The effect of a 6-month ketogenic medium-chain triglyceride supplement on plasma cardiometabolic and inflammatory markers in mild cognitive impairment

Prostaglandins Leukot Essent Fatty Acids. 2021 Jun:169:102236. doi: 10.1016/j.plefa.2020.102236. Epub 2020 Dec 24.

Abstract

Introduction: Mild cognitive impairment (MCI) is often accompanied by metabolic abnormalities and inflammation that might play a role in the development of cognitive impairment. The use of ketogenic medium-chain triglycerides (kMCT) to improve cognition in this population has shown promising results but remains controversial because of the potentially detrimental effect of elevated intake of saturated fatty acids on cardiovascular (CV) health and perhaps inflammatory processes. The primary aim of this secondary data analysis report is to describe changes in cardiometabolic markers and peripheral inflammation during a 6-month kMCT intervention in MCI.

Methods: Thirty-nine participants with MCI completed the intervention of 30 g/day of either a kMCT drink or calorie-matched placebo (high-oleic acid) for 6 months. Plasma concentrations of cardiometabolic and inflammatory markers were collected before (fasting state) and after the intervention (2 h following the last drink).

Results: A mixed model ANOVA analysis revealed a time by group interaction for ketones (P < 0.001), plasma 8:0 and 10:0 acids (both P < 0.001) and IL-8 (P = 0.002) with follow up comparison revealing a significant increase in the kMCT group (+48%, P = 0.005), (+3,800 and +4,900%, both P < 0.001) and (+147%, P < 0.001) respectively. A main effect of time was observed for insulin (P = 0.004), triglycerides (P = 0.011) and non-esterified fatty acids (P = 0.036).

Conclusion: Under these study conditions, 30 g/d of kMCT taken for six months and up to 2-hour before post-intervention testing had minimal effect on an extensive profile of circulating cardiometabolic and inflammatory markers as compared to a placebo calorie-matched drink. Our results support the safety kMCT supplementation in individuals with MCI. The clinical significance of the observed increase in circulating IL-8 levels is presently unknown and awaits future studies.

Keywords: Alzheimer disease; Cognition; Cognitive decline; Cytokines; Inflammation; Ketones.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cognitive Dysfunction / blood
  • Cognitive Dysfunction / diet therapy*
  • Diet, Ketogenic
  • Drug Administration Schedule
  • Fasting / blood
  • Fatty Acids / blood*
  • Female
  • Humans
  • Insulin / blood*
  • Interleukin-8 / blood*
  • Male
  • Treatment Outcome
  • Triglycerides / administration & dosage*
  • Triglycerides / pharmacokinetics

Substances

  • Biomarkers
  • CXCL8 protein, human
  • Fatty Acids
  • Insulin
  • Interleukin-8
  • Triglycerides