October 18, 2012

Alzheimer's and Coconut Oil: The Bottom Line

My blog's traffic statistics show that the most-visited post by far is my February 12. 2012 report on claims that coconut oil is a remedy for Alzheimer's. That post has been viewed three times more often than any other. My second "most popular" post involves a study about "Souvenaid, a nutrient cocktail that might boost memory for people with early Alzheimer's. In third place on my "Hit Parade" is the update I wrote in April about coconut oil and Alzheimer's.

Clearly, I'm not alone in worrying about dementia and Alzheimer's. Millions of people -- patients, families, caregivers -- are dealing with the disease. And millions more -- like me -- hope that dementia is not part of their future. It's natural for reports of new remedies to generate widespread interest and raise our hopes. Most of us would prefer an easy option (like taking a few spoonfuls of an unproven substance, like coconut oil) to a more challenging option (like exercising, eating wisely, and leading an active, engaged life, physically and mentally -- choices that science has shown -- time and time again -- to be good for us).

So, when we see claims for a quick and easy fix, we must ask: is the hype supported by clear scientific evidence?


Enter Dr. Newport 
When I began researching coconut oil, I discovered that much of the publicity came from Dr. Mary Newport, who claims her husband, suffering from Alzheimer's, improved after she fed him coconut oil (at 117 calories per spoonful).

One of her first efforts to publicize her findings came in a 2008 fact sheet titled "What If There Was a Cure for Alzheimer's Disease and No One Knew?" She dropped out of sight (or at least Google search sight) for the next few years. She probably was working on her 2011 book, Alzheimer's Disease: What If There Was a Cure? She also maintains a website that promotes the book.

In 2011, she also began getting media attention on TV shows that promote alternative and complimentary medicine. The publicity continues.

Dr. Oz, Dr. Mercola, and Pat Robertson Jump on the Coconut Oil Bandwagon
The claims for coconut oil as a treatment for Alzheimer's got a big publicity boost in January, 2011 when TV host Dr. Oz introduced Joe Mercola as "a man your doctor doesn't want you to know."

Dr. Mercola's website is one of the most-viewed websites on the internet, touting itself as "The World's No. 1 Natural Health Website." He has promoted studies claiming that (1) cancer is a fungus that can be cured with baking soda, and (2) cancer is a "man-made disease" because investigators haven't found cancer in Egyptian mummies, suggesting the disease didn't exist then. See Mercola cancer claims.

In his appearance on Dr. Oz's show in January 2011, Mercola defended himself against the attacks made on him as a supplement hawker who'll say anything to sell a product he promotes. Oz noted that he doesn't always agree with Mercola, but then described him as "so far ahead of the rest of us." Oz asked Mercola where he discovered all the wonderful information he provides. Good question.

Mercola then talked about coconut oil as a treatment for Alzheimer's. He didn't mention Newport as a source for the claim. In fact, he didn't provide any sources. 

Oz's website currently reviews some of Mercola's claims for supplements, including coconut oil, but expresses some reservations about the claims.

A year later, on January 5, 2012, Pat Robertson came through big time for Dr. Newport and her claims for coconut oil as an Alzheimer's treatment. On his weekly TV show, The 700 Club, Robertson not only reported on Newport's claim, but he also ran a sophisticated (and no doubt expensive) video produced by his Christian Broadcasting Network (CBN) supporting the claims. You can see his introduction about 18 minutes into this clip.

Two weeks later, The 700 Club ran the video again. And now it is available on this CBN link. It doesn't just tout coconut oil for Alzheimer's. Here's a "screen-grab" from that piece:



The story also described coconut oil as a “natural antibiotic that also helps kill viruses like HIV and herpes viruses.”

An Update from Dr. Newport
I sent Dr. Newport an e-mail asking her how many reports she had on other Alzheimer's patients with coconut oil results similar to her husband's. I also asked her whether there was any indication that coconut oil could retard the development of Alzheimer's for people with Parkinson's... people with an increased risk of AD. Here's her reply:
I have heard from about fifteen people with Parkinson's who feel they have improved with coconut oil and about 185 with Alzheimer's and other dementias, so it is worth a try.
I find those numbers surprisingly small, in light of all the hype from popular TV and internet hucksters. Of course, not everyone who has felt some improvement after taking coconut oil would share those results with Dr. Newport. But her website encourages people to try it.

As I reported recently about my year-long struggle with back pain, every time I've tried a new pill or a new treatment, I'd think, "Gee, this really looks like it's going to help!" Then, after a week or so, I'd realize the optimism was a placebo effect based on my own wishful thinking. This reaction is probably even more likely for people with Alzheimer's and their caregivers. So, I tend to discount much of the favorable reports Dr. Newport has received.

How Valid Is All This Hype for Coconut Oil?
For over ten years, neuropsychologist Dr. Dominic Carone has been writing a blog, MedFriendly, designed to make medical information easy to understand. Last October, he wrote a very helpful guide on Five Ways to Evaluate Suspicious Medical Treatment Claims. Let's see how the coconut oil claims stand up to these five tests:
  1. Search the peer-reviewed medical literature.  Coconut oil flunks this test. A search of the best source of information on peer-reviewed medical studies, NIH's PubMed, shows no peer-reviewed articles on coconut oil as a treatment for Alzheimer's. In addition, for about the past six months, I've set up a Google alert to notify me each day of any internet news involving coconut oil. I get a few hits each day, usually about applications for cooking or skin and hair care. Occasionally, there's a report on coconut oil and Alzheimer's, but it's always just another repeat of the standard unsubstantiated claims. I've yet to see any other positive reports about coconut and Alzheimer's like those that Dr. Newport has reported about her own husband. 
  2. Evaluate the quality of peer-reviewed literature.  Moot, since there are no peer-reviewed articles on coconut oil and Alzheimer's.
  3. Research who is promoting the treatment.  Dr. Carone says this guideline matters because promoters may have a financial interest, or a blinding desire to help a loved one, or anger toward conventional medicine, or bias toward alternative medicine. Dr. Newport is selling a book, and has made comments about personally outsmarting drug companies. Oz and Mercola have track records promoting dubious claims. I haven't figured out why Pat Robertson's 700 Club spent all that money on the video touting Newport's claims. Maybe they simply think a story about a potential Alzheimer's remedy will attract a large audience. 
  4. Be skeptical of suspicious claims.  Dr. Newport obviously had a subjective investment in seeing her husband improve with coconut oil. Her work is a long, long way from a randomized, double-blind, placebo-controlled study. 
  5. Research what respectable organizations devoted to the condition say about the treatment.  The Parkinson's Research Foundation has an "Ask the Doctor" feature on its website. Someone recently asked if there's any truth to claims about coconut oil and Parkinson's. On February 5, 2012, Dr. Sanchez-Ramos said:
Coconut oil is rich in plant "fats" or lipids, especially medium chain triglycerides. There are claims that coconut oil can "cure" all manner of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Lou Gehrig's disease and so forth, but there are no published reports of clinical studies supporting these anecdotal claims. But there are some researchers interested in trying to find the truth about the coconut oils and similar compounds. Dr. Beverly Teter, a lipid biochemist and researcher at University of Maryland is researching coconut oil and cholesterol, and Dr. Kieran Clarke from Oxford, England, is conducting a pilot study for Parkinson's disease using a ketone ester, a component found in coconut oil and other substances.
The Bottom Line on the Coconut Oil and Alzheimer's Claim 
Let's give the final word, appropriately, to the Alzheimer's Association. In its Spring/Summer 2012 Research Update, the Alzheimer's Association had this to say:
Every day we hear magical claims of products promising relief. Coconut oil, for example, is touted by a physician in Florida as having a miraculous impact on her husband. While the ketones in coconut oil are being widely studied for dementia and are a key ingredient in an FDA-approved food product for memory loss, there is no scientific evidence that coconut oil helps with Alzheimer’s.  
The coconut oil promise has been around for more than three years. If the administration of coconut oil was, indeed, beneficial, it would be shouted from every mountaintop (emphasis is mine).

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