Assessing the Impact of Factors that Influence the Ketogenic Response to Varying Doses of Medium Chain Triglyceride (MCT) Oil - 21/11/24

Doi : 10.14283/jpad.2020.53 
Angela G. Juby 1, , D.R. Brocks 2, D.A. Jay 1, C.M.J. Davis 1, D.R. Mager 3
1 Division of Geriatrics, Department of Medicine, 1-198 Clinical Sciences Building, 11350 83 Avenue, T6G 2P4, Edmonton, Canada 
2 Faculty of Pharmacy and Pharmaceutical Sciences, Edmonton, Alberta, Canada 
3 Department of Agriculture Food and Nutrition Science, University of Alberta, Edmonton, Alberta, Canada 

a ajuby@ualberta.ca

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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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Key words : Alzheimer’s disease, B-hydroxybutyrate, medium chain triglyceride (MCT), pharmacokinetic, body composition, coconut oil


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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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