Let the sunshine in: vitamin D good for mental health
B vitamins help schizophrenia: folic acid and B12 help reduce 'negative' symptoms in schizophrenia
Folic acid brain boost: folic acid in pregnancy reduces risk of autism in children
Coconut oil: can it help protect your memory?
Editorial by Jerome Burne
Recently the media has reported a number of stories relating to the health benefits of coconut oil, in particular, its ability to aid memory loss and the symptoms of Alzheimer's.
I wrote the first UK piece about it in the Daily Mail in January that had some amazing accounts of the benefits reported in America and why it made sense scientifically. Most dramatic though was the case of Vrajal Parmar in the UK, diagnosed with advanced Alzheimer's, who was being looked after by his wife and his son Kal.
Vrajal had been given the standard pencil and paper test called the Mini Mental State Examination by his doctor. This test is used to measure how a patient's Alzheimer's is progressing. A healthy person would score 30, Vrajal's results stated that he was "too severely affected to score anything at all”. Kal, his son, supports this result, "He [Vrajal] was so far gone he couldn't do anything for himself. Dad couldn't wash himself or dress or go to the toilet without help, he had to be watched all the time.”
After hearing about the benefits of coconut oil via a You Tube video, Kal initiated a teaspoon dose of coconut oil, three times a day mixed in with his father's food. This is when he saw a real change in his father's behavior which went from him being unable to do anything with frequent aggressive turns, to being able to hold simple conversations and less aggressive outbursts.
It could be suggested that the improvement came from medication, however, Kal states "Dad has never had any drugs” and comments that "when he [Vrajal] was first diagnosed three years ago the doctors said that his condition was already too advanced for him to benefit [from drugs].”
The YouTube video that introduced Kal to coconut oil was made by Dr Mary Newport, a pediatrician in Florida who began using coconut oil to treat her husband with Alzheimer's four years ago. He'd been diagnosed with early onset of Alzheimer's but had seen no benefit from the drugs. With the oil, says Dr Newport, there were positive changes: "he began to get his short-term memory back”.
Support for the idea that there is a very plausible scientific explanation for the benefit of coconut oil, in the treatment of Alzheimer's, comes from Kieran Clarke, Professor of Physiological Biochemistry at Oxford and head of the Cardiac Metabolism Research Group. Professor Clarke is an expert on the way the body makes and uses energy and her research explains that coconut oil might help with Alzheimer's by boosting the brain's energy supply.
Most of the time our brains rely on glucose from carbohydrates but if that is not available - because we haven't eaten anything for a while or because we are eating almost no carbohydrates - then our brain cells can switch to using the energy from out fat stores that comes in the form of small molecules called ketones. By the time we wake up in the morning we will have made a small amount of them due to the natural fasting period whilst we sleep.
"Coconut oil is interesting,” says Professor Clarke "because it contains a particular sort of fat that our bodies can use to make more of the ketone "brain food” without having to cut right back on carbohydrates or go on a fast. It's known as MCT (medium chain triglyceride) and it is not found in the fats that most of us eat.”
However, we may question why having extra ketones helps people with Alzheimer's?
One of the new ideas about the disease is that it is a type of diabetes of the brain. Just as diabetics have problems with glucose and insulin, similarly Alzheimer's sufferers can't get enough glucose into brain cells to give them the energy they need to lay down new memories and think clearly. If you have diabetes you are three times more likely to develop Alzheimer's. Getting extra ketones into brain cells provides the brain with an alternative source of fuel.
Currently the only type of drug that Alzheimer's patients can get works by boosting the amount of a brain chemical they are lacking. It slows down memory decline in about 1/3 of patients for between 6 months and a year. Last year the NHS spent over £70 million on the most widely used brand called Aricept. Side-effects include nausea, diarrhea, muscle cramps, urinary incontinence and abnormally slow heart rhythms which can lead to fainting and possibly dangerous falls. Contrast that with coconut oil which has been safely used by people for thousands of years. In high doses some people do report diarrhea.
However, professionals are still understandably skeptical of the coconut oil claims. "There is a huge placebo response in Alzheimer's,” warns Professor Robert Howard, Professor of Old Age Psychiatry and Psychopathology at the South London and Maudsley NHS Foundation Trust. "It is a remitting and relapsing disease, there are often times when things seem to be getting better. It is important to protect patients from false hope and not expose them to quackery.”
Additionally, Professor Rudy Tanzi Director of the Genetics and Aging Research Unit at Massachusetts General Hospital and Professor of Neurology at Harvard Medical School commented that as yet there was no evidence of the benefits of coconut oil treatment, and advised to "regularly monitor cholesterol and triglyceride levels if you are taking the oil." The issue of whether coconut oil, which is high in saturated fats, poses a threat to the heart is controversial. Dieticians and most doctors claim it does, paediatricianDr Newport points out that mother's milk contains high levels of the fat most abundant in coconut oil.
A placebo controlled trial to test the effectiveness of coconut oil is getting underway in the states. If the results are favourable that should make it more medically acceptable. But right now people are hungry for information on anything that might help with Alzheimer's. When Kal Parmar talked to a local newspaper about his father's improvement he received over 150 emails asking for help. So far dozens of people have come back to him saying that they had someone in their family on coconut oil, in some cases with impressive results. And the numbers are continuing to grow. For more information on Kal Parmar and his father's case please visit www.remembercoconut.com or contact him via his Twitter feed at twitter.com/coconutkal.
Jerome Burne is a medical journalist and author of the Body of Evidence blog.
Let the sunshine in! Vitamin D good for mental health
A new study from University College London investigated a potential association between vitamin D levels and common mental disorders. Their study analysed data from 7,401 participants of a group of people born in 1958. Validated questionnaires were used to determine levels of symptoms such as depression, anxiety, panic and phobia while blood tests were used to determine vitamin D levels. The researchers found that higher levels of vitamin D, at age 45, were associated with lower odds of depression and panic.
Our comment: This study illustrates a link between low vitamin D and mental ill-health, but doesn't tell us whether low vitamin D is a cause or whether there are other reasons for the link. However, this work adds to the growing body of evidence that suggests vitamin D is essential for mental well-being. At the Brain Bio Centre, we routinely test our patients for vitamin D and find that over 80% are deficient. This increases to around 90% when we include those with sub-optimal levels. The major source of vitamin D is sunshine (something which is often lacking here in the UK), and the only reasonable food source is oily fish, so most people require supplementation to maintain a healthy level throughout the year. Vitamin D and common mental disorders in mid-life: Cross-sectional and prospective findings. Clin Nutr. Jan 21. Click here for abstract.
B vitamins Help Schizophrenia Folic acid and B12 help reduce 'negative' symptoms in schizophrenia
People with psychotic disorders such as schizophrenia often get some benefit from antipsychotic medication for the 'positive' symptoms such as delusions and hallucinations, but antipsychotics often have little effect on the 'negative' symptoms such as apathy, social withdrawal, and lack of emotional expressiveness. This study involved 140 people with chronic schizophrenia who were already taking antipsychotic medication. For 16 weeks they were given either 2mg of folic acid and 400 µg of vitamin B12, or a placebo. Their positive and negative symptoms were monitored over the period using recognised assessment scales. Overall, there wasn't a significant difference in symptoms between the two groups. However, when genetics were considered by taking into account a gene which affects folate (folic acid) metabolism, by the end of the study period there was a significant improvement in the symptoms amongst the supplemented group compared with controls.
Our comment: As mentioned above, folic acid has a key role in mental health, not least in affecting gene expression and maintaining a low level of homocysteine. Our approach at the Brain Bio Centre, is to measure levels of folic acid (in red blood cells), vitamin B12 and homocysteine so that we can make recommendations suited to the individual. Randomized Multicenter Investigation of Folate Plus Vitamin B12 Supplementation in Schizophrenia. JAMA Psychiatry. Click here for abstract.
Folic acid brain boost Folic acid in pregnancy reduces risk of autism in children
It is recommended that folic acid is taken by all women who are planning a pregnancy to reduce the risk of neural tube defects (spina bifida) in the newborn. This study investigated whether the use of folic acid pre-conception and in pregnancy might also reduce the risk of autistic spectrum disorders. The researchers assessed folic acid intake in mothers and the presence of autism in the children (at an average age of 6 years old). They found that women who took folic acid were much less likely to have a child with autism.
Our comment: This study shows a positive association between folic acid use and reduced risk of autism which adds further support to the recommendation to take folic acid. Folic acid is a member of a group of vitamins called B vitamins. All B vitamins have an important role to play in health, so while the strongest recommendation is made to take folic acid, we would generally recommend taking the entire group in a B-complex form. The best dietary sources of folic acid are vegetables, especially those which are green and leafy, which are always to be encouraged. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA. Click here for abstract.