Ketogenic Medium Chain Triglycerides Increase Brain Energy Metabolism in Alzheimer's Disease.
Level 4 - case-series / case-control
Uncontrolled sequential before-and-after intervention study (case series)
PubMed 29914035 · doi:10.3233/JAD-180202
What was done
Patients with mild-to-moderate Alzheimer's disease (AD) sequentially consumed 30 g/day of two different medium-chain triglyceride (MCT) supplements for one month each: a mixture of 55% caprylic and 35% capric acid (n = 11), followed by a washout period, and then 95% tricaprylin (n = 6). Brain ketone uptake (11C-acetoacetate) and glucose uptake (18F-FDG) were measured using PET scans before and after each intervention.
What was found
Brain ketone consumption doubled on both types of MCT supplement. The slope of the relationship between plasma ketones and brain ketone uptake was reported to match that of healthy young adults. Both formulations increased total brain energy metabolism via ketone supply without altering brain glucose uptake. Exact numeric PET values were not reported in the abstract.
Why it matters
This indicates that the brain in mild-to-moderate Alzheimer's disease retains the capacity to consume ketones derived from oral MCT supplementation despite impaired glucose metabolism.
Limits
The study had a very small sample size (n = 11, dropping to n = 6 in the second phase), lacked a randomized control group, had a short duration of one month per phase, and did not assess cognitive or clinical outcomes.
Cited by
- supports Experiments by Stephen Cunnane and others show that when brain cells are given both glucose and ketones, they choose to burn a mixture of the two.