe, and we've had some different conversations in the last several months about metabolic flexibility and then again, just avoiding junk.
[01:00:54.330] – Rachel
[01:00:55.140] – Allan
Those two things are really the keys to health care.
[01:00:58.650] – Rachel
Well, like she said, better diet, better exercise, better sleep, it's better. Like, make better choices. Do you have to be perfect 100% of the time? No. I mean, we've got Thanksgiving, Christmas, holidays around the corner. There's time to celebrate, there's time to enjoy your home cooked foods and family traditions, but just make better choices most of the time. And absolutely, there's nothing good with sugar. There's nothing. No nutrients and refined flours. Just do what you can, when you can. It doesn't have to be perfect.
[01:01:33.060] – Allan
[01:01:34.080] – Rachel
Yeah. Great interview.
[01:01:35.910] – Allan
All right, well, thanks. I'll talk to you all next week.
[01:01:38.980] – Rachel
[01:01:39.810] – Allan
[01:01:40.770] – Rachel
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