Alzheimer’s. The mere mention of the word sends shivers down our collective spines. Millions have been touched by it, having witnessed the devastation up close with loved ones who’ve been diagnosed. More and more evidence is showing that we may be able to slow significantly or even stop the progression of Alzheimer’s by adopting as many brain-supportive habits as early in life as possible. The sooner you take action, the better the results and your chances.

Current evidence points to lifestyle factors such as diet and inactivity as the main driving forces of dementia. Ideally, patients in their 20s and 30s should be counselled on lifestyle strategies that promote brain and heart health throughout life. A major shift would then probably be seen in that generation’s Alzheimer’s statistics. This article covers a few diet and lifestyle-related strategies that will help prevent Alzheimer’s disease and optimise brain function.

Why Worry?

The prevalence of Alzheimer’s is on the rise, which makes it increasingly pressing to develop effective treatment and prevention. As 160 million cases are projected globally for 2050, potential bankruptcy of the medical systems is predicted with great concern – as there have not yet been any effective treatment and prevention methods discovered. (James, BD et al, 2014).

Thirty million people are currently affected globally and Alzheimer’s disease is now seen as the main cause of any age-related cognitive decline (Prince, MA, 2014).

According to Dr Dale Bredesen (Bredesen DE, 2013), therapeutic success has been achieved with many other illnesses such as cardiovascular disease, cancer and HIV by making use of combination therapies. Combination therapies for Alzheimer’s disease, however, have not yet been explored. Genetic and biochemical research over the past few decades have suggested that combination therapies might be the answer and that it may be way more feasible and effective than any target-based approaches (Bredesen, DE, 2014).

Cremonini (2019) also showed that pharmacological supplementation and treatments have not been very effective, to date, with the aim of the treatment and prevention of Alzheimer’s disease, but alternative strategies based on multimodal approaches such as cognitive training, exercise and diet are much more promising.

Dr Dale Bredesen’s therapeutic programme reversed 9/10 Alzheimer cases

Dr Dale Bredesen did a revolutionary study (Bredesen, DE, 2014) on the reversal of cognitive decline by using a novel therapeutic programme. Nine out of the 10 patients with Alzheimer’s disease showed subjective or objective improvement in cognition within three to six months. The one patient who failed to show improvement was already in a very late stage of Alzheimer’s disease.

The protocol included some of the following elements (see the full list of elements included in the protocol by directly referring to the study: Bredesen, DE, 2014. Reversal of cognitive decline: A novel therapeutic program, Dale E. Bredesen, Aging [Albany NY]. 2014 Sep; 6(9): 707–717.)

·         Optimising the patient’s diet (minimising simple carbohydrates and inflammation: Patients were given a choice of several low glycaemic, low inflammatory, low grain diets. Inflammation and insulin resistance were minimised);

·         Ketogenesis was encouraged (fasting for at least 12 hours each night, including three hours before bedtime);

·         Reducing stress (Yoga, meditation or music, etc.) for the reduction of cortisol;

·         Optimising sleep: Getting at least eight hours of sleep each night (melatonin was used in some cases);

·         Paying attention to digestive health (repairing the stomach lining if needed; using prebiotics and probiotics and avoiding gluten);           

·         Optimising antioxidants (including more colourful foods).

When participants started out with this study, six of the 10 had struggled a lot with their jobs or had to discontinue working because of their declining cognitive abilities. After three to six months of following the protocol, all were able to return to work with improved job performance. What is even more astonishing is the fact that the improvements had been sustained after a follow-up conducted two-and-a-half years later.    

One of the patients, a 67-year old woman, adhered to only some of the protocol components, but not all of them. She had been struggling with memory loss for over two years and had been forced to quit her job. After three months of following some elements of the protocol, all her symptoms were gone and she was able to again prepare reports, remember telephone numbers and continue with her work without any difficulty. She even noted that her memory was much better than it had been in many years. Almost three years later, at the age of 70, she was still working full time and she remained asymptomatic.

She did the following:

–          Eliminated all refined carbohydrates;

–          Eliminated processed food and gluten from her diet;

–          Increased non-farmed fish, fruits and vegetables;

–          She started doing Yoga to reduce stress;

–          She meditated twice a day for 20 minutes;

–          She took melatonin and increased her sleep from four to seven hours per night;

–          Each day she took 1mg methylcobalamin (a form of vitamin B12);

–          Each day she took vitamin D3 (2000iU), 2000mg fish oil and 200mg CoQ10;

–          She started using an electric toothbrush and electric flosser to optimise her oral hygiene;

–          She fasted for at least 12 hours throughout the night including at least three hours before she went to bed;

–          She exercised five days per week on average, for at least 30 minutes per day.

According to Dr Bredesen, this research shows that memory loss in the early phase of Alzheimer’s disease may be reversed and can be sustained by following the therapeutic programme as described. The only side effects of this programme are optimal BMI (body mass index) and improved overall health, which is in stark contrast with many drug-related treatments. It is also worth noting that the programme is not necessarily easy to follow and that not one of the patients was able to follow the entire protocol, but they still saw extraordinary results.

The Bredesen Diet Protocol

Zooming into the nutritional part of the Bredesen Diet Protocol, the following is advised:

–          Mild ketosis – a 12-hour fast nightly including three hours fast before bedtime;

–          Whole foods (no processed foods);

–          Including complex carbohydrates;

–          Having mostly plant-based foods;

–          Including healthy fats such as olive oil, seeds and nuts;

–          Having up to 15 servings of vegetables per day (non-starchy);

–          Including low-glycaemic fruit such as berries;

–          Having lean protein (low-mercury, cold-water fish and legumes).

What to avoid:

–          Large amounts of animal products and meat;

–          Highly processed foods;

–          Refined carbohydrates;

–          Non-nutritive sweeteners;

–          Simple sugar;

–          Gluten.

Note that this is not a typical ketogenic diet as it includes fruit and complex carbohydrates and reduces many foods such as high-saturated fat, animal products and meat that are common in these types of diets

*More info on Dr Bredesen and his research:
www.apollohealthco.com/dr-bredesen/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920/).

What About Drugs?

Unfortunately, many popular allergy and sleep medications have been linked to dementia. This includes ingredients used in medications such as doxylamine and diphenhydramine (for allergies), diphenhydramine citrate and ibuprofen (for sleep and pain) and dimenhydrinate (for nausea and motion sickness)

In some cases, these types of drugs have also been linked to reduced scores on memory tests and lower brain metabolism. Drugs for overactive bladder issues, asthma medications and certain antidepressants could also fall in this category. It would be wise to talk to your doctor to explore safer alternatives.

Statin drugs are also quite problematic as they suppress the synthesis of cholesterol, prevent adequate delivery of essential fats to your brain and deplete your brain of neurotransmitter precursors and coenzyme Q10

General diet dos and don’ts

To reduce your chances of suffering from Alzheimer’s disease, the following could be of great help:

·         Make sure to get enough antioxidants in your diet such as vitamins A, C, E, selenium and zinc. It is suggested that there might be a connection between Alzheimer’s disease and free radicals. Colourful fruits and vegetables should, therefore, be consumed at every meal as they are high in antioxidants and help combat any damage made by free radicals. Lack of antioxidants leads to oxidation damage.

·         Include Omega-3 fats (specifically DHA) such as wild-caught fish, seeds and nuts into your diet as it is critical for a healthy brain. These fats will slow down the progression of Alzheimer’s disease and lower your risk of developing it in the first place, as they prevent cell damage. A study done by Professor Martha Morris shows that you can reduce your risk of getting Alzheimer’s disease by up to 60 per cent if, once a week, you eat fish. This completely makes sense as 60 per cent of the brain is made of fat and is used as a building material for cell walls.  Essential fats are, therefore, key.

·         Coconut oil – some people suffering from Alzheimer’s have seen improvement by adding coconut oil to their diet as it provides the brain with ketones instead of glucose for brain fuel Patrick Holford confirms that coconut oil could slow down the rate of cognitive decline. To get dysfunctional brain cells to work better, one teaspoon coconut oil taken three times per day will increase ketones. Plenty of medium-chain triglycerides (MCT’s) can be found in coconut oil which easily converts into ketones.

* Research shows that a ketogenic diet could play a critical role in avoiding neurological diseases. Intermittent fasting also protects the brain against ‘age-related memory decline’

The following foods could be detrimental to your brain health and should be avoided as far as possible:

·         Foods that contain any additives or toxins as they could be neurotoxic. Even nonorganic vegetables and fruit are often coated with agricultural neurotoxic chemicals. Serum pesticide levels have even been associated with a higher risk of Alzheimer’s disease. It is best to remove all processed food from your diet.

·         Alcohol is a toxin which causes brain cells to die much quicker than normal. ‘Alcohol-related dementia’ is also a thing. An interesting study shows that people diagnosed with alcoholism’s frontal lobes are particularly susceptible to damage, as there is evidence of altered glucose metabolism, volume shrinkage and neuron density.

*Zhou (2014) has done research showing that smoking is “associated with a 2.1-fold risk of Alzheimer’s disease and daily drinking was associated with a 2.3-fold greater risk of Alzheimer’s disease”. Smoking was also associated with a decline in brain function as well as the “progression of vascular brain injury.” It has further also been shown that heavy alcohol consumption has detrimental long-term and immediate effects on neuropsychological functioning and brain health. Heavy alcohol consumption accelerates atrophy or shrinkage of the brain which is a critical determinant of cognitive decline and neurodegenerative changes in ageing.

·         To maintain brain health, it is important to keep your insulin levels low, as too much sugar tends to damage cells. This could be done by eliminating refined grains and sugar.

·         Any food packaged in aluminium containers should be avoided as far as possible as the aluminium has been proved to be extremely neurotoxic. Aluminium enters neurons which leads to the accumulation of aluminium. This damage has been linked to the progression of Alzheimer’s disease. It is especially dangerous to heat food in aluminium as more toxic compounds then get released. 

·         Avoid gluten. Gluten negatively affects the blood-brain barrier, makes the gut lining more leaky/ permeable and allows unwanted food particles, toxins and more to enter the bloodstream. As they don’t belong in the bloodstream, the immune system gets sensitised, which promotes autoimmunity and inflammation (both play a role in the progression and development of brain-related diseases).  It is, therefore, important to take good care of your gut and optimise your gut bacteria by eating fermented food or taking probiotic supplements.

Does lack of sleep increase your risk of Alzheimer’s disease?

Impaired sleep has been associated with Alzheimer’s disease. Participants’ brains have been scanned after a good night’s sleep as well as after about 31 hours without sleep. Beta-amyloid (a protein in the brain that has been associated with Alzheimer’s disease and impaired brain function) increased by five per cent in the participants deprived of sleep after one night. The changes occurred especially in the regions of the brain which are particularly vulnerable to damage such as the hippocampus and thalamus.

Another study shows that sleep deprivation causes tau levels (a protein that has also been associated with brain damage and Alzheimer’s disease) to rise and cause the spread of tau to accelerate through the brain. Researchers discovered that a sleepless night could cause tau levels to rise by up to 50 per cent.

What about chronic inflammation?

As many people suffering from diseases such as diabetes, pneumonia, urinary tract infection, cardiovascular disease and even Alzheimer’s disease also have chronic low-grade inflammation, studies now point to neuroinflammation playing an essential role in the progression of Alzheimer’s disease.

The Boston University School of Medicine has found that treating chronic inflammation could be effective for the prevention of Alzheimer’s disease. Risk factors that have been identified for developing Alzheimer’s disease include metabolic disorders such as diabetes, traumatic brain injury, age and cardiovascular changes. All of these risk factors can also be associated with immune responses in the body and the brain. This has led researchers to link inflammatory signalling and elevated inflammation to an increased risk of Alzheimer’s disease.

References:

Amos, A, 2018, Dietician Amylee Amos talks “Alzheimer’s Diet”, Apoe 4 & The Bredesen Protocol), https://www.whitneyerd.com/2018/03/alzheimers-diet-bredesen-protocol.html

Axe, J, 2018, Alzheimer’s Natural Treatment Options & 7 Notable Breakthroughs, https://draxe.com/health/alzheimers-natural-treatment/

Boston University School of Medicine, 2018, Link found between chronic inflammation and risk for Alzheimer’s disease, https://www.sciencedaily.com/releases/2018/10/181019120713.htm

Bredesen, DE, 2013. Next generation therapeutics for Alzheimer’s disease, EMBO Mol Med. 2013 Jun; 5(6):795-8.

Bredesen, DE, 2014. Reversal of cognitive decline: A novel therapeutic program, Dale E. Bredesen, Aging (Albany NY). 2014 Sep; 6(9): 707–717.

Camandola, S & M. P. Mattson, 2017. “Brain metabolism in health, aging and neurodegeneration,” The EMBO Journal, vol. 36, no. 11, pp. 1474–1492.

Cremonini, AL et al, 2019. Nutrients in the Prevention of Alzheimer’s Disease, Oxidative Stress in Age-Related Chronic Disease: From Bench to Bedside, Volume 2019, https://www.hindawi.com/journals/omcl/2019/9874159/

Dr Mercola, 2014, Alzheimer’s Disease—Yes, It’s Preventable!, https://articles.mercola.com/sites/articles/archive/2014/05/22/alzheimers-disease-prevention.aspx

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Holford, P. 2014. Good Medicine: Dementia and Alzheimer’s disease: pg. 129

Holtzman, D et al, 2019. Sleep deprivation accelerates Alzheimer’s brain damage, https://www.sciencedaily.com/releases/2019/01/190124141536.htm

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