Assessing the Impact of Factors that Influence the Ketogenic Response to Varying Doses of Medium Chain Triglyceride (MCT) Oil

Abstract

Objectives, Design, Setting

The ketogenic effect of medium chain triglyceride (MCT) oil offers potential for Alzheimer’s disease prevention and treatment. Limited literature suggests a linear B-hyroxybutyrate (BHB) response to increasing MCT doses. This pharmacokinetic study evaluates factors affecting BHB response in three subject groups.

Participants

Healthy subjects without cognitive deficits <65years, similarly healthy subjects >=65years, and those with Alzheimer’s Disease were assessed.

Intervention

Different doses (0g,14g, 28g, 42g) of MCT oil (99.3% C8:0) were administered, followed by fasting during the study period.

Measurements

BHB measured by finger prick sampling hourly for 5 hours after ingestion. Each subject attended four different days for each ascending dose. Data was also collected on body composition, BMI, waist/hip ratio, grip strength, gait speed, nutrient content of pre-study breakfast and side effects.

Results

Twenty-five participants: eight healthy; average age of 44yr (25–61), nine healthy; 79yr (65–90) and eight with AD; 78.6yr (57–86) respectively. Compiled data showed the expected linear dose response relationship. No group differences, with baseline corrected area under the blood vs. time curve (r2=0.98) and maximum concentrations (r2=0.97). However, there was notable individual variability in maximum BHB response (42g dose: 0.4 −2.1mM), and time to reach maximum BHB response both, within and between individuals. Variability was unrelated to age, sex, sarcopenic or AD status. Visceral fat, BMI, waist/hip ratio and pretest meal CHO and protein content all affected the BHB response (p<0.001).

Conclusion

There was a large inter-individual variability, with phenotype effects identified. This highlights challenges in interpreting clinical responses to MCT intake.

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Figure 1
Figure 2

Abbreviations

AD:

Alzheimer’s Disease

AUC:

area under the blood concentration time curve

BHB:

Beta hydroxybutyrate

BMI:

Body Mass Index

Cmax:

maximum blood concentration

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders, 4th edition

MCT:

Medium Chain Triglyceride

NINCDS-ADRDA:

National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association

tmax:

time of Cmax

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Acknowledgements

The participants who gave up their time to be in the study. Vickie Baker (Registered Nurse) who assisted with data collection. Dr Vera Mazurak’s lipid research laboratory for independently verifying the triglyceride content of the test oil.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors

Corresponding author

Correspondence to Angela G. Juby.

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Contributions of Authors

AGJ: designed the research, conducted the research, analyzed data, wrote the paper and had primary responsibility for the final content. DRB was involved in study design, and performed the pharmacokinetic statistical analysis. DAJ was involved in conducting the research, and data analysis. CMJD was involved in conducting the research, and data analysis. DRM performed the non-pharmacokinetic statistical analysis. All authors read and approved the final manuscript.

Conflict of Interest

Angela G Juby, Dion R Brocks, David A Jay, Christopher MJ Davis, Diana R Mager, all have no conflicts of interest with respect to this study.

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Juby, A.G., Brocks, D.R., Jay, D.A. et al. Assessing the Impact of Factors that Influence the Ketogenic Response to Varying Doses of Medium Chain Triglyceride (MCT) Oil. J Prev Alzheimers Dis 8, 19–28 (2021). https://doi.org/10.14283/jpad.2020.53

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Key words

  • Alzheimer’s disease
  • B-hydroxybutyrate
  • medium chain triglyceride (MCT)
  • pharmacokinetic
  • body composition
  • coconut oil